Format

Send to

Choose Destination
Am J Trop Med Hyg. 2017 Jun;96(6):1388-1393. doi: 10.4269/ajtmh.16-0447.

Travelers' Diarrhea and Other Gastrointestinal Symptoms Among Boston-Area International Travelers.

Author information

1
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia.
2
Maxwell Finland Laboratory for Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
3
Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
4
Department of Global Health, BUSPH, Boston, Massachusetts.
5
Center for Global Health and Development, Boston University School of Public Health (BUSPH), Boston, Massachusetts.
6
Section of Infectious Diseases, Boston University School of Medicine, Boston, Massachusetts.
7
Department of Medicine, Harvard Medical School, Boston, Massachusetts.
8
Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital, Cambridge, Massachusetts.

Abstract

AbstractThis prospective cohort study describes travelers' diarrhea (TD) and non-TD gastrointestinal (GI) symptoms among international travelers from the Boston area, the association of TD with traveler characteristics and dietary practices, use of prescribed antidiarrheal medications, and the impact of TD and non-TD GI symptoms on planned activities during and after travel. We included adults who received a pre-travel consultation at three Boston-area travel clinics and who completed a three-part survey: pre-travel, during travel, and post-travel (2-4 weeks after return). TD was defined as self-reported diarrhea with or without nausea/vomiting, abdominal pain, or fever. Demographic and travel characteristics were evaluated by χ2 test for categorical and Wilcoxon rank-sum test for continuous variables. Analysis of dietary practices used logistic generalized estimating equation models or logistic regression models. Of 628 travelers, 208 (33%) experienced TD and 45 (7%) experienced non-TD GI symptoms. Of 208 with TD, 128 (64%), 71 (36%), and 123 (62%) were prescribed ciprofloxacin, azithromycin, and/or loperamide before travel, respectively. Thirty-nine (36%) of 108 took ciprofloxacin, 20 (38%) of 55 took azithromycin, and 28 (28%) of 99 took loperamide during travel. Of 172 with TD during travel, 24% stopped planned activities, and 2% were hospitalized. Of 31 with non-TD GI symptoms during travel, six (13%) stopped planned activities. International travelers continue to experience diarrhea and other GI symptoms, resulting in disruption of planned activities and healthcare visits for some. Although these illnesses resulted in interruption of travel plans, a relatively small proportion took prescribed antibiotics.

PMID:
28719282
PMCID:
PMC5462577
DOI:
10.4269/ajtmh.16-0447
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Ingenta plc Icon for PubMed Central
Loading ...
Support Center