Related Subjects:
|Fever in a traveller
|Malaria Falciparum
|Malaria Non-Falciparum
|Viral Haemorrhagic Fevers (VHF)
|Lassa fever
|Dengue
|Marburg virus disease
|AIDS HIV
|Yellow fever
|Ebola Virus
|Leptospirosis
| Crimean-Congo haemorrhagic fever
|African Trypanosomiasis (Sleeping sickness)
|American Trypanosomiasis (Chagas Disease)
|Incubation Periods
|Notifiable Diseases UK
💩 Traveller’s Diarrhoea:
⚠️ Avoid antibiotics in enterohaemorrhagic E. coli → ↑ risk of Haemolytic Uraemic Syndrome (HUS).
🌍 About
- Affects 20–30% of travellers, usually within the first week.
- Triggered by contaminated food or water.
🦠 Aetiology
- ETEC (E. coli) → most common (toxigenic strains).
- Campylobacter → bloody diarrhoea, mimic “acute abdomen.”
- Amoebic dysentery (Entamoeba histolytica) → chronic bloody diarrhoea, abdominal pain.
- C. difficile → post-antibiotics, severe colitis.
- Giardia → foul-smelling, greasy stools, >7 days.
- Cryptosporidium / Cyclospora → prolonged or relapsing symptoms, esp. immunocompromised.
🤒 Clinical
- Watery or bloody diarrhoea.
- Nausea, vomiting, cramps, fever, dehydration.
- ⚠️ Severe: electrolyte imbalance, HUS (EHEC).
🧪 Investigations
- FBC → infection, dehydration.
- U&E → electrolytes, renal impairment.
- LFTs, CRP → systemic involvement.
- 💩 Stool MCS / PCR → bacteria, ova, cysts, parasites.
- Colonoscopy if persistent → exclude IBD.
🔍 Differentials
- IBD (Crohn’s/UC) – chronic, non-travel related.
- Food poisoning – short, linked to a meal.
- Viral gastroenteritis – usually self-limiting (24–48h).
🛡️ Prevention
- 💧 Water safety → bottled/boiled; avoid ice, salads washed in unsafe water.
- 🍗 Food safety → avoid undercooked meat, raw veg/fruit without peel.
- 🧼 Hand hygiene → soap/alcohol gel before meals.
💊 Prophylaxis
- Rarely used; consider in high-risk groups:
- Patients with ileostomy/short bowel.
- Immunocompromised (HIV, transplant).
- CKD or significant comorbidity.
⚕️ Management
- 💧 Hydration → ORS preferred; IV fluids if severe.
- 💊 Antibiotics → Ciprofloxacin or Azithromycin (for severe/prolonged cases).
❌ Avoid in EHEC (↑ risk HUS).
- 🚫 Antimotility (e.g. Loperamide) → safe in mild watery diarrhoea;
Contraindicated in bloody diarrhoea or fever.
- 🔄 Post-infectious IBS can follow in some patients.
- 🏥 Seek medical attention if severe dehydration, high fever, or persistent symptoms.
📚 References
