Travellers diarrhoea

Traveller's diarrhoea is a special problem in Mexico, Nepal, India, Pakistan, Latin America, the Middle East and central Africa and its many colourful labels include 'Bali Belly', 'Gippy Tummy', 'Rangoon Runs', 'Tokyo Trots' and 'Montezuma's Revenge'. It occurs about 6-12 hours after taking infected food or water.

The illness is usually mild and lasts only two or three days. It is unusual for it to last longer than five days. Symptoms include abdominal cramps, frequent diarrhoea with loose watery bowel motions and possible vomiting. Very severe diarrhoea, especially if associated with the passing of blood or mucus, may be a feature of a more serious bowel infection such as amoebiasis.

Most traveller's diarrhoea is caused by an enterotoxigenic E. coli. Travellers are infected because they are exposed to slightly different types or strains of E. coli from the ones they are used to at home. 3 The possible causes of diarrhoeal illness are listed in Table 12.1 .

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