J Korean Med Sci.  2011 Feb;26(2):196-200. 10.3346/jkms.2011.26.2.196.

Clinical Characteristics and Etiology of Travelers' Diarrhea among Korean Travelers Visiting South-East Asia

• Ahn JY
• Chung JW
• Chang KJ
• You MH
• Chai JS
• Kang YA
• Kim SH
• Jeoung H
• Cheon D
• Jeoung A
• Choi ES

• KMID: 1782106
• DOI: http://doi.org/10.3346/jkms.2011.26.2.196

Abstract

The morbidity of travelers' diarrhea (TD) is still high. This study examined the incidence of common pathogens and characteristics of TD among Korean travelers who visited South-East Asian countries. We performed a prospective study involving 479 Korean travelers with diarrheal disease from February 2009 to April 2009 and stool samples were examined and questionnaire surveys were done after arrival. Enterotoxigenic Escherichia coli (ETEC) was found in 36.0% of TD cases, as were the following: Enteroaggregative Escherichia coli (EAEC) in 27.0%, Vibrio parahaemolyticus in 13.1%, and Norovirus in 11.5%. The detected rate of classic TD was higher in men (P = 0.007), in patients who had a shorter duration trip (P = 0.023) and in patients who drank more than 1 liter of water per day (P = 0.037). Positive stool culture rates were higher in men (P = 0.005), in hospitalized patients (P = 0.013). and in those who consumed impure water or raw foods (P = 0.033). A higher severity of disease corresponded to a significantly higher culture positivity rate (P = 0.029). We should consider the possibility of other pathogens in addition to ETEC in patients with TD who visit South-East Asia. Travelers need to educate about risk factors associated with TD.

Keyword

Travelers' Diarrhea; Enterotoxigenic Escherichia coli; Enteroaggregative Escherichia coli; Vibrio parahaemolyticus; Norovirus

MeSH Terms

Adolescent
Adult
Aged
Asia, Southeastern/epidemiology
*Asian Continental Ancestry Group
Caliciviridae Infections/epidemiology/virology
Child
Diarrhea/epidemiology/*etiology/microbiology/virology
Escherichia coli/isolation & purification/pathogenicity
Escherichia coli Infections/epidemiology/microbiology
Feces/microbiology/virology
Female
Humans
Male
Middle Aged
Norovirus/isolation & purification/pathogenicity
Prospective Studies
Questionnaires
Republic of Korea
Risk Factors
*Travel
Travel Medicine
Vibrio parahaemolyticus/isolation & purification/pathogenicity
Young Adult

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