From time immemorial, human beings traveled long distances. was traveling by military campaigns, trade, the search for new territories to live in or, quite simply, the desire to discover new places. Today, the motivations are similar: business, tourism or, unfortunately, wars and migrations.
The fact is that sometimes these displacements have been accompanied by the appearance of Gastrointestinal problems. Without going any further, the effects of dysentery among crusaders go to the Holy Land and parasitic infections at the merchants of the silk road.
Currently, “traveller’s diarrhea” is more common when we travel from developed countries to others with a lower level of development. We must not lose sight of the fact that in many countries of Central and South America, Asia, Africa, Oceania and Eastern Europe, diarrheal diseases, caused by the presence of micro – pathogenic organisms of fecal origin in water and food, continue to be a major health problem.
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Is considered traveler’s diarrhea at the sudden onset of three or more saddles soft or liquid consistency in 24 hoursaccompanied by at least one of the following symptoms: nausea, vomiting, abdominal cramps, urgent need to defecate, fever or presence of blood/mucus in the stool.
typical of summer
may appear during the trip or on the way back of it, depending on various factors. For a given destination, infections are more frequent in summer than in winter.
Depending on the regions you are traveling to, the likelihood of contracting this infection varies. In general, its prevalence has decreased. This decrease appears to be due to an improvement in hygienic conditions in the countries of destination and not so much to changes in the behavior of travellers.
We don’t all have the same susceptibility to infection. People with gastric pathologies, inflammatory bowel diseases or who take antacids are generally more vulnerable.
There is also a higher incidence in young adultsprobably because travelers tend to take the least precautions.
Most common causes
Traveler’s diarrhea is usually caused by the ingestion of contaminated food or water. In the case of water, not only because of what we drink, but also ice cream that we add to drinks. Exceptionally, also for the one we use to brush our teeth or take a shower. If possible, it’s worth it use bottled water for oral hygiene.
In most cases, gastrointestinal problems are produced by bacteriayes, especially for Escherichia coli enterotoxigenicalthough also shigella, Campylobacter there SalmonellaIn order of importance.
There are cases due to parasites and, to a lesser extent, viruses. Among the parasites, Cyclospora cayetanensis there Giardia lamblia.
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Among viruses, Norovirusalso known as “ cruise ship virus‘. It is not uncommon for gastroenteritis outbreaks to occur with hundreds of people affected on this type of trip.
Traveler’s diarrhea usually produces a benign clinical picture (although very annoying) and self-limited. Normally, it is enough to control your hydration and to follow a soft and astringent diet.
Occasionally, a serious pathology may appear, depending on the microorganism and the person affected. It is important to control the course of the disease children, the elderly, pregnant women or people with previous pathologiesespecially the immunocompromised.
The use of drugs that reduce movement and intestinal secretions is not recommended in all cases.
Beware of antibiotics
It is not recommended to use antibioticsexcept for complications (and preferably under medical supervision). For example, if blood and mucus appear in the stool accompanied by a high fever. Until recently, quinolones were used, but resistance is increasing and they are not recommended for children and pregnant women. Currently, the the antibiotic of choice is azithromycin.
Antibiotic resistance is a serious health problem, so they should not be taken unless it is essential. In addition, antibiotics alter the gut microbiota. Researchers from the University of Alicante have designed a molecule that acts specifically against E.coli and has no effect against other bacteria.
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In case of traveler’s diarrhea, prevention is the best treatment. It is important for the person traveling to know how to avoid contracting the disease. You should also know how to self-diagnose and treat yourself, in case you travel to areas where medical assistance is not available.
Good hand hygiene, especially when preparing food, is one of the fundamental factors. How to avoid sideboards and raw foods (salads, for example). It is advisable to peel the fruit just before eating and drinking only bottled liquids and with the closure intact.
Doesn’t traveler’s diarrhea affect the inhabitants of the country of destination? The truth is that yes, but normally they suffer from these infections when they are still young.
According to the UN, about a thousand children die every day due to diarrheal diseases linked to poor hygiene. The number of patients is much higher. When they reach adulthood, their immune system has already adapted and protects them from subsequent infections by these microorganisms.
Between the Sustainable Development Goals it is guarantee the availability of water and its sustainable management and sanitation for all. the said WASH programs (Water, Sanitation and Hygiene) are essential to improve the situation. The access to drinking water and promoting hand washing would break the cycle of transmission.
Among other things, it is necessary to build latrines, sewage networks and avoid the irrigation of vegetables for raw consumption with untreated water. The Cooperation of state agencies there non-governmental organizations it is fundamental.
Health it’s a global problem. What we do to help improve health conditions in developing countries will benefit everyone.
*Professor of Microbiology at the University of Las Palmas de Gran Canaria.
*This article was originally published on The conversation.