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The management of travellers' diarrhoea

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Travellers' diarrhoea (TD) is the most common health problem encountered by travellers, effecting 60 to 80 per cent of those travelling to high risk destinations such as Africa, South and South East Asia, South and Central America, and the Middle East. 1,2 Individuals who remain close to locals, engage in low-budget travel, or backpack are at higher risk compared to older travellers on an organised tour or business trip. 1

Travellers' diarrhoea is contracted predominantly through the ingestion of contaminated food or beverages or from person-to-person due to poor hygiene. 1,2

Although a non-fatal illness it can cause serious morbidity. Symptoms usually resolve spontaneously within three to five days and are mostly considered an inconvenience, particularly for those on short trips with a busy schedule. The focus of education is therefore on principles of good hygiene and sanitation. 1-9

These are however limited, and in some higher risk cases prophylaxis or treatment with antibiotics may be indicated. 5,8,11

Self-treatment with anti-motility or anti-secretory agents for mild to moderate symptoms are recommended, however these are not curative and although complications are rare, persistent symptoms, severe dehydration or dysentery, defined as diarrhoea mixed with visible blood, necessitate further medical attention.

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