Current concepts in travelers' diarrhea: epidemiology, antimicrobial resistance and treatment.
OBJECTIVE
The aim of this article is to review recent advances in travelers' diarrhea, which remains one of the most common health problems afflicting individuals from developed countries visiting less affluent regions of the world.


RESULTS
A large epidemiologic study done at the point of departure provided insights into regional risk factors for travelers' diarrhea and demonstrated that visitors rarely exercised dietary precautions aimed at disease prevention. A preventive program implemented with the close interaction between public health agencies, hotel industry and academia can result in effective reduction of cases. A polymorphism in the IL-8 gene promoter is associated with susceptibility to diarrhea due to enteroaggregative Escherichia coli. New diagnostic tools assist in better understanding the role of norovirus and emerging bacterial enteric pathogens such as enteroaggregative E. coli. Rifaximin, a non-absorbable antibiotic, is a safe and effective alternative for the prevention and treatment of travelers' diarrhea due to non-invasive organisms.


CONCLUSIONS
Traditional public health and new antimicrobial agents can decrease the risk of travel related diarrhea.
Okhuysen
Pablo C
PC
Division of Infectious Diseases, The University of Texas Health Science Center, Houston Medical School, 6431 Fannin, Houston, TX 77030, USA. Pablo.c.okhuysen@uth.tmc.edu
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003967:Diarrhea / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D004926:Escherichia coli / Q000187:drug effects; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D016209:Interleukin-8 / Q000235:genetics; D011110:Polymorphism, Genetic; D011401:Promoter Regions, Genetic; D012294:Rifamycins / Q000627:therapeutic use*; D000078262:Rifaximin; D014195:Travel
D000900:Anti-Bacterial Agents; D016209:Interleukin-8; D012294:Rifamycins; D000078262:Rifaximin