title: Clinical characteristics and etiology of travelers' diarrhea among Korean travelers visiting South-East Asia.
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.
authors.affiliation: Division of Epidemic Intelligence Service, Center for Infectious Disease, National Institute of Health, Korea Centers for Disease Control and Prevention, Seoul, Korea.
authors.forename: Ji Yong
authors.initials: JY
authors.lastname: Ahn
authors.forename: Jin-Won
authors.initials: JW
authors.lastname: Chung
authors.forename: Kyu-Jin
authors.initials: KJ
authors.lastname: Chang
authors.forename: Myung Hwan
authors.initials: MH
authors.lastname: You
authors.forename: Jin Sung
authors.initials: JS
authors.lastname: Chai
authors.forename: Young A
authors.initials: YA
authors.lastname: Kang
authors.forename: Seong-Han
authors.initials: SH
authors.lastname: Kim
authors.forename: Hyesook
authors.initials: H
authors.lastname: Jeoung
authors.forename: Doosung
authors.initials: D
authors.lastname: Cheon
authors.forename: Ahyong
authors.initials: A
authors.lastname: Jeoung
authors.forename: Eun Suk
authors.initials: ES
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001210:Asia, Southeastern / Q000453:epidemiology; D044466:Asian People; D017250:Caliciviridae Infections / Q000453:epidemiology / Q000821:virology; D002648:Child; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology / Q000821:virology; D004926:Escherichia coli / Q000302:isolation & purification / Q000472:pathogenicity; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology; D005243:Feces / Q000382:microbiology / Q000821:virology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029322:Norovirus / Q000302:isolation & purification / Q000472:pathogenicity; D011446:Prospective Studies; D056910:Republic of Korea; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014195:Travel; D057236:Travel Medicine; D014736:Vibrio parahaemolyticus / Q000302:isolation & purification / Q000472:pathogenicity; D055815:Young Adult