title: An update on travelers' diarrhea.
abstract: OBJECTIVE
  Travelers' diarrhea, affecting millions of travelers every year globally, continues to be a leading cause of morbidity despite advances in vaccination, prevention, and treatment. Complications of travelers' diarrhea often present to gastroenterologists and some patients followed by gastroenterologists are at higher risk of developing travelers' diarrhea. This review will provide an update on recent progress made in the epidemiology, pathogenesis, diagnosis, prevention, and treatment of travelers' diarrhea.
  
  
  RESULTS
  Most causes of travelers' diarrhea remain bacterial, but newly recognized pathogens are emerging. Patient-related and travel-related factors affect disease development risk and should guide prophylaxis and treatment. Although specific vaccines are being developed, they have not yet had a major impact on travelers' diarrhea, and understanding their roles and limitations is especially important. Prophylaxis and treatment of populations at risk (children, chronically ill patients, and those on immunosuppressive medications) remain challenging and require a tailored approach.
  
  
  CONCLUSIONS
  Travelers' diarrhea will continue to challenge patients and physicians despite the use of sanitation advice, prophylactic vaccines, and treatment with antibiotics. Effects may extend beyond the time of travel, such as postinfectious complications and exacerbation of preexisting disease. Future research should focus on novel strategies for reducing exposure to pathogens, vaccine development, early detection, and targeted treatments.
authors.affiliation: Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Deenaz
authors.initials: D
authors.lastname: Zaidi
authors.forename: Eytan
authors.initials: E
authors.lastname: Wine
mesh_terms: D003967:Diarrhea / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology / Q000628:therapy*; D006293:Health Promotion / Q000379:methods; D006801:Humans; D016867:Immunocompromised Host; D017410:Practice Guidelines as Topic; D019936:Probiotics / Q000627:therapeutic use; D014195:Travel; D014611:Vaccination