ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Steffen R, Rickenbach M, Wilhelm U, Helminger A, Schär M, 1987. Health problems after travel to developing countries. J Infect Dis 156: 84–91.
-
2.
Leder K, Torresi J, Libman M, Cramer JP, Castelli F, Schlagenhauf P, Wilder-Smith A, Wilson ME, Keystone JS, Schwartz E, Barnett ED, von Sonnenburg F, Brownstein JS, Cheng AC, Sotir MJ, Esposito DH, Freedman DO; GeoSentinel Surveillance Network, 2013. GeoSentinel surveillance of illness in returned travelers, 2007–2011. Ann Intern Med 158: 456–468.
-
3.
Hagmann S, Han P, Stauffer W, Miller AO, Connor BA, Hale DC, Coyle CM, Cahill JD, Marano C, Esposito DH, Kozarsky PE; GeoSentinel Surveillance Network, 2014. Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel. Fam Pract 31: 678–687.
-
4.
Hill D, 2000. Health problems in a large cohort of Americans traveling to developing countries. J Travel Med 7: 259–266.
-
5.
Centers for Disease Control and Prevention, 2012. CDC Health Information for International Travel 2012. New York, NY: Oxford University Press.
-
6.
Ericsson CD, DuPont HL, Mathews JJ, West MS, Johnson PC, Bitsura JA, 1990. Treatment of travelers' diarrhea with sulfamethoxazole and trimethoprim and loperamide. JAMA 263: 257–261.
-
7.
Hill D, 2000. Occurrence and self-treatment of diarrhea in a large cohort of Americans traveling to developing countries. Am J Trop Med Hyg 62: 585–589.
-
8.
Steffen R, van der Linde F, Gyr K, Schär M, 1983. Epidemiology of diarrhea in travelers. JAMA 249: 1176–1180.
-
9.
von Sonnenburg F, Tornieporth N, Waiyaki P, Lowe B, Peruski LF Jr, DuPont HL, Mathewson JJ, Steffen R, 2000. Risk and aetiology of diarrhea at various tourist destinations. Lancet 356: 133–134.
-
10.
Ericcson CD, DuPont HL, Steffen R, 2003. Travelers' Diarrhea. London, United Kingdom: BC Decker Inc.
-
11.
Chen LH, Han PV, Wilson ME, Stoney RJ, Jentes EJ, Benoit C, Ooi WW, Barnett ED, Hamer DH, 2016. Self-reported illness among Boston-area International travelers: a prospective study. Travel Med Infect Dis 14: 604–613.
-
12.
United Nations Development Programme, Human Development Index (HDI) Value. Available at: https://data.undp.org/dataset/Human-Development-Index-HDI-value/8ruz-shxu. Accessed March 26, 2014.
-
13.
United Nations Statistics Division, Composition of Macro Geographical (Continental) Regions, Geographical Sub-Regions, and Selected Economic and Other Groupings. Available at: http://millenniumindicators.un.org/unsd/methods/m49/m49regin.htm. Accessed March 26, 2014.
-
14.
Soonawala D, Vlot J, Visser L, 2011. Inconvenience due to travelers' diarrhea: a prospective follow-up study. BMC Infect Dis 11: 322.
-
15.
Tuteja A, Talley N, Gelman S, Alder SC, Thompson C, Tolman K, Hale DC, 2008. Development of functional diarrhea, constipation, irritable bowel syndrome, and dyspepsia during and after traveling outside the USA. Dig Dis Sci 53: 271–276.
-
16.
Steffen R, Tornieporth N, Clemens SA, Cavalcanti AM, Collard F, De Clercq N, DuPont HL, von Sonnenburg F, 2004. Epidemiology of travelers' diarrhea: details of a global survey. J Travel Med 11: 231–238.
-
17.
Kendall ME, Crim S, Fullerton K, Han PV, Cronquist AB, Shiferaw B, Ingram LA, Rounds J, Mintz ED, Mahon BE, 2012. Travel-associated enteric infections diagnosed after return to the United States, Foodborne Diseases Active Surveillance Network (FoodNet) 2004–2009. Clin Infect Dis 54 (Suppl 5): S480–S487.
-
18.
Harvey K, Esposito DH, Han P, Cronquist AB, Shiferaw B, Ingram LA, Rounds J, Mintz ED, Mahon BE, 2013. Surveillance for travel-related disease: GeoSentinel Surveillance System, United States, 1997–2011. MMWR Surveill Summ 62: 1–23.
-
19.
Kollaritsch H, Paulke-Korinek M, Wiedermann U, 2012. Travelers' diarrhea. Infect Dis Clin North Am 26: 691–706.
-
20.
Lalani T, Maguire JD, Grant E, Fraser J, Ganesan A, Johnson MD, Deiss RG, Riddle MS, Burgess T, Tribble DR; IDCRP TravMil Study Group, 2014. Epidemiology and self-treatment of travelers' diarrhea in a large, prospective cohort of department of defense beneficiaries. J Travel Med 22: 184–189.
-
21.
Hill D, Ryan E, 2008. Management of travellers' diarrhea. BMJ 337: 863–867.
-
22.
Shlim D, 2005. Looking for evidence that personal hygiene precautions prevent traveler's diarrhea. Clin Infect Dis 41: S531–S535.
-
23.
DuPont H, Ericsson C, Reves R, Galindo E, 1986. Antimicrobial therapy for travelers' diarrhea. Rev Infect Dis 8 (Suppl 2): S217–S222.
-
24.
McNutt L, Wu C, Xue X, Hafner JP, 2003. Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol 157: 940–943.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 381 | 306 | 18 |
| Full Text Views | 820 | 14 | 0 |
| PDF Downloads | 203 | 8 | 0 |
Travelers' Diarrhea and Other Gastrointestinal Symptoms Among Boston-Area International Travelers
Rhett J. Stoney
Rhett J. Stoney
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia.
Search for other papers by Rhett J. Stoney in
Current site
Google Scholar
PubMed
Search for other papers by Rhett J. Stoney in
Current site
Google Scholar
PubMed
Pauline V. Han
Pauline V. Han
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia.
Search for other papers by Pauline V. Han in
Current site
Google Scholar
PubMed
Search for other papers by Pauline V. Han in
Current site
Google Scholar
PubMed
Elizabeth D. Barnett
Elizabeth D. Barnett
Maxwell Finland Laboratory for Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
Search for other papers by Elizabeth D. Barnett in
Current site
Google Scholar
PubMed
Search for other papers by Elizabeth D. Barnett in
Current site
Google Scholar
PubMed
Mary E. Wilson
Mary E. Wilson
Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
Search for other papers by Mary E. Wilson in
Current site
Google Scholar
PubMed
Search for other papers by Mary E. Wilson in
Current site
Google Scholar
PubMed
Emily S. Jentes
Emily S. Jentes
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia.
Search for other papers by Emily S. Jentes in
Current site
Google Scholar
PubMed
Search for other papers by Emily S. Jentes in
Current site
Google Scholar
PubMed
Christine M. Benoit
Christine M. Benoit
Maxwell Finland Laboratory for Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
Search for other papers by Christine M. Benoit in
Current site
Google Scholar
PubMed
Search for other papers by Christine M. Benoit in
Current site
Google Scholar
PubMed
William B. MacLeod
William B. MacLeod
Center for Global Health and Development, Boston University School of Public Health (BUSPH), Boston, Massachusetts.
Department of Global Health, BUSPH, Boston, Massachusetts.
Search for other papers by William B. MacLeod in
Current site
Google Scholar
PubMed
Department of Global Health, BUSPH, Boston, Massachusetts.
Search for other papers by William B. MacLeod in
Current site
Google Scholar
PubMed
Davidson H. Hamer
Davidson H. Hamer
Center for Global Health and Development, Boston University School of Public Health (BUSPH), Boston, Massachusetts.
Department of Global Health, BUSPH, Boston, Massachusetts.
Section of Infectious Diseases, Boston University School of Medicine, Boston, Massachusetts.
Search for other papers by Davidson H. Hamer in
Current site
Google Scholar
PubMed
Department of Global Health, BUSPH, Boston, Massachusetts.
Section of Infectious Diseases, Boston University School of Medicine, Boston, Massachusetts.
Search for other papers by Davidson H. Hamer in
Current site
Google Scholar
PubMed
Lin H. Chen
Lin H. Chen
Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital, Cambridge, Massachusetts.
Department of Medicine, Harvard Medical School, Boston, Massachusetts.
Search for other papers by Lin H. Chen in
Current site
Google Scholar
PubMed
Department of Medicine, Harvard Medical School, Boston, Massachusetts.
Search for other papers by Lin H. Chen in
Current site
Google Scholar
PubMed
This prospective cohort study describes travelers' diarrhea (TD) and non-TD gastrointestinal (GI) symptoms among international travelers from the Boston area, the association of TD with traveler characteristics and dietary practices, use of prescribed antidiarrheal medications, and the impact of TD and non-TD GI symptoms on planned activities during and after travel. We included adults who received a pre-travel consultation at three Boston-area travel clinics and who completed a three-part survey: pre-travel, during travel, and post-travel (2–4 weeks after return). TD was defined as self-reported diarrhea with or without nausea/vomiting, abdominal pain, or fever. Demographic and travel characteristics were evaluated by χ2 test for categorical and Wilcoxon rank-sum test for continuous variables. Analysis of dietary practices used logistic generalized estimating equation models or logistic regression models. Of 628 travelers, 208 (33%) experienced TD and 45 (7%) experienced non-TD GI symptoms. Of 208 with TD, 128 (64%), 71 (36%), and 123 (62%) were prescribed ciprofloxacin, azithromycin, and/or loperamide before travel, respectively. Thirty-nine (36%) of 108 took ciprofloxacin, 20 (38%) of 55 took azithromycin, and 28 (28%) of 99 took loperamide during travel. Of 172 with TD during travel, 24% stopped planned activities, and 2% were hospitalized. Of 31 with non-TD GI symptoms during travel, six (13%) stopped planned activities. International travelers continue to experience diarrhea and other GI symptoms, resulting in disruption of planned activities and healthcare visits for some. Although these illnesses resulted in interruption of travel plans, a relatively small proportion took prescribed antibiotics.
Author Notes
Financial support: This work was supported by a cooperative agreement (1 U19CI000508-01) between the Centers for Disease Control and Prevention and Boston Medical Center.
Authors' addresses: Rhett J. Stoney, Pauline V. Han, and Emily S. Jentes, Travelers' Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: uyn2@cdc.gov, pauline.han@gmail.com, and ejentes@cdc.gov. Elizabeth D. Barnett and Christine M. Benoit, Maxwell Finland Laboratory for Infectious Diseases, Boston Medical Center, Boston, MA, E-mails: elizabeth.barnett@bmc.org and christine.m.benoit@gmail.com. Mary E. Wilson, Harvard T. H. Chan School of Public Health, Global Health and Population, Boston, MA, E-mail: mary_wilson@harvard.edu. William B. MacLeod and Davidson H. Hamer, Center for Global Health and Development, Boston University School of Public Health, Crosstown Center, Boston, MA, E-mails: wmacleod@bu.edu and dhamer@bu.edu. Lin H. Chen, Travel Medicine Center, Mount Auburn Hospital, Cambridge, MA, E-mail: lchen@hms.harvard.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Steffen R, Rickenbach M, Wilhelm U, Helminger A, Schär M, 1987. Health problems after travel to developing countries. J Infect Dis 156: 84–91.
-
2.
Leder K, Torresi J, Libman M, Cramer JP, Castelli F, Schlagenhauf P, Wilder-Smith A, Wilson ME, Keystone JS, Schwartz E, Barnett ED, von Sonnenburg F, Brownstein JS, Cheng AC, Sotir MJ, Esposito DH, Freedman DO; GeoSentinel Surveillance Network, 2013. GeoSentinel surveillance of illness in returned travelers, 2007–2011. Ann Intern Med 158: 456–468.
-
3.
Hagmann S, Han P, Stauffer W, Miller AO, Connor BA, Hale DC, Coyle CM, Cahill JD, Marano C, Esposito DH, Kozarsky PE; GeoSentinel Surveillance Network, 2014. Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel. Fam Pract 31: 678–687.
-
4.
Hill D, 2000. Health problems in a large cohort of Americans traveling to developing countries. J Travel Med 7: 259–266.
-
5.
Centers for Disease Control and Prevention, 2012. CDC Health Information for International Travel 2012. New York, NY: Oxford University Press.
-
6.
Ericsson CD, DuPont HL, Mathews JJ, West MS, Johnson PC, Bitsura JA, 1990. Treatment of travelers' diarrhea with sulfamethoxazole and trimethoprim and loperamide. JAMA 263: 257–261.
-
7.
Hill D, 2000. Occurrence and self-treatment of diarrhea in a large cohort of Americans traveling to developing countries. Am J Trop Med Hyg 62: 585–589.
-
8.
Steffen R, van der Linde F, Gyr K, Schär M, 1983. Epidemiology of diarrhea in travelers. JAMA 249: 1176–1180.
-
9.
von Sonnenburg F, Tornieporth N, Waiyaki P, Lowe B, Peruski LF Jr, DuPont HL, Mathewson JJ, Steffen R, 2000. Risk and aetiology of diarrhea at various tourist destinations. Lancet 356: 133–134.
-
10.
Ericcson CD, DuPont HL, Steffen R, 2003. Travelers' Diarrhea. London, United Kingdom: BC Decker Inc.
-
11.
Chen LH, Han PV, Wilson ME, Stoney RJ, Jentes EJ, Benoit C, Ooi WW, Barnett ED, Hamer DH, 2016. Self-reported illness among Boston-area International travelers: a prospective study. Travel Med Infect Dis 14: 604–613.
-
12.
United Nations Development Programme, Human Development Index (HDI) Value. Available at: https://data.undp.org/dataset/Human-Development-Index-HDI-value/8ruz-shxu. Accessed March 26, 2014.
-
13.
United Nations Statistics Division, Composition of Macro Geographical (Continental) Regions, Geographical Sub-Regions, and Selected Economic and Other Groupings. Available at: http://millenniumindicators.un.org/unsd/methods/m49/m49regin.htm. Accessed March 26, 2014.
-
14.
Soonawala D, Vlot J, Visser L, 2011. Inconvenience due to travelers' diarrhea: a prospective follow-up study. BMC Infect Dis 11: 322.
-
15.
Tuteja A, Talley N, Gelman S, Alder SC, Thompson C, Tolman K, Hale DC, 2008. Development of functional diarrhea, constipation, irritable bowel syndrome, and dyspepsia during and after traveling outside the USA. Dig Dis Sci 53: 271–276.
-
16.
Steffen R, Tornieporth N, Clemens SA, Cavalcanti AM, Collard F, De Clercq N, DuPont HL, von Sonnenburg F, 2004. Epidemiology of travelers' diarrhea: details of a global survey. J Travel Med 11: 231–238.
-
17.
Kendall ME, Crim S, Fullerton K, Han PV, Cronquist AB, Shiferaw B, Ingram LA, Rounds J, Mintz ED, Mahon BE, 2012. Travel-associated enteric infections diagnosed after return to the United States, Foodborne Diseases Active Surveillance Network (FoodNet) 2004–2009. Clin Infect Dis 54 (Suppl 5): S480–S487.
-
18.
Harvey K, Esposito DH, Han P, Cronquist AB, Shiferaw B, Ingram LA, Rounds J, Mintz ED, Mahon BE, 2013. Surveillance for travel-related disease: GeoSentinel Surveillance System, United States, 1997–2011. MMWR Surveill Summ 62: 1–23.
-
19.
Kollaritsch H, Paulke-Korinek M, Wiedermann U, 2012. Travelers' diarrhea. Infect Dis Clin North Am 26: 691–706.
-
20.
Lalani T, Maguire JD, Grant E, Fraser J, Ganesan A, Johnson MD, Deiss RG, Riddle MS, Burgess T, Tribble DR; IDCRP TravMil Study Group, 2014. Epidemiology and self-treatment of travelers' diarrhea in a large, prospective cohort of department of defense beneficiaries. J Travel Med 22: 184–189.
-
21.
Hill D, Ryan E, 2008. Management of travellers' diarrhea. BMJ 337: 863–867.
-
22.
Shlim D, 2005. Looking for evidence that personal hygiene precautions prevent traveler's diarrhea. Clin Infect Dis 41: S531–S535.
-
23.
DuPont H, Ericsson C, Reves R, Galindo E, 1986. Antimicrobial therapy for travelers' diarrhea. Rev Infect Dis 8 (Suppl 2): S217–S222.
-
24.
McNutt L, Wu C, Xue X, Hafner JP, 2003. Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol 157: 940–943.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 381 | 306 | 18 |
| Full Text Views | 820 | 14 | 0 |
| PDF Downloads | 203 | 8 | 0 |