Chapter 122. Acute Infectious Diarrheal Diseases and Bacterial Food Poisoning (Part 6)

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Chapter 122. Acute Infectious Diarrheal Diseases and Bacterial Food Poisoning (Part 6) Chapter 122. Acute Infectious Diarrheal Diseases and Bacterial Food Poisoning (Part 6) Table 122-3 Epidemiology of Travelers Diarrhea Etiologic Agent Approximate Comments Percentage of Cases Enterotoxigenic 15–50 Single most importantEscherichia coli agent, particularly in summertime in semitropical areas; percentage of cases ranges from 15% in Asia to 50% in Latin America Enteroaggregative 20–35 Emerging entericE. coli pathogen of worldwide distribution Shigella and 10–25 Major causes of feverenteroinvasive E. coli and dysentery Salmonella 5–10 Causes fever and dysentery Campylobacter 3–15 More common in winterjejuni in semitropical areas; more common in Asia Aeromonas 5 Important in Thailand Plesiomonas 5 Related to tropical travel and seafood consumption Vibrio cholerae 0–10 Most common in India and Asia; also common in Central and South America Rotavirus and 10–40 Latin America, Asia, and Africa; norovirusnorovirus associated with seafood ingestion on cruise ships Entamoeba 5 Particularly important inhistolytica Mexico and Thailand Giardia lamblia Unknown 20 Illness improves with antibacterial therapy, implicating bacterial diarrhea Source: After Dupont. Location Day-care centers have particularly high attack rates of enteric infections.Rotavirus is most common among children One-third of elderly patients in chronic-care institutions develop a significantdiarrheal illness each year; more than half of these cases are caused by cytotoxin-producing C. difficile. Antimicrobial therapy can predispose topseudomembranous colitis by altering the normal colonic flora and allowing themultiplication of C. difficile (Chap. 123).