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Travelers Diarrhea

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41. CRACKCast E031 – Diarrhea

-flags’ of diarrhea? Lets break it down a little bit so the knowledge ‘flows’ a little better… Location: Encounters with hospital system, travel, day care and wilderness Exposure : Antibiotic exposure, strange animals (shellfish, farm animals, amphibians), sick amigos, known contaminated meats or dairy Symptoms: Vomiting immediately after suspicious food, pain/n/v/blood/fever/tenesmus (my favorite work), more than a week of poops Signs and labs : HUS (HGB < 80 with peripermal smear schistos (...) CRACKCast E031 – Diarrhea CRACKCast E031 - Diarrhea - CanadiEM CRACKCast E031 – Diarrhea In , by Justin Roos March 16, 2017 This episode of CRACKCast covers Rosen’s Chapter 31, Diarrhea. This chapter covers a common ED complaint including the pathophysiology, risk factors for non-benign diarrhea, and the approach to treatment. Shownotes – Rosen’s in Perspective Runny poo accounts for 5% of all ED visits… or about 6 patients a week for the average provider. While in the developed world we

2017 CandiEM

42. Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea

. , , , , EXECUTIVE SUMMARY The following evidence-based guidelines for management of infants, children, adolescents, and adults in the United States with acute or persistent infectious diarrhea were prepared by an expert panel assembled by the Infectious Diseases Society of America (IDSA) and replace guidelines published in 2001 [ ]. Public health aspects of diarrhea associated with foodborne and waterborne diarrhea, international travel, antimicrobial agents, immunocompromised hosts, animal exposure, certain (...) can be found online in the full text of the guidelines. RECOMMENDATIONS FOR THE DIAGNOSIS AND MANAGEMENT OF INFECTIOUS DIARRHEA Clinical, Demographic, and Epidemiologic Features I. In people with diarrhea, which clinical, demographic, or epidemiologic features have diagnostic or management implications? (Tables 1–3) Table 1. Modes of Acquisition of Enteric Organisms and Sources of Guidelines Mode Title URL Author/Issuing Agency International travel Expert Review of the Evidence Base for Prevention

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2017 Infectious Diseases Society of America

43. Pharmacy travel health services: current perspectives and future prospects (PubMed)

therapy, and given the largely preventive nature of most travel health recommendations, pharmacists are well suited to help address this need. Pharmacists generally possess a high degree of knowledge and confidence with more commonly observed travel health topics in community practice such as travelers' diarrhea; however, training in more specialized travel health topics such as travel vaccinations and traveling at altitude has generally been lacking from pharmacy curricula. Pharmacists (...) Pharmacy travel health services: current perspectives and future prospects Rates of international travel are increasing annually, with particular growth observed in travel to Southeast Asia and to emerging economies. While all patients traveling across geographic regions are recommended to receive a pre-travel consultation to consider their individual risks, many do not, or receive care and recommendations that are not consistent with current evidence-based guidelines. As experts in drug

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2018 Integrated pharmacy research & practice

44. A review of antibiotic prophylaxis for traveler’s diarrhea: past to present (PubMed)

A review of antibiotic prophylaxis for traveler’s diarrhea: past to present As there is rapid increase in international travel to tropical and subtropical countries, there will likely be more people exposed to diarrheal pathogens in these moderate to high risk areas and subsequent increased concern for traveler's diarrhea. The disease may appear as a mild clinical syndrome, yet a more debilitating presentation can lead to itinerary changes and hospitalization. As bacterial etiologies (...) are the most common causative agents of TD, the use of antibiotic prophylaxis to prevent TD has been reported among travelers for several years. The most common type of antibiotic used for TD has changed over 50 years, depending on many influencing factors. The use of antibiotic prophylaxis for TD prevention in travelers is still controversial, mainly because of difficulties balancing the risks and benefits. Many factors, such as emerging drug resistance, side effects, cost and risk behavior need

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2018 Tropical diseases, travel medicine and vaccines

45. Plasmid-mediated quinolone resistance in different diarrheagenic Escherichia coli pathotypes responsible for complicated, non-complicated, and travelers' diarrhea cases. (PubMed)

Plasmid-mediated quinolone resistance in different diarrheagenic Escherichia coli pathotypes responsible for complicated, non-complicated, and travelers' diarrhea cases. 26711743 2016 12 13 2018 11 13 1098-6596 60 3 2015 Dec 28 Antimicrobial agents and chemotherapy Antimicrob. Agents Chemother. Plasmid-Mediated Quinolone Resistance in Different Diarrheagenic Escherichia coli Pathotypes Responsible for Complicated, Noncomplicated, and Traveler's Diarrhea Cases. 1950-1 10.1128/AAC.02909-15 (...) United States Antimicrob Agents Chemother 0315061 0066-4804 0 Escherichia coli Proteins 0 Qnr protein, E coli 0 Quinolones EC 3.5.2.- beta-lactamase CTX-M-15 EC 3.5.2.6 beta-Lactamases EC 3.5.2.6 beta-lactamase TEM-1 IM Diarrhea drug therapy microbiology Escherichia coli Proteins genetics metabolism Humans Plasmids genetics Quinolones therapeutic use Shiga-Toxigenic Escherichia coli drug effects genetics beta-Lactamases genetics metabolism 2015 12 30 6 0 2015 12 30 6 0 2016 12 15 6 0 epublish

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2015 Antimicrobial Agents and Chemotherapy

46. Study Comparing Rifaximin With Xifaxan 200mg in Traveler's Diarrhea

Study Comparing Rifaximin With Xifaxan 200mg in Traveler's Diarrhea Study Comparing Rifaximin With Xifaxan 200mg in Traveler's Diarrhea - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Study Comparing (...) Rifaximin With Xifaxan 200mg in Traveler's Diarrhea The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02498418 Recruitment Status : Completed First Posted : July 15, 2015 Last Update Posted : June 27, 2017 Sponsor: Actavis Inc. Information provided by (Responsible Party): Actavis Inc. Study Details Study

2015 Clinical Trials

47. Trial Evaluating Chemoprophylaxis Against Travelers' Diarrhea

Trial Evaluating Chemoprophylaxis Against Travelers' Diarrhea Trial Evaluating Chemoprophylaxis Against Travelers' Diarrhea - Prevent TD - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Trial Evaluating (...) Chemoprophylaxis Against Travelers' Diarrhea - Prevent TD The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT02498301 Recruitment Status : Recruiting First Posted : July 15, 2015 Last Update Posted : January 21, 2019 See Sponsor

2015 Clinical Trials

48. An update on travelers' diarrhea. (PubMed)

An update on travelers' diarrhea. 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.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

2015 Current opinion in gastroenterology

49. Seroepidemiology of norovirus-associated travelers' diarrhea. (PubMed)

Seroepidemiology of norovirus-associated travelers' diarrhea. Noroviruses (NoVs) are the most common cause of epidemic gastroenteritis, responsible for at least 50% of all gastroenteritis outbreaks worldwide and were recently identified as a leading cause of travelers' diarrhea (TD) in US and European travelers to Mexico, Guatemala, and India.Serum and diarrheic stool samples were collected from 75 US student travelers to Cuernavaca, Mexico, who developed TD. NoV RNA was detected in acute (...) infection was identified in 12 (16%; 9 GI-NoV and 3 GII-NoV) of 75 travelers by either RT-PCR or fourfold or more rise in antibody titer. Significantly more individuals had detectable preexisting IgA antibodies against HOV (62/75, 83%) than against NV (49/75, 65%) (p = 0.025) VLPs. A significant difference was observed between NV- and HOV-specific preexisting IgA antibody levels (p = 0.0037), IgG (p = 0.003), and BT50 (p = <0.0001). None of the NoV-infected TD travelers had BT50  > 200, a level that has

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2014 Journal of Travel Medicine

50. Targeting of Rifamycin SV to the Colon for Treatment of Travelers' Diarrhea: A Randomized, Double-Blind, Placebo-Controlled Phase 3 Study. (PubMed)

Targeting of Rifamycin SV to the Colon for Treatment of Travelers' Diarrhea: A Randomized, Double-Blind, Placebo-Controlled Phase 3 Study. Rifamycin SV is under development for treatment of travelers' diarrhea (TD) in a new oral formulation, Rifamycin SV MMX (RIF-MMX; Santarus Inc., San Diego, CA, USA), which targets its delivery to the colon, making it a unique rifamycin drug.This was a randomized, double-blind, phase 3 study of adult travelers to Mexico or Guatemala experiencing acute (...) diarrhea. A total of 264 patients received RIF-MMX (2 × 200 mg twice daily for 3 days, n = 199) or placebo (n = 65) in a 3 : 1 ratio. The primary endpoint was the length of time between the administration of first dose of study drug and passage of the last unformed stool (TLUS; after which clinical cure was declared). Other endpoints included eradication of pathogens from the stools, pathogen minimum inhibitory concentration (MIC), and adverse events (AEs).TLUS was significantly shorter in the RIF-MMX

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2014 Journal of Travel Medicine

51. Ordering Stool Test for Investigation of Suspected Infectious Diarrhea

and parasite (O & P) tests and C. difficile toxin tests. ? A CLINICAL HISTORY should be provided to the laboratory, including the type and duration of symptoms, underlying medical conditions, recent travel and recent or current antibiotic therapy. ? A SINGLE stool test should be ordered initially and as indicated (see appendix A algorithm). X Stool C & S and/or stool O & P tests are generally NOT clinically indicated for patients with an onset of diarrhea four days after discharge from hospitalization (see (...) period in the summer months. This is likely due to improper food handling practices and is associated with outdoor activities. Infections occurring at other times of the year are more likely acquired while travelling in underdeveloped countries. C. difficile is the primarily due to antibiotic associated diarrhea and pseudomembranous colitis. C. difficile has become one of the most commonly detected enteric pathogens, particularly in hospitalized patients and nursing home residents where infection may

2014 Toward Optimized Practice

52. Travelers' health problems and behavior: prospective study with post-travel follow-up. (PubMed)

population consisted of 460 subjects, 79 % of whom reported illness during travel or on arrival: 69 % had travelers' diarrhea (TD), 17 % skin problems, 17 % fever, 12 % vomiting, 8 % respiratory tract infection, 4 % urinary tract infection, 2 % ear infection, 4 % gastrointestinal complaints other than TD or vomiting, and 4 % other symptoms. Of all subjects, 10 % consulted a doctor and 0.7 % were hospitalized; 18 % took antimicrobials, with TD as the most common indication (64 %). Ongoing symptoms were (...) Travelers' health problems and behavior: prospective study with post-travel follow-up. The annual number of international tourist arrivals has recently exceeded one billion, yet surprisingly few studies have characterized travelers' behavior, illness, and risk factors in a prospective setting. Particularly scarce are surveys of data spanning travel, return, and follow-up of the same cohort. This study examines behavior and illness among travelers while abroad, after return home, and at follow

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2016 BMC Infectious Diseases

53. Travel Medicine and Vaccines for HIV-Infected Travelers (PubMed)

to vaccination. Available data indicate that immunization during antiretroviral therapy restores vaccine immunogenicity, improves the rate and persistence of immune responses, and reduces risk of vaccine-related adverse events, although vaccine responses often are suboptimal. Major issues for travelers to the developing world are vaccine-preventable illnesses (hepatitis A virus, yellow fever, and typhoid fever), traveler's diarrhea, and malaria. This article summarizes a presentation by D. Scott Smith, MD (...) Travel Medicine and Vaccines for HIV-Infected Travelers For the purposes of vaccination, persons with asymptomatic HIV infection and CD4+ cell counts of 200/μL to 500/μL are considered to have limited immune deficits and are generally candidates for immunization. HIVinfected persons with CD4+ cell counts less than 200/μL or history of an AIDS-defining illness should not receive live-attenuated viral or bacterial vaccines because of the risk of serious systemic disease and suboptimal response

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2016 Topics in antiviral medicine

54. Standard pre-travel consultation versus shorter consultation combined with smartphone support: a randomized controlled trial. (PubMed)

of diarrhea (4), malaria prophylaxis (2), and altitude sickness prophylaxis (5). Other consultations consisted mainly of reassurances of worried travelers and provision of data. Knowledge about travel-related risks was higher in the control group before travelling (8.86 ± 1.12 versus 8.34 ± 1.32, p = 0.014), and there was a trend towards higher levels of knowledge also during the trip (8.29 ± 1.35 versus 7.89 ± 1.39 , p = 0.06). Travelers' satisfaction before and during the trip was similar in both groups (...) Standard pre-travel consultation versus shorter consultation combined with smartphone support: a randomized controlled trial. Immediate and long-term recall of a pretravel consultation are suboptimal. We aimed to assess the role of online consultation for travelers.We randomized travelers into two study groups. In the intervention arm, each traveler was given a short pre-travel consultation of 8-12 minutes, combined with the option of smartphone support before and during the trip

2019 Journal of Travel Medicine

55. A Comparison of Pretravel Health Care, Travel-Related Exposures, and Illnesses among Pediatric and Adult U.S. Military Beneficiaries. (PubMed)

A and B (90% versus 67% of adults; 85% versus 44%), visit friends and relatives (36% versus 16%), report mosquito bites (69% versus 44%), and have close contact with wild or domesticated animals (40% versus 20%) than adults (P < 0.05). Subjects < 10 years of age were less likely to be prescribed antibiotics (28% versus 95%; RR = 0.63; 95% CI: 0.46-0.85) and antidiarrheals (9% versus 100%; RR = 0.10; 95% CI: 0.03-0.29) for travelers' diarrhea (TD) self-treatment than adults. Travel medicine providers (...) A Comparison of Pretravel Health Care, Travel-Related Exposures, and Illnesses among Pediatric and Adult U.S. Military Beneficiaries. We evaluated differences in pretravel care, exposures, and illnesses among pediatric and adult travelers, using a prospective, observational cohort. Eighty-one pediatric travelers were matched 1:1 with adult military dependents by travel region, destination's malaria risk, and travel duration. Pediatric travelers were more likely to have coverage for hepatitis

2019 American Journal of Tropical Medicine & Hygiene

56. Global Geographic Trends in Antimicrobial Resistance: The Role of International Travel. (PubMed)

travelers' diarrhea (other than antibiotic use) and be informed on safe sexual practices. The healthcare systems of low- and middle-income countries require investment to reduce the transmission of resistant strains by improving access to clean water, sanitation facilities and vaccines. Efforts are needed to curb inappropriate antibiotic use worldwide. In addition, more surveillance is needed to understand the role of the movement of humans, livestock and food products in resistance transmission (...) of preventing and treating travelers' diarrhea, other than use of antibiotics, and on safe sexual practices, such as condom use. Healthcare facilities need to be aware of the travel history of patients to provide appropriate treatment to those who are at high risk of exposure and to prevent further spread. Internationally, in countries without reliable and universal access to clean water, sanitation and hygiene, investment is needed to reduce the emergence and spread of resistance and ensure

2019 Journal of Travel Medicine

57. Incidence of health problems in travelers to Southeast Asia: A prospective cohort study. (PubMed)

included in the final analysis. The incidence of acute diarrhea per month per 1,000 travelers was 217 (95% confidence interval (95%CI 189-248) episodes; skin problems 197 (95%CI 170-227); respiratory symptoms 133 (95%CI 111-158); fever 49 (95%CI 36-65); and potential rabies exposure 34 (95%CI 24-48). The incidence of acute diarrhea episodes per month per 1,000 travelers was significantly higher during the first two weeks of travel compared with subsequent weeks of travel: 325 (95%CI 291-362) versus 132 (...) (95%CI 110-1157), (p<0.05). The incidence of outpatient visits and hospitalizations per month per 1,000 travelers was 49 (95%CI 36-65) and 5 (95%CI 2-10) respectively.In this prospective cohort study we observed substantial burden of acute diarrhea, skin and respiratory symptoms among travelers to Southeast Asia. The higher incidence of diarrhea in the first 2 weeks of travel should be further investigated.© International Society of Travel Medicine 2019. Published by Oxford University Press. All

2019 Journal of Travel Medicine

58. Efficacy of a travelers' diarrhea vaccine system in travelers to India. (PubMed)

Efficacy of a travelers' diarrhea vaccine system in travelers to India. A patch vaccine containing heat-labile toxin (LT) from enterotoxigenic Escherichia coli (ETEC) has demonstrated to be beneficial in reducing the rate and severity of travelers' diarrhea in Latin America. To evaluate the efficacy of this transdermal vaccine system in an area with a different diarrheal pathogen profile, an additional phase 2 study was conducted in European travelers to India.For this multicenter, randomized (...) diarrheas were observed in India. The vaccine delivery system frequently produced rash and pruritus at the site of application, long term hyperpigmentation persisted in a minority of LT recipients, and also few site reactions were noted in the placebo group.The evaluated patch vaccine failed to satisfy mainly with respect to protective efficacy. Noninvasive prophylactic agents against travelers' diarrhea, particularly vaccines against the most frequent pathogens, thus continue to be badly needed.© 2013

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2013 Journal of Travel Medicine

59. Got diarrhea? The latest trend in fashionable nonsense is “raw water”

Got diarrhea? The latest trend in fashionable nonsense is “raw water” Got diarrhea? The latest trend in fashionable nonsense is "raw water" - RESPECTFUL INSOLENCE March 27, 2019 March 25, 2019 March 22, 2019 March 20, 2019 March 19, 2019 March 18, 2019 Denice Walter on squirrelelite on Derek Freyberg on RJ on RJ on RJ on RJ on rs on Christine Rose on Nancie on on Search and explore Browse "A statement of fact cannot be insolent." The miscellaneous ramblings of a surgeon/scientist on medicine (...) , quackery, science, and pseudoscience (and anything else that interests him). Got diarrhea? The latest trend in fashionable nonsense is “raw water” As an old year fades into its final days and a new year approaches, I always wonder what new quackery will make an appearance in the new year. I know, of course, that all the old quackeries, cancer quackery, antivaccine pseudoscience, homeopathy, naturopathy, reflexology, and the huge number of other variations on self-deception will still be there. I also

2018 Respectful Insolence

60. Prophylactic doxycycline for travelers' diarrhea. Results of a prospective double-blind study of Peace Corps volunteers in Kenya. (PubMed)

Prophylactic doxycycline for travelers' diarrhea. Results of a prospective double-blind study of Peace Corps volunteers in Kenya. We performed a randomized double-blind study to determine the efficacy of doxycycline (100 mg daily) in preventing travelers' diarrhea among 39 Peace Corps volunteers during their first five weeks in Kenya. The volunteers took either doxycycline or placebo for three weeks and were observed for an additional two weeks. Nine of 21 taking placebo and one of 18 taking (...) doxycycline had travelers' diarrhea during the treatment period (P = 0.012). The protection seemed to persist for at least one week after the drug was stopped. Enterotoxigenic Escherichia coli was the only pathogen isolated from the placebo group, but was not detected in persons taking doxycycline. None of these organisms were resistant to doxycycline or tetracycline, whereas resistance to tetracyclines and other antibiotics was common among the nonenterotoxigenic Esch. coli. We conclude that doxycycline

1978 NEJM

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