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A quantitative polymerase chain reaction assay for rapid detection of 9 pathogens directly from stools of travelers with diarrhea. Every year, 80 million tourists traveling to tropical and subtropical areas contract traveler'sdiarrhea (TD). Forty percent to 80% of cases are caused by bacteria, yet clinical diagnostic tests are available to identify only a few of the strains that cause TD. We aimed to develop a quantitative polymerase chain reaction (qPCR) assay to identify all major pathogens (...) positive and negative stool samples. In addition, stool samples were collected from 96 returning travelers with TD. The findings were compared with those from routine diagnostic tests.The assay detected the bacterial strains with 100% sensitivity and specificity, compared with results from the reference tests. Of all stool samples collected from travelers with TD, EPEC was found in 47%, EAEC in 46%, ETEC in 22%, enterohemorrhagic E coli in 7%, Campylobacter in 6%, Shigella or enteroinvasive E coli in 2
Strategies to Improve Management of Acute Watery Diarrhea during a Military Deployment: A Cost Effectiveness Analysis. To inform policy and decision makers, a cost-effectiveness model was developed to predict the cost-effectiveness of implementing two hypothetical management strategies separately and concurrently on the mitigation of deployment-associated travelers' diarrhea (TD) burden. The first management strategy aimed to increase the likelihood that a deployed service member with TD
MKSAP: 30-year-old woman with diarrhea Giardiasis should be considered in patients with chronic diarrhea MKSAP: 30-year-old woman with diarrhea | | March 4, 2017 4 Shares Test your medicine knowledge with the , in partnership with the . A 30-year-old woman is evaluated for a 2-month history of diarrhea with three to five loose stools per day. She has mild abdominal cramps, bloating, intermittent nausea, and mild anorexia that has resulted in the loss of 2.3 kg (5.0 lb). She has had no fever (...) or blood in the stool. She works in a day care center and has not traveled recently or had exposure to antibiotics. She is otherwise healthy and takes no medications. On physical examination, temperature is 37.0 °C (98.6 °F), blood pressure is 112/74 mm Hg, and pulse rate is 70/min. The abdomen is soft with normal bowel sounds and mild distention but no tenderness. Which of the following is the most appropriate management? A. Colonoscopy B. Stool cultures C. Stool testing for ova and parasites D
examination for common enteric pathogens to include C. jejuni and C. coli by culture from two case-control traveler'sdiarrhea (TD) studies conducted in Thailand (cases = 26; controls = 30) and Nepal (cases = 83; controls = 75) respectively were assayed by PCR for the detection of Campylobacter 16S rRNA and two specific heat shock protein genes specific for C. concisus (cpn60) and C. ureolyticus (Hsp60) respectively.Campylobacter 16S rRNA was detected in 28.5% (61/214) of the pathogen-negative TD stool (...) . concisus and C. ureolyticus detected from traveler'sdiarrhea cases from travelers to Nepal and Thailand.
Commentary: Implementation and Evaluation of Deployment Health Guidelines on Acute Diarrhea Management â€“ a medical call to arms 28885923 2019 01 07 2019 01 07 1930-613X 182 S2 2017 09 Military medicine Mil Med Implementation and Evaluation of Deployment Health Guidelines on Acute Diarrhea Management: A Medical Call to Arms. 53-56 10.7205/MILMED-D-17-00076 Riddle Mark S MS Enteric Disease Department, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910. Tribble David (...) D Infectious Disease Clinical Research Program, Preventive Medicine and Biostatistics Department, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814. eng Y01 AI005072 AI NIAID NIH HHS United States Y01 AI005072-05 AI NIAID NIH HHS United States Journal Article Research Support, N.I.H., Extramural Research Support, U.S. Gov't, Non-P.H.S. England Mil Med 2984771R 0026-4075 IM Diarrhea therapy Disease Management Guidelines as Topic standards Humans
Preface: Guidelines for the Treatment of Travelersâ€™ Diarrhea in Deployed Military Personnel Diarrheal disease frequently affects military personnel deployed to developing countries, resulting in decreased job performance and potential negative impacts on military operational readiness. Travelers' diarrhea is a self-limiting illness; however, antibiotic treatment (with and without use of adjunct loperamide therapy) has been shown to significantly reduce clinical presentation of symptoms (...) and duration of illness. Nonetheless, the choice of first-line antibiotics must be carefully considered as increasing resistance of enteric pathogens in endemic regions has rendered many first-line antibiotics ineffective (e.g., Campylobacter spp. are resistant to fluoroquinolones in Southeast Asia). Presently, there are no standardized recommendations for the treatment of travelers' diarrhea among deployed military personnel. Therefore, an expert panel was convened to develop evidence-based, consensus
) causes traveler’sdiarrhea. • Enteropathogenic E. coli (EPEC) rarely causes disease in adults. • Enteroinvasive E. coli (EIEC)* causes bloody mucoid (dysentery) diarrhea; fever is common. • Enterohemorrhagic E. coli (EHEC)* causes bloody diarrhea, severe hemorrhagic colitis, and the hemolytic uremic syndrome in 6–8% of cases; cattle are the predominant reservoir of infection. Pediatric details. Nearly all types cause disease in children in the developing world: • Enteroaggregative E. coli (EAggEC (...) there is clinical and/or epidemiological suspicion of cholera, particularly during the early days of outbreaks/epidemics (also to determine antimicrobial susceptibility) and to identify the pathogen causing dysentery. Epidemiologic clues to infectious diarrhea can be found by evaluating the incubation period, history of recent travel in relation to regional prevalence of different pathogens, unusual food or eating circumstances, professional risks, recent use of antimicrobials, institutionalization, and HIV
Effectiveness of rifaximin and fluoroquinolones in preventing travelers' diarrhea (TD): a systematic review and meta-analysis. Recent developments related to a safe and effective nonabsorbable antibiotic, rifaximin, and identification of postinfectious irritable bowel syndrome as a frequent sequela call for a need to reconsider the value of primary prevention of traveler'sdiarrhea (TD) with antibiotics.Randomized, placebo-controlled, double-blind studies evaluating the effectiveness and safety (...) in preventing TD. However, further studies that include prevention of secondary chronic health outcomes among travelers to different geographic regions, and a formal risk-benefit analysis for antibiotic chemoprophylaxis, are needed.
Efficacy of rifaximin in prevention of travelers' diarrhea: a meta-analysis of randomized, double-blind, placebo-controlled trials. Rifaximin has been used successfully for the prevention of travelers' diarrhea (TD), the most general cause of disability among international travelers to developing tropical and semitropical regions.We sought to better evaluate the efficacy of rifaximin in the prevention of TD. Randomized controlled trials (RCTs) of rifaximin for the prevention of TD published (...) in Pubmed, the Cochrane Central Register of Controlled Trials, Embase, and the Science Citation Index were searched. [Correction added on 3 October 2012, after first online publication: the phrase "protection of TD" was replaced with "prevention of TD".] The primary efficacy outcome was occurrence of TD over a 2-week treatment period. Secondary outcomes were requirement for antibiotic treatment, occurrence of mild diarrhea (MD), occurrence of TD in the third week after drug withdrawal, incidence of TD
Trial Evaluating Ambulatory Treatment of Travelers' Diarrhea Trial Evaluating Ambulatory Treatment of Travelers' 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. Trial Evaluating Ambulatory (...) Treatment of Travelers' Diarrhea (TrEAT 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. Read our for details. ClinicalTrials.gov Identifier: NCT01618591 Recruitment Status : Terminated (AWD arm was completed. ADF diarrhea arm was unable to fill completely and there are no funds remaining to continue recruiting/enrolling.) First Posted : June 13, 2012 Last
Traveler'sDiarrhea Management TravelersDiarrhea Management Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Traveler'sDiarrhea (...) Management Traveler'sDiarrhea Management Aka: Traveler'sDiarrhea Management From Related Chapters II. Precautions : Overall Avoid trimethoprim-sulfamethoxazole ( , ) and due to high resistance rates Most is self-limited and spontaneously resolves WITHOUT antibiotics Use of antibiotics (esp. self treatment) is associated with multi-drug resistance, c. diff : Travel to Southeast Asia, Thailand, India or Nepal -resistant is common as first-line agent is preferred in these cases s Antimalarials and both
Traveler'sDiarrheaTravelersDiarrhea Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Traveler'sDiarrheaTraveler'sDiarrhea Aka (...) : Traveler'sDiarrhea , TravelersDiarrhea , Turkey Trots , Montezuma's Revenge , Delhi Belly From Related Chapters II. Epidemiology : 20-50% per short visit to endemic area (affects 10 million patients annually) Timing Peak for travelers from U.S. in October and June Ages affected Most common among younger patients (children, teens and young adults) Endemic Regions Developing countries in Africa, South Asia, Latin America, Middle East Highest risk countries Kenya Tunisia Morocco Egypt Mexico Honduras
2010 Status: Green (complete) Three Part Question In [recent travelers or migrants with fever and a history of exposure to malaria endemic areas] does the [BinaxNOW malaria rapid diagnostic test] have [adequate diagnostic accuracy to guide initial treatment decisions]? Clinical Scenario A 28-year-old female presents to the emergency department with fever, influenza-like symptoms and diarrhea. History reveals she recently returned from a two week trip to rural Kenya. You consider malaria in your (...) BinaxNOW Malaria rapid diagnostic test in returning travelers? BestBets: BinaxNOW Malaria rapid diagnostic test in returning travelers? BinaxNOW Malaria rapid diagnostic test in returning travelers? Report By: Nicholas Kuhl MD - Resident Physician Search checked by Jeff Jones MD - Research Director, Emergency Physician Institution: Grand Rapids Medical Education & Research/Michigan State University Date Submitted: 15th April 2010 Date Completed: 24th November 2010 Last Modified: 24th November
vaccination, influenza prevention advice, and respiratory symptoms.Of 987 enrolled travelers, 628 (64%) completed all surveys, of which 400 (64%) reported health problems during and/or after travel; median trip duration was 12 days. Diarrhea affected the most people during travel (172) while runny/stuffy nose affected the most people after travel (95). Of those with health problems during travel, 25% stopped or altered plans; 1% were hospitalized. After travel, 21% stopped planned activities, 23% sought (...) Self-reported illness among Boston-area international travelers: A prospective study The Boston Area Travel Medicine Network surveyed travelers on travel-related health problems.Travelers were recruited 2009-2011 during pre-travel consultation at three clinics. The investigation included pre-travel data, weekly during-travel diaries, and a post-travel questionnaire. We analyzed demographics, trip characteristics, health problems experienced, and assessed the relationship between influenza
Etiological Diagnosis of Traveler's Diarrhoea Etiological Diagnosis of Traveler's Diarrhoea - 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. Etiological Diagnosis of Traveler's Diarrhoea (DIAVOY) The safety (...) by (Responsible Party): Assistance Publique Hopitaux De Marseille Study Details Study Description Go to Brief Summary: Traveler's diarrhoea or turista is the most common disease in travelers. It has been reported based on studies in 20 to 60% of travelers, depending among other conditions and travel destinations. Currently, less than 30% of the etiology of diarrhoea is identified by bacteriological v,irological and parasitology traditional techniques. This ignorance of the diarrhoea etiology causes
Spectrum of Imported Infectious Diseases: A Comparative Prevalence Study of 16,817 German Travelers and 977 Immigrants from the Tropics and Subtropics. The aim of this study was to assess the spectrum of imported infectious diseases (IDs) among patients consulting the University of Munich, Germany, between 1999 and 2014 after being in the sub-/tropics. The analysis investigated complete data sets of 16,817 diseased German travelers (2,318 business travelers, 4,029 all-inclusive travelers (...) , and 10,470 backpackers) returning from Latin America (3,225), Africa (4,865), or Asia (8,727), and 977 diseased immigrants, originating from the same regions (112, 654 and 211 respectively). The most frequent symptoms assessed were diarrhea (38%), fever (29%), and skin disorder (22%). The most frequent IDs detected were intestinal infections with species of Blastocystis(900),Giardia(730),Campylobacter(556),Shigella(209), and Salmonella(183). Also frequently observed were cutaneous larva migrans (379