Management of travellers' diarrhoea

The Hajj: a constant travel destination amidst changing times

“…24 The Middle East is considered an area of moderate reporting rate ratio for traveller's diarrhoea. 25 During the Hajj of 1987, gastroenteritis was the commonest reason for hospital admission, Whether it is due to the easy availability of loperamide and other medications, patient awareness of the illness and its prevention (it is extensively mentioned at the Hajj awareness programmes) or a combination of the factors mentioned is not known.…”

Infectious diarrhea: when to test and when to treat

“…10,11 Although many suggest a diet that contains easily digested foods such as bananas, rice, applesauce and toast (the BRAT diet), data from a pilot study show that dietary restriction does not enhance recovery. 12 Over-the-counter medications such as bismuth subsalicylate (525 mg four times daily) and loperamide (4 mg initially, followed by 2 mg after each loose stool; maximum 16 mg/d) are available to treat acute diarrhea; 13 however, an openlabel comparison be tween these two medications published in 1990 found that loperamide was more effective.…”

“…13,15 Bismuth subsalicylate is not routinely recommended for use in children, because the salicylate component could predispose them to Reye syndrome.…”

“…When clinicians are considering the use of empirical therapy, it is helpful to categorize patients into the following groups: travellers with nonbloody diarrhea, non- travellers with nonbloody diarrhea and people with bloody diarrhea (Figure 2). 3,5,13 The most common causes of communityacquired, infectious diarrhea are viral and shortlived. Conservative management with hydration, with or without loperamide, is the most appropriate approach in most instances.…”

Travel and pregnancy: an infectious diseases perspective

“…However, pregnant women have an estimated 17-fold increased risk of listerial bacteraemia 31 in which case infection typically manifests as febrile gastroenteritis, sepsis syndrome or meningitis. 32 Dietary recommendations for preventing listeriosis in pregnancy include: 33 † Thorough cooking of raw food from animal sources; † Washing of raw vegetables prior to consumption; † Avoiding consumption of products containing unpasteurised dairy products; † Avoiding soft cheeses (e.g. feta, brie, camembert); † Thorough re-heating of leftover food; † Avoidance of foods from delicatessen counters and buffets.…”