30 Questions
What is the traditional definition of Travelers Diarrhea?
3 or more unformed stools in a 24 hour period with one or more additional symptoms
Which bacterial agent accounts for approximately 80-90% of Travelers' Diarrhea cases?
Enterotoxigenic E. coli (ETEC)
What was the standard prophylaxis for Traveler's Diarrhea in the 1970s to 1985?
Bactrim and doxycycline
What percentage of Travelers' Diarrhea cases are caused by viral agents?
5-10%
Which parasite accounts for approximately 10% of Travelers' Diarrhea cases?
Giardia
What is the 'new' approach for treating Travelers' Diarrhea in 2018 based on?
Published guidelines in 2017
What defines the severity scale of 'Mild' according to the new definitions of Travelers Diarrhea Severity Scale?
Diarrhea that is tolerable, is not distressing, and does not interfere with planned activities
What percentage of Travelers' Diarrhea cases are caused by bacterial agents?
90-95%
'COOK IT, PEEL IT, BOIL IT, OR FORGET IT' refers to:
Preventive measures to avoid Travelers' Diarrhea
'Golden Age' of TD self-treatment occurred during which time period?
'Golden Age' of TD self-treatment from 1990-2000s
Which antibiotic is recommended for the treatment of cholera to reduce fluid requirements and duration of illness?
Azithromycin
What is the causative agent of cholera?
Vibrio cholerae
Which vaccine provides protective efficacy of 65-67% for 2-5 years against cholera?
Shanchol
What is the incubation period of cholera?
2-5 days
Which disease presents with symptoms like bacterial meningitis, including headache, stiff neck, nausea, and vomiting?
Rat lungworm disease
Which antibiotic is used to reduce fluid requirements and duration of illness in cholera treatment?
Doxycycline
What is the primary mode of transmission for Vibrio cholerae?
Water or food contamination
Which antibiotic is NOT recommended for the treatment of cholera?
Ampicillin
Which antibiotic is used to reduce fluid requirements and duration of illness in cholera treatment?
Azithromycin
What are the symptoms associated with cholera?
Acute watery diarrhea and vomiting
What is the first-line antibiotic of choice for severe travelers' diarrhea?
Azithromycin
What is the recommended treatment for mild travelers' diarrhea?
Sacharomyces boulardii CNCM 1-745
What is the most likely cause of foul-smelling, greasy stools, and gradual onset diarrhea after a 2-week surfing trip in Indonesia?
Giardia
What type of diarrhea often has a sudden onset of relatively uncomfortable symptoms?
Bacterial diarrhea
Which pathogen can be detected using nucleic acid testing and is transmitted fecal-orally?
Giardia
Which bacteria can cause bullous cellulitis after saltwater exposure?
Vibrio vulnificus
What is the incubation period for Leptospirosis after exposure to infected animals or contaminated water?
~10 days
Which region has the highest morbidity of Leptospirosis?
Oceania
Which medication is the preferred treatment for Leptospirosis?
Doxycycline
What should be avoided as a food and water precaution to prevent travelers' diarrhea?
Peeled fruit (banana, oranges)
Study Notes
Travelers' Diarrhea
- Traditional definition: diarrhea that occurs during or shortly after travel, typically in the first week
- Accounts for 80-90% of Travelers' Diarrhea cases: Enterotoxigenic E. coli (ETEC)
Prophylaxis and Treatment
- Standard prophylaxis for Traveler's Diarrhea in the 1970s to 1985: prophylactic antibiotics
- New approach for treating Travelers' Diarrhea in 2018: based on risk assessment, symptom management, and antimicrobial therapy
- First-line antibiotic of choice for severe travelers' diarrhea: fluoroquinolones
- Recommended treatment for mild travelers' diarrhea: fluid replacement, rest, and bismuth subsalicylate
Etiology and Pathogenesis
- Causes of Travelers' Diarrhea: bacterial agents (80-90%), viral agents (10-20%), and parasites (10%)
- Parasite that accounts for approximately 10% of Travelers' Diarrhea cases: Giardia
- Causative agent of cholera: Vibrio cholerae
Cholera
- Incubation period of cholera: 1-5 days
- Symptoms of cholera: diarrhea, vomiting, and dehydration
- Recommended antibiotic for the treatment of cholera: doxycycline
- Vaccine that provides protective efficacy of 65-67% for 2-5 years against cholera: oral cholera vaccine
Other Diseases
- Disease that presents with symptoms like bacterial meningitis, including headache, stiff neck, nausea, and vomiting: leptospirosis
- Symptoms of leptospirosis: headache, muscle aches, and fever
- Preferred treatment for Leptospirosis: doxycycline
- Region with the highest morbidity of Leptospirosis: Southeast Asia
- Incubation period for Leptospirosis: 2-26 days
- Pathogen that can be detected using nucleic acid testing and is transmitted fecal-orally: Norovirus
Prevention
- 'COOK IT, PEEL IT, BOIL IT, OR FORGET IT' refers to: food and water precautions to prevent travelers' diarrhea
- Food and water precaution to prevent travelers' diarrhea: avoid undercooked meat, unpeeled fruits, and untreated water
Learn about the causes and prevention of traveler's diarrhea, as well as food safety tips for travelers. This quiz covers bacterial and viral agents, as well as practical advice for avoiding food and water-borne illnesses while traveling.
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