Wednesday 18 May 2016
Travelers' Diarrhea in Children: What Have We Learnt?
Summer is coming, so this week WAidid suggests an article on diarrhea, that is the most common travel-associated illness. The paper was published last May on Pediatric Infectious Disease Journal.
This paper intends to provide an update on existing knowledge on this topic in children, highlight clinical areas requiring further research and training, and conclude with practical recommendations:
- In an era of increasing international travel, travelers' diarrhea is one of the most common illnesses that children and families will encounter.
- Risk factors for travelers' diarrhea include certain destinations (such as Africa or South Asia), young age, VFR and adventure travel.
- During a pretravel medical visit, caregivers should be given information on appropriate precautions regarding hygiene and behavior during travel.
- As no vaccine against most forms of travelers' diarrhea is available (except cholera and rotavirus infection), prevention centers around hygiene and food and water precautions.
- Travelers' diarrhea is usually self-limited; dehydration and electrolyte disturbances are the most frequent complications.
- The mainstay of treatment is correction offluid and electrolyte losses, preferably by ORS. Carrying commercial ORS and an antibiotic agent (e.g. azithromycin) for selftreatment is advisable
- Antimicrobial use should be limited to moderate to severe bloody diarrhea, severe watery diarrhea in areas where V. cholerae or ETEC are prevalent, or for prolonged debilitating diarrhea (preferably after medical consultation, stool culture and parasite examination).
- Pediatric-focused research into travelers' diarrhea is needed to formulate evidencebased guidelines tailored for children, including immunocompromised children.
- Better strategies are needed to increase the uptakeofpretravel clinic visits and improve the training of physicians providing pretravel advice to families.
AUTHORS: Ashkenazi S, Schwartz E, O'Ryan M.