Incidence and clinical features of traveler's diarrhea in infants and children

To assess the incidence rate and the characteristics of traveler's diarrhea in small children ages 0 to 2 years, children ages 3 to 14 years, and adolescents ages 15 to 20 years a retrospective survey was conducted. Of the pretravel visitors to the Zurich University Vaccination Center, all those ages 0 to 20 years were selected between October, 1987, and May, 1988. They received a questionnaire within 2 weeks after returning home. Of the 446 young travelers who were recruited, 363 (81.3) could be evaluated. Within 14 days in the tropics or subtropics, traveler's diarrhea occurred in 8 of 20 (40.0) small children, in 4 of 47 (8.5) children ages 3 to 6 years, in 10 of 46 (21.7) children ages 7 to 14 years and in 90 of 250 (36.0) adolescents (P= 0.0003). In small children the clinical course tended to be severe and prolonged (average duration, 29.5; median, 17.5 days) when compared with other age groups (3 to 5 days). In 40 of all the children the parents reported that they had consistently practiced dietary preventive measures. For self-treatment oral re-hydration solutions were used in 5.0 and loperamide in 33.8. In conclusion adults should be discouraged from taking small children to developing countries unless necessary. Parents should be instructed about how to prevent traveler's diarrhea and about the mainstay of self-therapy in pediatric patients by oral rehydration solutions.