| 2009 |
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| Epidemiology of travelers' diarrhea in Thailand. |
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| Chongsuvivatwong, V., Chariyalertsak, S., McNeil, E., Aiyarak, S., Hutamai, S., Dupont, H. L.,
Jiang, Z. D., Kalambaheti, T., Tonyong, W., Thitiphuree, S., and Steffen, R. |
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| Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hatyai, Thailand
cvirasak@medicinepsuacth |
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| Abstract: BACKGROUND: Current data on risk of travelers' diarrhea (TD) among visitors to
Thailand largely comes from US military personnel, Peace Corps volunteers, or expatriates. We performed a 14-month systematic study of the incidence
rate and characteristics of TD and a smaller study of etiology of the disease among visitors to Phuket and Chiang Mai. METHODS: One randomly
selected day each week from August 2005 until October 2006, data were collected from foreign tourists departing from airports serving Phuket and
Chiang Mai. A separate subgroup of subjects with TD acquired in Phuket were invited to submit a stool sample for enteropathogens. RESULTS: Based
on 22,401 completed questionnaires, the attack rate for TD was highest among residents from Australia or New Zealand (16%), while those from the
United States and Europe had attack rates of 7% to 8%. Independent risk factors for the development of TD were eating outside the hotel and eating
meat. In contrast, a history of drinking tap water and consuming ice cream were protective. In 56 subjects studied for etiology, Aeromonas spp were
found in 8 subjects (14%), enterotoxigenic Escherichia coli (ETEC) or Vibrio spp each was found in 7 (13%) with O1 V. cholera (cholera) seen in one,
mixed pathogens were found in 3 (5%), with no pathogen being detected in 33 (59%). CONCLUSIONS: Phuket and Chiang Mai should not be considered
high-risk destinations for development of TD among US and European travelers to Thailand. In the study, Aeromonas, ETEC, and Vibrio spp were the
most frequent enteropathogens identified |
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| Published in:J.Travel.Med. 16[3], 179-185. 2009. |
