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When is travelers diarrhea considered severe?

Severe (acute) diarrhea is incapacitating or completely prevents planned activities. All dysentery (passage of grossly bloody stools) is considered severe. The expert panel defines persistent diarrhea as diarrhea that lasts for = 14 days [6].



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Your diarrhea lasts beyond two days. You become dehydrated. You have severe stomach or rectal pain. You have bloody or black stools.

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Seek medical attention if you have bloody diarrhea, high fever, persistent vomiting, severe abdominal pain, profuse sweating, or signs of dehydration.

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Recent studies have shown that approximately 25% of travelers develop TD in the first 2 weeks abroad, with the highest rates occurring in travel to Africa and South, Central and West Asia.

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Traveler's diarrhea may get better without any treatment. But while you're waiting, it's important to try to stay hydrated with safe liquids, such as bottled water or water with electrolytes such as an oral rehydration solution (see below).

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Although traveler's diarrhea is typically a benign, self-resolving condition, it can lead to dehydration and, in severe cases, significant complications.

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Untreated, bacterial diarrhea usually lasts 3–7 days. Viral diarrhea generally lasts 2–3 days. Protozoal diarrhea can persist for weeks to months without treatment. An acute bout of TD can lead to persistent enteric symptoms, even in the absence of continued infection.

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Although most cases of travelers' diarrhea (TD) are acute and self-limited, a certain percentage of people afflicted will develop persistent (>14 days) gastrointestinal (GI) symptoms.

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It can be fatal if it's left untreated. In addition to being picked up from contaminated food or water, the bacteria or parasites that cause dysentery can be passed from person to person in close contact, or you can get it by swimming in unclean water.

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Mild diarrhea (up to three loose bowel movements a day) can be self-treated with oral rehydration and loperamide. If symptoms worsen or do not improve after 24 h, treatment with an antibiotic should be initiated.

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  • Do not eat raw fruits and vegetables unless you peel them. ...
  • Do not eat raw leafy vegetables (e.g., lettuce, spinach, cabbage) because they are hard to clean.
  • Do not eat raw or rare meats.
  • Avoid uncooked or undercooked shellfish.
  • Do not buy food from street vendors.
  • Eat hot, well-cooked foods.


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