Most travelers will experience four or five loose stools per day. More than one attack can be experienced on the same trip. Young adults under 30 years of age have higher rates of diarrhea. Those who live in the non-commercialized regions, especially with indigenous tribes and in the rainforest will have high rates of diarrhea. Duration of time in the country increases risk.
Food is the major source of transmission in all studies.
Excessive fatigue, stress, and consumption of alcohol further increased risk in several studies. 8 Diagnosis Typically diagnosis will not occur since the traveler will institute treatment on symptomatic grounds. Should a patient have or develop symptoms on return from a trip, recommended evaluation would include stool culture and smears for ova and parasites, with stool smears for the presence of pus and blood. 9 Barium studies should not be performed until studies have been ordered for pathogens. Occasionally, special studies will be needed including special cultures for Yersenia, Vibro, Aeromonas, Plesimonas , or identification of toxigenic E. coli strains.