1 Symptoms usually begin within two week of arrival in the country, with a typical incubation period from exposure of 3-5 days. Rare cases are severe enough to warrant hospitalization. The most common causes are gram negative bacteria, but viruses and intestinal parasites may also occur. The risk of infection and types of organism involved varies by country and time of year. 4,5 Staph aureus, Bacillus cerus, and Clostridia welchii exotoxin food poisoning also occur.
Malaria can have diarrhea as an early manifestation.
Presentation Travelers' diarrhea is considered a syndrome because of the number of etiological organisms. It is defined as the passage of 3 or more loose stools in a 24 hour period with at least one symptom such as nausea, vomiting, cramps, fever, fecal urgency, tenesmus, or passage of blood, mucoid stools. For practical purposes one or two loose stools with symptoms will prompt most travelers to begin treatment before they develop the full syndrome. Most travelers will experience four or five loose stools per day. More than one attack can be experienced on the same trip.