Steffen R, Collard F, Tornieporth N, Campbell-Forrester S, Ashley D, Thompson S, Mathewson J J, Maes E, Stephenson B, DuPont H L, von Sonnenburg F
Division of Epidemiology and Prevention of Communicable Diseases, University of Zurich, Institute of Social and Preventive Medicine, Switzerland.
JAMA. 1999 Mar 3;281(9):811-7. doi: 10.1001/jama.281.9.811.
Traveler's diarrhea (TD) can incapacitate travelers. Characteristics of TD could be helpful in identifying individuals who might benefit from a vaccine against TD.
To determine epidemiology, etiology, and impact of TD in Jamaica. Design Two-armed, cross-sectional survey conducted between March 1996 and May 1997.
Sangster International Airport and 10 hotels in Montego Bay area, Jamaica.
To investigate epidemiology and impact, 30369 short-term visitors completed a questionnaire just before boarding their homebound aircrafts. To investigate etiology, 322 patients (hotel guests) with TD provided stool samples.
Attack and incidence rates of reported diarrhea and of classically defined TD (> or =3 unformed stool samples in 24 hours and > or =1 accompanying symptom), incapacity, risk factors, and etiology.
The attack rate for diarrhea was 23.6% overall, with 11.7% having classically defined TD. For a mean duration of stay of 4 to 7 days, the incidence rate was 20.9% (all TD) and 10.0% (classic TD). Among airport respondents, the incapacity lasted a mean of 11.6 hours. Less than 3% of all travelers avoided potentially high-risk food and beverages. The most frequently detected pathogens were enterotoxigenic Escherichia coli, Rotavirus, and Salmonella species.
A realistic plan for reducing TD is needed. Preventive measures such as the improvement of hygienic conditions at the destination, and/or the development of vaccines against the most frequent pathogens associated with TD may contribute toward achieving this goal.
旅行者腹泻（TD）会使旅行者身体不适。TD的特征有助于识别可能从TD疫苗中获益的个体。
确定牙买加TD的流行病学、病因及影响。设计：1996年3月至1997年5月进行的双臂横断面调查。
牙买加蒙特哥贝地区的桑斯特国际机场和10家酒店。
为调查流行病学及影响，30369名短期访客在登机回国前填写了问卷。为调查病因，322例TD患者（酒店住客）提供了粪便样本。
报告的腹泻及经典定义的TD（24小时内≥3次不成形粪便样本且≥1种伴随症状）的发病率、失能情况、危险因素及病因。
腹泻的总体发病率为23.6%，其中11.7%为经典定义的TD。平均停留时间为4至7天，发病率为20.9%（所有TD）和10.0%（经典TD）。在机场受访者中，失能平均持续11.6小时。所有旅行者中不到3%避免食用可能高风险的食品和饮料。最常检测到的病原体是产肠毒素大肠杆菌、轮状病毒和沙门氏菌属。
需要制定一个切实可行的减少TD的计划。诸如改善目的地卫生条件和/或研发针对与TD相关的最常见病原体的疫苗等预防措施可能有助于实现这一目标。
