Travellers' diarrhea is a very most common illness among both short term and long term travellers. The cause of travellers' diarrhea is usually bacterial, but can also be viral or protozoal, and depending on the kind of infectious agent responsible, symptoms of untreated cases can last ranging from 3-5 days to weeks or even months. Most countries in Asia, Middle East, Africa, Central and South America are considered high risk; unfortunately one cannot eliminate the risk by simply following the traditional rule of "boil it, cook it, peel it or forget it" as some risk factors are beyond the traveller's control. Taking oral vaccine Dukoral prior to travel or using Pepto-Bismol regularly (2 tablets four times daily) during travel can reduce the risk of travellers' diarrhea. Treatments of travellers' diarrhea may include the use of oral rehydration solution, anti-diarrheal medication and a short course of suitable antibiotics.
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Dukoral is an oral vaccine that can be taken prior to travel to lower the risk of travellers' diarrhea and cholera. For protection against travellers diarrhea, it consists of 2 doses to be taken 1-6 weeks apart, finishing the last dose at least 1 week before travel, and is effective for 3 months. Those who are revisiting or staying in high risk areas are recommended to receive a single booster dose. For protection against cholera, children between 2 to 6 years of age should receive 3 doses, 1-6 weeks apart between each dose, and finishing the last dose 1 week prior to travel. Dosing schedule for those over 6 is the same as for travellers' diarrhea.
Ciprofloxacin and azithromycin
Depending on the destination and the type of travel, sometimes a short course of antibiotics may be prescribed for self-treatment of travellers diarrhea. Due to the risk of drug resistance and the disturbance of the normally protective microflora in the bowel, antibiotics are usually not taken as a preventive measure but are reserved for treatment only.