Travel-related acquisition of diarrhoeagenic bacteria, enteral viruses and parasites in a prospective cohort of 98 Dutch travellers

Travel Med Infect Dis. 2017 Sep:19:33-36. doi: 10.1016/j.tmaid.2017.08.003. Epub 2017 Aug 24.

Abstract

Background: Limited prospective data are available on the acquisition of viral, bacterial and parasitic diarrhoeagenic agents by healthy individuals during travel.

Methods: To determine the frequency of travel associated acquisition of 19 pathogens in 98 intercontinental travellers, qPCR was used to detect 8 viral pathogens, 6 bacterial enteric pathogens and 5 parasite species in faecal samples collected immediately before and after travel.

Results: We found high pre-travel carriage rates of Blastocystis spp. and Dientamoeba fragilis of 32% and 19% respectively. Pre-travel prevalences of all other tested pathogens were below 3%. Blastocystis spp. (10%), Plesiomonas shigelloides (7%), D. fragilis (6%) and Shigella spp. (5%) were the most frequently acquired pathogens and acquisition of enteral viruses and hepatitis E virus in this relatively small group of travellers was rare or non-existent.

Conclusions: Our findings suggest that the role of viruses as the cause of persisting traveller's diarrhoea is limited and bacterial pathogens are more likely as a cause of traveller's diarrhoea. The substantial proportion of travellers carrying Blastocystis spp. and D. fragilis before travel warrants cautious interpretation of positive samples in returning travellers with gastrointestinal complaints.

Keywords: Acquisition; Bacteria; Diarrhoea; Parasites; Travel; Viruses.

MeSH terms

  • Cohort Studies
  • Diarrhea* / microbiology
  • Diarrhea* / parasitology
  • Diarrhea* / virology
  • Enterobacteriaceae Infections / epidemiology
  • Enterovirus Infections / epidemiology
  • Feces / microbiology
  • Feces / parasitology
  • Feces / virology
  • Humans
  • Netherlands / epidemiology
  • Parasitic Diseases / epidemiology
  • Prevalence
  • Prospective Studies
  • Travel-Related Illness*