The Diarrhea of Travelers to Mexico

Abstract

The syndrome is a definite clinical entity characterized by acute non-bloody diarrhea, slight fever, abdominal pain, nausea, chills, and malaise. It occurs in one-quarter to one-third of visitors to Mexico; more often in young people than in old; and usually develops several days after arrival. The illness lasts from 1 to 3 days and incapacitates briefly one-third of those affected. The cause of Turista remains unknown, but viruses, Salmonella sp., Shigella sp., and Entamoeba histolytica could not be incriminated in these studies. Shifts in the bacterial populations of the intestinal tract, possibly involving enteropathogenic strains of Escherichia coli are suspect. The incidence of Turista can be reduced substantially by the prophylactic use of Phthalylsulfathiazole, 2 g daily or Neomycin sulphate, 1 g daily. Enterovioform and a lactose placebo are ineffective. Furazolidine, on the basis of limited studies, has questionable usefulness. Simple hygienic precautions and symptomatic treatment remain the current recommendations for travelers to Mexico.