Entero-Vioform in Travelers' Diarrhea

Abstract

To the Editor.— There are two principal areas of concern raised by Wolfe and Mishtowt—the efficacy of iodochlorhydroxyquin (Entero-Vioform) and its implied association with "subacute myelo-optic neuropathy" (SMON). Although iodochlorhydroxyquin has never been advocated for prophylactic therapy in this country—"travelers' diarrhea" is not considered a significant domestic problem—there is substantive evidence in favor of such usage, some of which has been cited by Wolfe and Mishtowt. As recently as 1968, an editorial inLancetsupported this widely accepted practice abroad, ie, "... for the prophylaxis and treatment of amebic dysentery and shigellosis."¹ On the other hand, the SMON situation warrants a careful illumination of all the known facts. We believe emphasis should first be placed on Wolfe's own observation, presented but understated in his letter, that "... the rare observance of this syndrome in England, Israel, and this country suggests that presently unknown but peculiar specific factors in Japan might have