Bacteriological Studies of Travellar's Diarrhoea

During the period of investigation from Sept. 4, 1994 to Dec, 1996, a total of 11, 446, 534 overseas travellers were quarantined at Kansai Airport Quarantine Station, and 22, 187 voluntarily reported of episodes suffering from diarrhoea. Bacteriological examination of the stools a total of 9, 299 individuals' was performed, and the following results were obtained.<BR>1) Various enteropathogenic bacteria were isolated from 33.3% of the stools examined . Bacterial species isolated were as follows: Plesiomonas shigelloides, 2, 066 cases (66.7%); Vibrio parahaemolyticus, 358 cases (11.6%); Aeromonas sobria, 360 cases(11.6%); Shigella spp., 291 cases (9.4%); Salmonella spp., 183 cases (5.9%); A.hydrophila, 126 cases (4.1%); and V. cholerae non-01, 121 cases(3.9%). However, ETEC was not done with an object of test.<BR>2) In 502 cases (16.2%), plural enteropathogenic bacteria were isolated from single patient, suggesting high frequency of a mixed infections.<BR>3) From Feb. to Mar. 1995, thirteen cases cholera were found from patients who had travelled to Bali, Indonesia. Cases with enteropathogenic bacteria other than V. cholerae 01 were found without any seasonal variation.<BR>4) The major regions where the travellers were infected with the pathogens are as follows: Vibrio spp., were from only Asia; Shigella, widely distributed but especially in India and Indonesia; P. shigelloides and Salmonella, widely distributed.<BR>5) Among the Shigella strains, S. sonneiwere isolated the most, followed by S. flexneri, S. boydii and S. dysenteriae. A strain of S. boydii provisional serovar E 16553 was isolated from a patient infected in India.<BR>6) Among the Salmonella serovars, Salmonella Enteritidis was isolated the most frequently(49 cases, 25.7%).<BR>7) 265(89.2%) of 297 Shigella strains, 52(27.2%)of 191 Salmonella strains, and 19(95.0%)of 20 V. cholerae O1 were resistant to one or more drugs tested(SM. CP. TC. KM. ABPC. NA. OFLX).<BR>8) All of the 20 V. cholerae O1 strains were Ogawa, El Tor. All of them were toxigenic strains.<BR>9) The most frequently isolated serovar of V. parahaemolyticus was O3: K6. 89.8% of all V. parahaemolyticus strains were positive for thermostable direct hemolysin (TDH) gene, and 14.6% of them were positive for TDH-related hemolysin(TRH)gene by DNA-probe or PCR method.