August 2006
Literature Review
Noroviruses as a Cause of Traveler’s Diarrhea among Students from the United States Visiting Mexico
Go to full text in PubMed: Ko G, Garcia C, Jiang ZD, et al. J Clin Microbiol 2005;43:6126
The authors investigated the cause of “Traveler’s diarrhea” among 124 international travelers with acute diarrhea when visiting Guadalajara, Mexico during the summer of 2004. The following is a summary of the etiologic agents identified:
| Total Sampled | 119-124 |
| Enterotoxigenic E. coli | 54 (45%) |
| Norovirus | 21 (17%) |
| Enteroadherent E. coli | 18 (15%) |
| Providencia | 9 (8%) |
| Cryptosporidia | 5 (4%) |
| Shigella | 4 (3%) |
| Aeromonas | 1 (1%) |
| Plesiomonas | 1 (1%) |
| None identified | 399 (31%) |
The authors conclude that Norovirus is a “under-appreciated cause of traveler’s diarrhea”.
Comment: Norovirus seems to be found everywhere: the more you look, the more you find. This is in large part due to improved techniques (PCR) for detection. It is not surprising that this was an important agent in traveler’s diarrhea, but has simply not been sought in most of the prior studies.
Literature Review by John G. Barlett, M.D. Professor, Division of Infectious Diseases