ETEC is transmitted by contaminated food and, less often, contaminated water. The incubation period is usually 24 to 72 hours and excretion of ETEC may be prolonged.
The most important determinants of risk for travellers’ diarrhea are the travel destination and the type of travel (e.g., five-star accommodations vs. backpacking). Factors associated with a higher probability of acquiring travellers’ diarrhea include gastric hypochlorhydria and the relative lack of gut immunity seen in small children. In addition, specific groups of travellers are at an increased risk of serious consequences of travellers’ diarrhea:
- persons with chronic illnesses, such as immunodeficiency diseases
- individuals with chronic renal failure
- persons with congestive heart failure
- individuals with insulin-dependent diabetes mellitus
- persons with inflammatory bowel disease
Source: Public Health Agency of Canada