Noroviruses as a Cause of Traveler's Diarrhea among Students from the United States Visiting

Stool specimens from 124 international travelers with acute diarrhea were tested for the presence of entero-pathogens. Noroviruses (NoVs) were the second most commonly identified enteric pathogen in diarrheal stool samples (21/124, 17%), exceeded only by enterotoxigenic Escherichia coli (50/106, 47%). This study indicates that NoV is an underappreciated cause of traveler’s diarrhea. Traveler’s diarrhea (TD) is the most common medical com-plaint of international travelers (16, 24). The majority of TD cases are due to bacterial agents, which can be identified in up to 60% of cases (2, 14, 23, 25). A subset of TD cases appears to be caused by nonbacterial agents since antibiotic therapy fails to shorten illness duration (7, 8, 10). Also, in travelers with enteric disease, a viral type of clinical gastroenteritis syndrome is commonly seen (13). Noroviruses (NoVs) are recognized as the most common cause of acute nonbacterial gastroenteritis in persons over the age of 5 years and are responsible for more than 90 % of nonbacterial gastroenteritis outbreaks (11). The aims of this study were t