輸入消化管感染症

Imported Enteric Infection

要旨　輸入消化管感染症は旅行者下痢症とチフス性疾患（腸チフス，パラチフス）に分けられる．前者は，発展途上国に到着後2～3日から帰国後およそ1～2週間以内に発症し，下痢のほか，悪心，嘔吐，腹痛，発熱，テネスムス，粘液または血便のうち少なくとも1つ以上を伴うものと考えてよい．細菌性のものが多く，世界的にみて最も頻度が高いのは毒素原性大腸菌であり，赤痢菌，コレラ菌などが含まれる．原虫ではランブル鞭毛虫が多い．我が国ではいずれもアジアでの感染が多い．旅行者下痢症の治療は対症療法と抗菌薬の初期治療である．チフス性疾患では菌確認後治療開始する．

　Travelers' diarrhea (TD) and enteric fever (typhoid and paratyphoid fever) are common infections in overseas travel. TD is defined as diahrrea with at least one of such symptoms as nausea, vomiting, abdominal cramp, fever, fecal urgency, or the passage of bloody or mucoid stools, generally occurring a few days after arrival and one to two weeks after return. ETEC is the major cause of TD, and Shigella spp, V. cholerae 01 and G. lamblia are less commonly detected. Seventy-five percent of Japanese cases are infected in the Indian subcontinent and South-East Asia.