Travelers' Diarrhea in Panamanian Tourists in Mexico

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Abstract
To determine whether residentsof developingcountries are unlikelyto acquire travelers' diarrhea, 64 Panamanians of widely divergentsocioeconomic strata werestudied during a IS-day tour through Mexico. Twenty-three (36%) tourists experienced27 episodes of travelers' diarrhea that were caused by sevendifferent pathogens. The most commonly identified etiologic agents were rotavirus (26%), Norwalk virus (15%), and Campylobacter fetus (11 %), whereas enterotoxigenic Escherichia coli was not frequently associated with travelers' diarrhea. Acquisition of travelers' diarrhea was correlated directly with high socioeconomic status. Varyinglevels of immunity to enteropathogens that are endemic in Panama may explain the different isolation rates of pathogens.