Thirty-five members of the Yale Glee Club participated in a study of the etiologies of turista during a 1-month tour of 12 Latin American cities in May–June 1975. Seventy-four percent developed acute watery diarrhea, lasting an average of 5 days and usually without fever, vomiting, myalgia, or dysentery. Of 16 patients whose stools were cultured during their illnesses, nine (56%) had toxigenic organisms. Isolates from four patients produced only the heat-labile enterotoxin (LT); isolates from three patients produced only the heat-stable toxin (ST); and isolates from two patients produced both LT and ST. Thirty-eight percent of the enterotoxigenic organisms were resistant to tetracycline. While some previously recognized enterotoxigenic serogroups were found, previously unrecognized enterotoxigenic serotypes of Escherichia coli were also described. No salmonellae, shigellae or vibrios were isolated and none of the illness specimens had rotaviruses by enzyme-linked immunosorbent assay. Cary-Blair semisolid agar proved much better than buffered glycerol saline as a transport medium for the pathogens found. This study reaffirms the high frequency of turista among North American visitors to Latin America; toxigenic E. coli that produce LT, ST or both appear to be responsible for most of these illnesses and over one-third of these enterotoxigenic E. coli are resistant to tetracycline.
Present address: Mount Zion Hospital, San Francisco, California 94109.
Currently Chief, Water-Related Diseases Activity, Enteric Diseases Branch, Bacterial Diseases Division, Bureau of Epidemiology, Center for Disease Control, Atlanta, Georgia 30333.