Turista

Whenever and wherever the itchy-footed U.S. tourist goes beyond his own borders, he runs a high risk of coming down with diarrhea. For this spoilsport condition he has a variety of evocative names,* and he invariably blames it on the local food and water, which he suspects of harboring amoebae or other low and exotic forms of life. In this he is almost certain to be wrong, said Manhattan's Dr. B. H. Kean in a report to the A.M.A. For all its global prevalence and frequent severity (it can touch off fever and vomiting, lead to dehydration and even prove fatal), tourists' diarrhea has had little scientific study seeking its causes and cures.

From one of the first major scientific projects, backed by prestigious public and private organizations in both the U.S. and Mexico, Dr. Kean reported that one thing is clear: the most popularly suspected microbes are usually not to blame for the diarrhea that strikes in major tourist centers. His research team based its findings mainly on the experience of travelers to Europe and Mexico, found that amoebae and the most-feared bacteria could be eliminated as suspects. A probable culprit in many cases: microbes of the common genus Staphylococcus, which may multiply in food kept under poor refrigeration and prepared under unsanitary conditions--but this usually has nothing to do with fecal contamination of food and water. In other cases, overeating and consumption of highly spiced or oily foods may be to blame.

Using U.S. students in Mexico City as willing guinea pigs, Dr. Kean and colleagues tested the value of drugs as preventives. They found that a popular nonprescription item, Entero-Vioform, gave no more protection than an inert (dummy) pill; an antibiotic, neomycin, appeared to give about 40% protection. But before they prescribe free-for-all use of such potent drugs as antibiotics and sulfas, the researchers want to know more about many factors, including viruses, as causes of globetrotters' trots.

* Most of them in the tradition of Union soldiers, who dubbed it the Virginia or Tennessee quickstep, depending on where they were campaigning. Currently popular: turista in most of Latin America; "Aztec two-step" or "Montezuma's revenge" in Mexico; "Turkey trot" and "Gyppy tummy" in the Middle East; "Delhi belly" in India; and--universally--"the trots" and "the G.I.'s" referring not to government issue but to gastrointestinal symptoms.

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