Infectious diarrhoea is the most common illness reported by travellers’ visiting developing countries and among US troops deployed overseas. The morbidity and associated discomfort stemming from diarrhoea decreases daily performance, affects judgment, decreases morale and declines operational readiness. The first line of treatment for infectious diarrhoea is the prescription of antibiotics. Unfortunately, in the last decade, several enteric pathogens have demonstrated increasing resistance to commonly prescribed antibiotics. In addition, travellers’ diarrhoea is now recognized by the medical community to result in post-infectious sequelae, including post-infectious irritable bowel syndrome (IBS) and several post-infectious autoimmune diseases. A preventative treatment that defends against infectious enteric diseases is a high priority objective for the US Military.

Travellers’ diarrhoea (TD) is the most common and predictable travel-related illness. Attack rates range from 30%–70% of travellers’ during a 2-week period, depending on the destination and season of travel. Traditionally, TD was thought to be prevented by following simple dietary recommendations (e.g., “boil it, cook it, peel it, or forget it”), but studies have found that people who follow these rules can still become ill. Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. TD is a clinical syndrome that can result from a variety of intestinal pathogens. Bacteria are the predominant enteropathogens thought to account for ≥80%–90% of cases.

Bacteria are the most widespread cause of TD. Overall, the most common pathogen identified is enterotoxigenic Escherichia coli, Enteroaggregative and other E. coli pathotypes followed by Campylobacter jejuni spp., Shigella spp., and Salmonella spp. and .  There are also less common viral and parasitic causes of TD.

Clinical Trial

Immuron has recently completed a clinical study led by Principal Investigator Dr Mohamed Al-Ibrahim at the Pharmaron CPC FDA inspected Clinical Research Facility Inpatient Unit located in Baltimore, Maryland US. The Phase 2 clinical trial is designed to evaluate the safety and protective efficacy of Travelan® compared to a placebo in a controlled human infection model (CHIM). The primary efficacy outcome is prevention and/or reduction of moderate to severe diarrhea. Clinicaltrials.gov identifier: NCT05933525.