• Dieter Stürchler.
• Department of Clinical Research, Basel University, Schanzenstrasse 55, 4031 Basel, Switzerland.
• J Travel Med. 2023 Oct 31; 30 (6).

IntroductionFaecal-oral transmission refers to the process whereby disease is transmitted via the faeces of an infected individual to the mouth of a susceptible individual. This transmission can occur through failures in sanitation systems leading to exposure via various routes in particular contaminated water, food, and hands. Travellers' diarrhoea is the most common travel-related illness. A score could enhance risk assessment and pre-travel advice.MethodsA simple score was developed based on the frequency of defecating in the open (country prevalence > 1%), occurrence of cholera in the period between 2021 and 2017 (one or more case in a country) and reported typhoid fever cases between 2015 and 2019.ResultsData were available for 199 out of 214 countries for the score to be applied. 19% of the 199 countries scored as high risk countries for faecal-oral transmission (score 3), 47% as medium risk (score 2), and 34% as minimal risk (score 0). The percentage of countries scoring 3 was highest in Africa (63%) and lowest in Europe and Oceania (score 0).ConclusionsA global risk map was developed based on a simple score that could aid travel medicine providers in providing pre-travel risk assessment. For travellers to high and medium risk countries, pre-travel consultation must include detailed advice on food and water hygiene.© International Society of Travel Medicine 2023. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

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