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Enterotoxigenic Escherichia coli (ETEC) is a type of Escherichia coli and one of the leading bacterial causes of diarrhea in the developing world, [1] as well as the most common cause of travelers' diarrhea. [2] Insufficient data exists, but conservative estimates suggest that each year, about 157,000 deaths occur, mostly in children, from ETEC.
Shigella results in about 165 million cases of diarrhea and 1.1 million deaths a year with nearly all cases in the developing world. [5] In areas with poor sanitation nearly half of cases of diarrhea are due to Entamoeba histolytica. [6] Entamoeba histolytica affects millions of people and results in more than 55,000 deaths a year. [12]
Acute diarrhea is most commonly due to viral gastroenteritis with rotavirus, which accounts for 40% of cases in children under five. [1] In travelers, however, bacterial infections predominate. [27] Various toxins such as mushroom poisoning and drugs can also cause acute diarrhea.
Rotavirus is the most common cause of gastroenteritis in children, [25] and produces similar rates in both the developed and developing world. [20] Viruses cause about 70% of episodes of infectious diarrhea in the pediatric age group. [13] Rotavirus is a less common cause in adults due to acquired immunity. [27]
Diarrhea is separated into three clinical categories; acute diarrhea may last multiple hours or days, acute bloody diarrhea, also known as dysentery, and finally, chronic or persistent diarrhea which lasts 2–4 weeks or more. [2] There is normal growth with no evidence of malnutrition in the child experiencing persistent diarrhea.
Enterotoxigenic E. coli (ETEC) produces a toxin that acts on the intestinal lining, and is the most common cause of traveler's diarrhea. Enteropathogenic E. coli (EPEC) can cause diarrhea outbreaks in newborn nurseries. Enteroaggregative E. coli (EAggEC) can cause acute and chronic (long-lasting) diarrhea in children.
The prodromal symptoms are fever, headache, and myalgia, which can be severe, lasting as long as 24 hours.After 1–5 days, typically, these are followed by diarrhea (as many as 10 watery, frequently bloody, bowel movements per day) or dysentery, cramps, abdominal pain, and fever as high as 40 °C (104 °F).
Rotavirus is responsible for infecting 140 million people and causing 1 million deaths each year, mostly in children younger than five years. [6] [15] This makes it the most common cause of severe childhood diarrhoea and diarrhea-related deaths in the world. [6]