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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.
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.
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]
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.
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.
Appendicitis may present with vomiting, abdominal pain, and a small amount of diarrhea in up to 33% of cases. [1] This is in contrast to the large amount of diarrhea that is typical of gastroenteritis. [1] Infections of the lungs or urinary tract in children may also cause vomiting or diarrhea. [1]
Chronic, watery diarrhea and failure to thrive are the most common symptoms in infants and toddlers. Other symptoms include abdominal distention, gassiness, colic, irritability, excoriated buttocks, severe diaper rash due to acidic diarrhea, indigestion, and vomiting. [4] [7]
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]