title: Enterotoxigenic Escherichia coli diarrhea of travelers: a prospective study of American Peace Corps volunteers.
abstract: Travelers' diarrhea was studied prospectively in a group of 39 American Peace Corps Volunteers (PCVs) during their first five weeks in Kenya. Twenty-seven developed diarrheal disease and 12 remained well. Multiple episodes were documented in 11 of the symptomatic volunteers. Enterotoxigenic Escherichia coli of many serotypes producing heat-labile and/or heat-stable enterotoxin were isolated from 17 of the 27 volunteers with diarrhea and from 1 of the 12 well volunteers. The enterotoxigenic E. coli were more likely to be antibiotic sensitive than the non-enterotoxigenic E. coli. A serum antibody rise to the heat-labile toxin (LT) was detected in six symptomatic volunteers, five of whom had a positive culture for LT-producing E. coli, and from one asymptomatic, culture negative volunteer. Salmonella cubana was isolated from two volunteers, and three volunteers had serologic evidence of infection with human reovirus-like (rotavirus) agent. This study confirms the role of enterotoxigenic E. coli as a major cause of travelers' diarrhea and suggests that the disease is similar in widely separated geographic areas.
mesh_terms: D000328:Adult; D000368:Aged; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000453:epidemiology*; D006077:Government Agencies; D006801:Humans; D007391:International Cooperation; D007630:Kenya; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D012088:Reoviridae Infections / Q000453:epidemiology; D012480:Salmonella Infections / Q000453:epidemiology; D014481:United States / Q000208:ethnology; D014838:Volunteers