Causes: Enterotoxigenic Escherichia coli:
Volunteer feeding studies indicate that a relatively large dose (100 million to 10 billion bacteria) of enterotoxigenic E. coli is probably necessary to establish colonization of the small intestine, where these organisms proliferate and produce toxins which induce fluid secretion. With high infective dose, diarrhea can be induced within 24 hours. Infants may require fewer organisms for infection to be established. (Source: FDA Bad Bug Book)
Infection occurs when a person eats food, or drinks water or
ice contaminated with ETEC bacteria. Human or animal wastes (e.g.,
feces) are the ultimate source of ETEC contamination. (Source: excerpt from Enterotoxigenic Escherichia coli (ETEC): DBMD)
As with all medical conditions, there may be many causal factors. Further relevant information on causes of Enterotoxigenic Escherichia coli may be found in:
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Although some strains of E. coli exist as part of the normal GI flora, infection usually results from certain nonindigenous strains. For example, noninvasive diarrhea results from two toxins produced by strains called enterotoxic or enteropathogenic E. coli. Enteropathogenic E. coli serotype 0157:H7 is the most well-known strain in the United States. These toxins interact with intestinal juices and promote excessive loss of chloride and water. In the invasive form, E. coli directly invades the intestinal mucosa without producing enterotoxins, thereby causing local irritation, inflammation, and diarrhea. Normal strains can cause infection in immunocompromised patients.
Transmission can occur directly from an infected person or indirectly by ingestion of contaminated food or water or contact with contaminated utensils. Incubation takes 12 to 72 hours.
Incidence of E. coli infection is highest among travelers returning from other countries, particularly Mexico, Southeast Asia, and South America. E. coli infection also induces other diseases, especially in people whose resistance is low. The strain E. coli 0157:H7 has been associated with undercooked hamburger and with animals and petting zoos.
Source: Professional Guide to Diseases (Eighth Edition), 2005
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