Escherichia coli. EAEC, EHEC, EIEC, ETEC.

There are at least four different ways in which E. coli can cause diarrheal disease: invasion of the intestinal epithelium, enterotoxin production, STx production, and adherence with disruption of the normal functioning of the intestinal epithelium. Fecally contaminated food and water are the source of E. coli infections in humans. Travelers from industrialized countries with good sanitation systems are at risk for obtaining these organisms when they travel to the developing world, where these organisms are endemic. In the developing world, these organisms are a major cause of infant mortality. Infections in adults are usually self-limited and typically respond to oral rehydration therapy. Only in severe illness is antimicrobial therapy needed. Prevention of these infections requires good sanitation and food handling practices. In addition, travelers to the developing world should avoid certain types of food and contaminated water.