The diarrhoeal diseases in England and Wales, with special reference to those caused by Salmonella, Escherichia and Shigella.

The diarrhoeal diseases are now a minor cause of death in England and Wales, although they remain a major cause of acute illness in children and of absenteeism among adults. Since the Second World War there has been a general rise in the annual number of Salmonella infections, with, however, a drop in the years 1956 and 1957. Infection with Shigella sonnei-the only member of the dysentery group which causes disease at all commonly in England and Wales-has shown a steady increase. Escherichia coli infection has fallen considerably but continues to be a common cause of infantile diarrhoea.A number of environmental factors are discussed in connexion with these three main agents of diarrhoeal disease; and in a consideration of sources of infection the author suggests that while cases of clinical illness are the most important source of illness due to Sh. sonnei and E. coli, human foods, animal feeding stuffs and fertilizers are also responsible for much infection with the salmonellae. The different serotypes or Salmonella and E. coli are reviewed in relation to the epidemiology of the diseases they give rise to.