I thank Ghenghesh and colleagues for their interest and comments on the paper ‘Enterohaemorrhagic Escherichia coli O157: a survey of dairy cattle in Tripoli, Libya’ (1). The Libyan data presented by Ghenghesh et al. in the 1990s were based on the analysis of stool specimens from pediatric patients aged between only a few days to 3 years, admitted to one hospital and involving different enteric organisms (2, 3). This study design limits the ability to make broad conclusions on the prevalence of E. coli O157 throughout all of Libya. A recent limited study detected E. coli O157 in 0.7% of children presented with diarrheal illness to a local hospital in Libya (4). Thus, well-designed epidemiological studies are needed to estimate the burden of E. coli O157 in Libya.