Epidemiology of enterotoxigenic Escherichia coli-associated diarrheal disease occurring on board U.S. Navy ships visiting Asian ports.

Diarrhea represents a major health threat to U.S. military forces overseas, especially in developing countries. For military units, this illness can adversely affect combat readiness. USNAMRU-2 investigators joined several U.S. Navy ships to assess the epidemiology of diarrhea illness as a result of port visits to Asia. The primary goals were to enumerate episodes of diarrhea associated with port visits, identify epidemiologic factors leading to illness, and characterize the etiologic agents. Enterotoxigenic Escherichia coli (ETEC) was the most common organism isolated from patients presenting with diarrhea and represented 22% of diarrhea cases. Vomiting and abdominal pain differentiated ETEC from other causes of diarrhea.