38 - Infectious Diarrhea

Abstract

According to the World Health Organization, diarrheal disease is the second leading cause of death in children younger than 5 years of age worldwide. It is also the leading cause of malnutrition in children younger than 5 years of age. Globally, diarrhea alone kills more than 2000 children daily, more than the daily death rate from other deadly diseases such as human immunodeficiency virus, malaria, and measles combined. In the United States, it has been estimated that approximately 369 childhood deaths occur annually from diarrheal illness. Knowledge of diarrheal disease has increased remarkably during the past few decades, increasing our understanding of pathogenic organisms and mechanisms. Although this has led to improvements in therapy and significant reductions in mortality, diarrheal disease remains a devastating childhood condition in many countries. For example, most attributable cases of moderate-to-severe childhood diarrhea in Africa and Asia are caused by four pathogens: rotavirus, Cryptosporidium spp., enterotoxigenic Escherichia coli producing heat-stable toxin, and Shigella spp. This chapter discusses the major viral and bacterial agents of infectious diarrhea, including epidemiology, pathogenesis, clinical manifestations, diagnosis, and therapy.