Abstract
Twenty-eight United States adult travelers to developing countries participated in a prospective study designed to determine whether there was an association between diarrheal illness and the acquisition of strains of enteropathogenic Escherichia coli. Stool specimens were collected and stored in transport media before, during, and after travel and at the onset of any diarrheal illness. From each specimen, five E. coli colonies were screened for enterotoxin production with the suckling mouse test, and three E. coli colonies were tested for penetration of epithelial cells (Serény test). Positive colonies were serotyped. Eleven of 28 travelers experienced diarrheal illness. Of these, four (36%) acquired enterotoxin-producing E. coli at the time of illness. None of the 17 well travelers had identifiable enterotoxin-producing E. coli before, during, or after travel. No strains of E. coli that penetrated epithelial cells were found. Three of the four travelers with enterotoxin-producing E. coli acquired serotype 027:K·:H20, a serotype not previously recorded at the Center for Disease Control. This study suggests that enterotoxin-producing E. coli, as detected by the suckling mouse test, may be a significant cause of traveler's diarrhea in adults.
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