Non-seasonal viral and bacterial episode of diarrhoea in the Jordan Valley, West of Jordan.

Abstract

A non-seasonal diarrhoeal episode in the Jordan Valley occurred over a 2-month period, during which no traditional enteropathogens were detected by the health authority laboratories. A total of 17 diarrhoeal stool specimens from infants, young children and adults were randomly collected and delivered to our laboratories to investigate the presence of unusual aetiological agents. Stools were examined for parasites, ova, viruses and cultured for bacterial pathogens. A multiplex polymerase chain reaction was developed to investigate the involvement of diarrhoeagenic Escherichia coli in this episode. Recognised pathogenic organisms were detected in 8 out of 17 of the diarrhoeatic patients, one patient of whom had a mixed infection with two agents. Rotavirus, enteroinvasive E. coli (EIEC), enteropathogenic E. coli (EPEC), and enterotoxigenic E. coli (ETEC) were found to be associated with the diarrhoea. EIEC was the most common enteropathogen detected (4 out of 17) followed by rotavirus (3 out of 17). One of the EIEC isolates detected in one patient was associated with rotavirus. The clinical features of the diarrhoeatic patients were remarkably similar, regardless of aetiology. This study reveals the identity of pathogenic agents that are not detected by traditional methods employed by the health authority laboratories, which emphasise the urgent need for developing the current diagnostic techniques.