Enterotoxigenic ''Escherichia coli'' (ETEC) is a type of ''

Escherichia coli ''Escherichia coli'' ( )Wells, J. C. (2000) Longman Pronunciation Dictionary. Harlow ngland Pearson Education Ltd. is a gram-negative, facultative anaerobic, rod-shaped, coliform bacterium of the genus '' Escherichia'' that is commonly fo ...

'' and one of the leading bacterial causes of

diarrhea Diarrhea (American English), also spelled diarrhoea or diarrhœa (British English), is the condition of having at least three loose, liquid, or watery bowel movements in a day. It often lasts for a few days and can result in dehydration d ...

in the developing world, as well as the most common cause of travelers' diarrhea. Insufficient data exists, but conservative estimates suggest that each year, about 157,000 deaths occur, mostly in children, from ETEC. A number of

pathogen In biology, a pathogen (, "suffering", "passion" and , "producer of"), in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a Germ theory of d ...

ic isolates are termed ETEC, but the main hallmarks of this type of

bacterium Bacteria (; : bacterium) are ubiquitous, mostly free-living organisms often consisting of one biological cell. They constitute a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria were among the ...

are expression of one or more enterotoxins and presence of fimbriae used for attachment to host intestinal cells. The bacterium was identified by the Bradley Sack lab in

Kolkata Kolkata, also known as Calcutta ( its official name until 2001), is the capital and largest city of the Indian state of West Bengal. It lies on the eastern bank of the Hooghly River, west of the border with Bangladesh. It is the primary ...

in 1968.

Signs and symptoms

Infection with ETEC can cause profuse, watery diarrhea with no blood or leukocytes and abdominal cramping. Fever, nausea with or without vomiting, chills, loss of appetite, headache, muscle aches and bloating can also occur, but are less common.

Pathogenic factors

Attachment

ETEC use fimbrial colonization factor (CF) or coli surface (CS) antigens to attach to red blood cells in the upper small intestine. There are several types of CF antigens; the same is true of CS.

Enterotoxins

ETEC send toxins into target cells after successful attachment. Enterotoxins produced by ETEC include heat-labile enterotoxin (LT) and heat-stable enterotoxin (ST).

Prevention

To date, no licensed vaccines specifically target ETEC, though several are in various stages of development. Studies indicate that protective immunity to ETEC develops after natural or experimental infection, suggesting that vaccine-induced ETEC immunity should be feasible and could be an effective preventive strategy. Prevention through vaccination is a critical part of the strategy to reduce the incidence and severity of diarrheal disease due to ETEC, particularly among children in low-resource settings. The development of a vaccine against this infection has been hampered by technical constraints, insufficient support for coordination, and a lack of market forces for research and development. Most vaccine development efforts are taking place in the public sector or as research programs within biotechnology companies. ETEC is a longstanding priority and target for vaccine development for the

World Health Organization The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...

Management

Treatment for ETEC infection includes rehydration therapy and antibiotics, although ETEC is frequently resistant to common antibiotics. Improved

sanitation Sanitation refers to public health conditions related to clean drinking water and treatment and disposal of human excreta and sewage. Preventing human contact with feces is part of sanitation, as is hand washing with soap. Sanitation systems ...

is also key. Since the transmission of this bacterium is fecal contamination of food and water supplies, one way to prevent infection is by improving public and private health facilities. Another simple prevention of infection is by drinking factory bottled water—this is especially important for travelers and traveling military—though it may not be feasible in developing countries, which carry the greatest disease burden.

References

External links

US Centers for Disease Control and Prevention: Enterotoxigenic ''Escherichia coli''

Vaccine Resource Library: Shigellosis and enterotoxigenic ''Escherichia coli'' (ETEC)
{{Digestive system diseases Escherichia coli