A Foodborne Outbreak of EnterotoxigenicEscherichia coliDiarrhea

Abstract

AFTER the discovery that Escherichia coli could produce a pathogenic toxin,¹ toxigenic Esch. coli was identified as a major cause of childhood diarrhea in the less-developed parts of the world^{2 , 3} and as the leading cause of travelers' diarrhea.^{4 , 5} Despite worldwide distribution,⁶ cases of diarrhea caused by toxigenic Esch. coli are rarely detected in the United States.⁷ Five outbreaks have been reported: three in nurseries^{8 9 10} and two after exposure to a common source.^{11 , 12} Apart from person-to-person transmission in nurseries, only water has been conclusively demonstrated as a vehicle of transmission.¹² In this paper we describe a common-source outbreak of toxigenic Esch. . . .