Infectious Enteric Disease

According to the World Health Organization, diarrhea caused by pathogenic bacteria, viruses, and parasites is the leading cause of malnutrition and the second-leading cause of death in children under five. In children alone, the annual global incidence of diarrhea is 1.7 billion cases per year. Sadly, approximately 525,000 children under the age of five die annually from this preventable, treatable illness. In developing countries, the most common enteric pathogens responsible for life-threatening diarrhea are rotavirus, pathogenic strains of Escherichia coli such as enterotoxigenic E. coli (ETEC), Cryptosporidium, and Shigella. Common risk factors for enteric infection include poverty, malnutrition, inadequate sanitation, poor hygienic practices, and lack of access to safe drinking water. To address infant malnutrition, the WHO strongly recommends that mothers breastfeed their infants exclusively for at least the first 6 months of life so that they derive full benefit from the balanced nutrition and protective, anti-diarrheal components contained in human breastmilk.

Another clinically significant infectious enteric disease is antibiotic-resistant Clostridium difficile (C. diff), a major cause of infection in hospitals, clinics, nursing homes, and other medical settings, and currently one of the fastest-developing multidrug-resistant “superbugs.” More than 29,000 deaths annually in the US alone are attributable to C. diff infection. C. diff infection generally begins as an outgrowth after antibiotic disruption of normal gut flora, and causes diarrhea, abdominal pain, fever, nausea and vomiting. Because the strong antibiotics required to treat C. diff cause continued disruption of gut bacteria, infection recurs in as many as 20 percent of cases.