Enterotoxigenic Escherichia coli (ETEC) is an important cause of diarrhea around the world. It may go undiagnosed if specific testing is not performed.
It is a common cause of traveler's diarrhea and an important cause of diarrhea in developing countries. It can cause outbreaks of foodborne disease.
Exposures are related to fecal-oral spread and may include:
(1) contaminated water
(2) unwashed and uncooked vegetables
(3) contaminated meat products, especially pork and poultry
(4) raw seafood
(5) unpasteurized milk
The bacteria can release both heat-labile (LT) and heat stable (ST) enterotoxins.
The incubation period ranges from 10 to 72 hours with median 48 hours.
Clinical features:
(1) cholera-like watery diarrhea
(2) abdominal cramps
(3) nausea and vomiting
(4) fever
(5) weakness
Laboratory analysis:
(1) isolation of E. coli from the patient that is toxigenic, as determined by assay
(2) isolation of E. coli from implicated food that is toxigenic
(3) molecular identification
