Enterotoxigenic Escherichia coli diarrhea of travelers: A prospective study of American Peace Corps Volunteers

D. A. Sack, D. C. Kaminsky, R. B. Sack, I. A. Wamola, F. Orskov, I. Orskov, R. C. Slack, R. R. Arthur, A. Z. Kapikian

Research output: Contribution to journalArticlepeer-review


Travelers' diarrhea was studied prospectively in a group of 39 American Peace Corps Volunteers (PCVs) during their first five weeks in Kenya. Twenty-seven developed diarrheal disease and 12 remained well. Multiple episodes were documented in 11 of the symptomatic volunteers. Enterotoxigenic Escherichia coli of many serotypes producing heat-labile and/or heat-stable enterotoxin were isolated from 17 of the 27 volunteers with diarrhea and from 1 of the 12 well volunteers. The enterotoxigenic E. coli were more likely to be antibiotic sensitive than the nonenterotoxigenic E. coli. A serum antibody rise to the heat-labile toxin (LT) was detected in six symptomatic volunteers, five of whom had a positive culture for LT-producing E. coli, and from one asymptomatic, culture negative volunteer. Salmonella cubana was isolated from two volunteers, and three volunteers had serologic evidence of infection with human reovirus-like (rotavirus) agent. This study confirms the role of enterotoxigenic E. coli as a major cause of travelers' diarrhea and suggests that the disease is similar in widely separated geographic areas.

Original languageEnglish (US)
Pages (from-to)63-70
Number of pages8
JournalJohns Hopkins Medical Journal
Issue number2
StatePublished - 1977

ASJC Scopus subject areas

  • Medicine(all)


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