ENTEROTOXIGENIC ESCHERICHIA COLI AND REOVIRUS-LIKE AGENT IN RURAL BANGLADESH

48 patients admitted to a rural Bangladesh hospital with dehydration secondary to diarrhœa were examined for infection caused by reovirus-like agent (R.L.A.) or enterotoxigenic Escherichia coli (E.T.E.C.). The diagnosis of R.L.A. infection was established by electron microscopy of stool filtrates and by a fourfold or greater rise in serum complement-fixing antibodies to the Nebraska calf diarrhœa virus. Evidence of infection by heat-labile-toxin (L.T.)-producing E.T.E.C. was sought by stool culture and serological testing using the adrenal-cell tissue-culture system. Infection by heat-stable-toxin (S.T.)-producing E.T.E.C. was sought by stool culture using the infant mouse test. 12 patients, all less than two years old, had evidence of R.L.A. infection, accounting for illness in 55% of the 22 patients who were less than two years old. None of these 22 children had evidence of E.T.E.C. infection. R.L.A. diarrhœa lasted five to six days, often led to serious dehydration, and was associated with vomiting and fever. 11 cases of E.T.E.C. diarrhœa were detected, accounting for 56% of the cases of diarrhœa in the 18 patients who were more than ten years old. Diarrhœa caused by E.T.E.C. was sudden in onset, shorter in duration, and caused pronounced dehydration. In a community survey E.T.E.C. was isolated with equal frequency in the stools of control and case family members. The data suggest that E.T.E.C. is a common cause of adult diarrhœa in Bangladesh, while R.L.A. is a common cause of diarrhœa in children.