Biopharmaceutical Solutions

Background information

• What is Enterotoxigenic E. coli (ETEC)?
  Enterotoxigenic E. coli (ETEC), a virulent strain of the bacterium Escherichia coli, is a major cause of severe diarrhea leading to hospitalization. Infection by this bacterium is a leading killer of children in the developing world. 
• Global Burden
  Each year an estimated 300 million to 400 million new infections of ETEC result in 400,000 to 500,000 deaths. Ninety percent of these deaths occur in lower income countries. ETEC is a major cause of childhood diarrhea; most fatal cases occur in children under the age of two. ETEC is also the leading cause of travelers’ diarrhea.
• Geographic Distribution
  ETEC cases are reported worldwide; incidence rates are highest in Central and South America, Africa, and Southeast Asia.
• Causative Agent/Transmission
  E. coli is a bacterium with numerous serotypes, most of which normally inhabit the human intestinal tract with little ill effect. Several strains, however, secrete toxins that act on the intestinal lining and cause disease. E. coli that cause diarrheal illness can be broken down into four categories based on virulence mechanism: enterotoxigenic (ETEC), enteropathogenic (EPEC), enteroinvasive (EIEC), and enteroaggregative (EAggEC). ETEC is transmitted through food or water contaminated with human or animal feces.

Presentation

Toxins released by gut-colonizing ETEC cause water and salts to be lost into the intestine, resulting in watery diarrhea, abdominal cramping, fever, and vomiting. Death is caused by extreme dehydration.

Trends

The disease burden associated with ETEC and other diarrheal infections remains enormous across all developing countries. ETEC is also a concern for travelers visiting the developing world.

Although ETEC can be treated with antibiotics, the most effective drugs are prohibitively expensive. Misuse of antibiotics has led to drug resistant ETEC strains.

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