Diarrheal diseases, bacterial

Centers for Disease Control and Prevention. 2003. Mary Ann Liebert, Inc., Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, http //www.cdc. gov/narms/publications/2003/a anderson 2003.pdf (accessed June 16, 2006). 

In diseases of the small intestine, active secretion caused by cyclic nucleotide stimulation can result in a large volume of water and electrolytes moving into the lumen. Additionally, enteric neuron activation of mast cells can increase intestinal capillary permeability and promote passive fluid secretion. Diseases that increase intestinal permeability can result in passive secretion of protein-rich fluid into the intestinal lumen. Active secretion of electrolytes and water is a feature of many diarrheal disorders and can be stimulated by bacterial enterotoxins. Several bacterial enterotoxins interact with intestinal epithelial cell membrane adenylate cyclase or guanylate cyclase, resulting in increased cAMP or cGMP. These, in turn, activate basolateral chloride channels, resulting in an increase in the luminal secretion of chloride, accompanied by sodium and followed by water (Gemmell 1984). Bacterial enterotoxins that stimulate cAMP include cholera toxin, Escherichia coli... 

Acute viral diarrheal illness often occurs in day care centers and nursing homes. As person-to-person contact is the mechanism by which viral disease spreads, isolation techniques must be initiated. For bacterial, parasite, and protozoal infections, strict food handling, sanitation, water, and other environmental hygiene practices can prevent transmission. If diarrhea is secondary to another illness, controlling the primary condition is necessary. Antibiotics and bismuth subsalicylate are advocated to prevent traveler s diarrhea, in conjunction with treatment of drinking water and caution with consumption of fresh vegetables. 

---