Diarrheal Disease among Military Personnel During Operation Restore Hope, Somalia, 1992–1993

Sharp, Trueman W.; Thornton, Scott A.; Wallace, Mark R.; DeFraites, Robert F.; Sánchez, José L.; Batchelor, Roger A.; Rozmajzl, Patrick J.; Hanson, R. Kevin; Echeverria, Peter; Kapikian, Albert Z.

doi:10.4269/ajtmh.1995.52.188

Cited by 63 publications

(21 citation statements)

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“…In both scenarios, antimicrobial use provides selective pressure for toxigenic strains and plasmids. Resistance rates to previously effective drugs such as the tetracyclines, trimethoprim-suphamethoxazole and ampicillin have risen to 30-90% in some parts [62,64,85,95,117]. As a consequence, quinolones became the drugs of choice for traveller's diarrhea but resistance to these drugs has also emerged.…”

Section: Enteropathogenic E Colimentioning

confidence: 99%

“…Due to resistance, quinolones have replaced doxycycline and trimethoprim-sulphamethoxazole as drugs of choice for travellers diarrhea, but quinolone resistance has since emerged and is increasing. The only promising alternative is rifaximin, a recently licensed, non-absorbable antimicrobial that can be used to treat infections by non-invasive E. coli pathotypes [85,119,[270][271][272][273]. Availability and costs mean that rifamixin is presently limited to adjusting recommendations for travellers from affluent countries to compensate for the emergence of resistance, a niche occupied until now by ciprofloxacin.…”

Section: Clinically Relevant Unanswered Questions About the Biology Omentioning

confidence: 99%

“…Shigella spp are the etiologic agents of bacillary dysentery and a common cause of travellers' [85], childhood, and adult diarrheal disease. Dysentery is a typically non-voluminous, invasive diarrheal syndrome that may, but not always, be accompanied by gross blood, leukocytes and/or mucus in stool.…”

Section: Enteroinvasive E Coli and Shigellamentioning

confidence: 99%

“…The definition is fuzzy in that some -atypical‖ strains are unavoidably typical isolates that lost the EAF after isolation and others contain parts of the plasmid but do not express bundle-forming pili [69,70]. [12,[84][85][86]. ETEC vaccines could therefore be revenue-generating and their development is consequently an area of priority research [11,87].…”

Section: Enteropathogenic E Colimentioning

confidence: 99%

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Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

Okeke

2009

J Infect Dev Ctries

120

103

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Diarrhea is a leading cause of illness and death, particularly in developing countries. Enteropathogenic Escherichia coli, enterotoxigenic E. coli (ETEC), enteroinvasive E. coli, enterohemorrhaghic E. coli (EHEC), enteroaggregative E. coli (EAEC) and diffusely adherent E. coli (DAEC) have been associated with diarrheal disease in different parts of Africa, particularly among young children, HIV-positive individuals, and visitors from abroad. Each of these E. coli pathotypes uses distinct mechanisms, which are only partially understood, to colonize infected hosts and produce diarrhea. All known diarrheagenic E. coli pathotypes have been reported from diverse locations within Africa but the true burden from these pathogens is unknown because very few studies seeking these organisms with discriminatory methodology have been performed. Recent reports implicate ETEC and EAEC in a considerable proportion of childhood and travellers' diarrheas and suggest that some sub-types of these categories may have greater epidemiological significance than others. The significant contribution of EHEC to bloody diarrhea and hemolytic uremic syndrome is underappreciated because diagnostic capacity for this pathotype is generally inferior to that for confounders such as Shigella and Entamoeba. Recent studies in Africa have revealed the worrisome emergence of antimicrobial resistance and high asymptomatic carriage rates for diarrheagenic E. coli but bacterial and host factors that predispose to disease, as well as non-human reservoirs, are largely unknown. Future diarrheal disease research needs to focus on broadening the repertoire of pathogens sought in epidemiological surveys to include multiple categories of diarrheagenic E. coli while building capacity to detect these pathogens in local reference laboratories.

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Section: Enteropathogenic E Colimentioning

confidence: 99%

Section: Clinically Relevant Unanswered Questions About the Biology Omentioning

confidence: 99%

Section: Enteroinvasive E Coli and Shigellamentioning

confidence: 99%

Section: Enteropathogenic E Colimentioning

confidence: 99%

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Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

Okeke

2009

J Infect Dev Ctries

120

103

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“…ing problem for civilian travelers and military visiting endemic regions [2][3][4][5]. Vaccine development remains a high priority given the disease burden, increasing antibiotic resistance, and growing appreciation of post-infectious sequelae associated with shigellosis [6,7].…”

Section: Introductionmentioning

confidence: 99%

Safety and immunogenicity of an intranasal Shigella flexneri 2a Invaplex 50 vaccine

Riddle¹,

Kaminski²,

Williams³

et al. 2011

Vaccine

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Results: There were no serious adverse events and the majority of adverse events (98%) were mild. Antibody secreting cells (ASC), plasma, and mucosal immune responses to Shigella antigens were detected at all three dose levels with the 690 g dose inducing the highest magnitude and frequency of responses. Vaccination with comparable doses of Invaplex 50 via the Dolphin TM resulted in higher plasma and ASC immune responses as compared to pipette delivery. Conclusion: In this trial the S. flexneri 2a Invaplex 50 vaccine was safe, well-tolerated and induced robust levels of antigen-specific intestinal IgA and ASC responses. The spray device performed well and offered an advantage over pipette intranasal delivery.Published by Elsevier Ltd.

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Immunization Against Bacterial Diseases of the Intestine

Levine

2000

J. pediatr. gastroenterol. nutr.

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Diarrheal Disease among Military Personnel During Operation Restore Hope, Somalia, 1992–1993

Cited by 63 publications

References 0 publications

Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

Safety and immunogenicity of an intranasal Shigella flexneri 2a Invaplex 50 vaccine

Immunization Against Bacterial Diseases of the Intestine

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