Enteropathogenic Escherichia Coli

Typical Enteropathogenic E. coli (EPEC) primarily causes disease in neonates and young children, with most cases occurring in children < 2 years old and particularly in those < 6 months old. Disease may occur in adults if sufficiently high inocula are ingested. Outbreaks have occurred in pediatric wards, nurseries, and day care centers and in adults that have consumed contaminated food from a buffet. In developing countries, EPEC are highly prevalent and are an important cause of childhood diarrheal disease and dehydration-associated deaths. Studies in Brazil, Mexico, and South Africa have shown that 30 -40% of infant diarrhea can be attributed to EPEC. Atypical EPEC are prevalent in both developed and developing countries. They appear to cause disease in a broader range of ages and have been associated with outbreaks in developed countries. However, the enteropathogenicity and the role of certain atypical EPEC strains is controversial. At least two case-control studies showed no statistical difference in infection rates between cases and matched controls suggesting they may be part of the normal human flora. It is likely that EPEC and atypical EPEC in particular, are vastly under-reported.

May be transmitted when handling infected cattle, dogs, cats, sheep, rabbits, and horses.