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Section 8 – Bacterial Infections

Chapter 50 – Introduction to Acute Infective Diarrhoea

C. Anthony Hart

Diarrhoeal disease is a major cause of morbidity and mortality worldwide. In a global estimate of causes of death in 1990, diarrhoeal disease was the fourth commonest after ischaemic heart disease (6.25 million deaths), cardiovascular disease (4.4 million) and respiratory tract infections (4.3 million).[1] It was responsible for approximately 3 million of the total 50.5 million deaths.

Although the burden of diarrhoeal disease is greatest in children under 5 years, and especially in developing countries, causing approximately 2 million deaths per annum,[2] adults and especially the elderly are also at risk. In general, viral enteropathogens are more important in childhood gastroenteritis in developed and developing countries alike, whereas bacterial and protozoal enteropathogens predominate in adults.[3]

In developing countries, estimates of the annual incidence of diarrhoea in children vary from 3.3 …