ABSTRACT
More than a century ago, in 1885, the German paediatrician Theodore Escherich described for the first time a bacterium that could be found in the faeces of healthy individuals and that was called Bacterium coli commune. This facultative anaerobic micro-organism, known today as Escherichia coli, is a normal inhabitant of the large intestine of mammals and birds where it fulfils an important role in the intestinal physiology. It has taken quite some time to realise that some strains of E. coli are the causative agents of diseases as different as diarrhoea, urinary tract infections, cystitis, pyelonephritis, meningitis, peritonitis, septicemia and gram-negative pneumonia. It is surprising that it was 1945 before Bray and Beavan could unequivocally prove that E. coli may be diarrhoegenic in man, especially in children (for a detailed historical review and early references mentioned in this introduction see Robins-Browne, 1987). Outbreaks of severe, often mortal diarrhoea in children have been described both in the USA and Europe since the second half of the seventeenth century. Several investigators had noticed that diarrhoea, especially in childhood, is most prominent during the summer and consequently was also referred to as ‘summer diarrhoea’, and that the disease was most prevalent during the first two years of life at the age of weaning. At the beginning of this century, studies conducted in Britain showed a clear correlation between the socioeconomic status of children and mortality by diarrhoea, and also that breast-feeding was protective against the disease.
