ABSTRACT
Escherichia coli strains that cause diarrhea are classified into four major categories: enterotoxigenic, enteroinvasive, enteropathogenic, and enterohemorrhagic E. coli. This chapter describes these four groups of E. coli and discusses their transmission from food and water. It explores a newer technique to identify these E. coli strains in food and water. The proportion of diarrhea that is food- and waterborne may be lower in developing than in developed countries because of the more varied and frequent opportunities for other modes of transmission. From volunteer studies in adults the infective dose of Enteropathogenic E. coli (EPEC) is highsuggesting that EPEC is most likely transmitted by food or water. EPEC outbreaks of gastroenteritis in adults that were either water- or foodborne have been reported from Romania, Sweden, and the United States. As reviewed by F. L. Bryan, E. coli is commonly isolated from hands of workers in the food industry in developed countries.
