ABSTRACT
Enteric infections exact a heavy toll on human populations, particularly among children. Despite the explosion of knowledge on the pathogenesis of enteric diseases experienced during the past decade, the number of diarrheal episodes and childhood deaths reported worldwide remains of apocalyptic dimensions. In the next 15s, a child somewhere in the world will die from diarrhea. Worldwide, it is estimated that 6-60 billion cases of gastrointestinal illness occur annually, the vast majority being severe enough and affecting so many unprivileged populations to pose a serious global health burden. In overpopulated developing countries, poor sanitation and hygiene, unsafe water supplies and limited education contribute to the propagation of diarrheal diseases. In industrialized nations, diarrhea had been thought of as more of an inconvenience rather than a serious cause of illness, but recent attention to food contamination by pathogens such as Salmonella and Escherichia coli, in combination with a growing population of immunosuppressed patients, has led to increased recognition of their impact. The situation is further complicated by the recent escalation of international terrorism that is raising the risk of epidemics of enteric pathogens beyond the boundaries of natural endemic areas.
