First Diarrhea Outbreak of Enterotoxigenic Escherichia coli (ETEC) Infection in Taiwan, 2017

DOI: 10.6525/TEB.201905_35(9).0001

Chien-Hua Chu^1*, Wan-Chin Chen², Chia-Ping Su²,Fang-Tzy Wu³, Hsiao-Lun Wei^{3, I-Ping Lin4}

2019 Vol.35 NO.9

Correspondence Author： Chien-Hua Chu^1*

Abstract：

      Enterotoxigenic Escherichia coli (ETEC) is recognized as a leading cause of diarrhea in low-income countries with unsatisfactory sanitary conditions and among travelers to those countries. Taiwan Centers for Disease Control was notified that 206 of 360 students from a senior high school in New Taipei City developed gastro-intestinal symptoms after returning from their graduation excursion during June 6 to June 9, 2017. Stool specimens from ill students and restaurant food handlers were negative for routine enteric pathogens. Because diarrhea was more common than vomiting in this outbreak, the median incubation period was 47 hours, and the median duration of diarrhea was 97 hours, ETEC infection was highly suspected. Specimens were further tested and positive for ETEC, so the first diarrhea outbreak of ETEC infection in Taiwan was confirmed. In order to achieve early treatment and effective prevention, we recommend that ETEC should be considered as the cause of illness when stool cultures are negative for routine enteric pathogens, and the symptoms are similar to ETEC. Additionally, use of PCR techniques along with routine methods to confirm ETEC infection should be considered.