Volume 74, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


To identify enteropathogens for vaccine development, we implemented clinic-based surveillance for severe pediatric diarrhea in Egypt’s Nile River Delta. Over 2 years, a physician clinically evaluated and obtained stool samples for microbiology from patients with diarrhea and less than 6 years of age. In the first ( = 714) and second clinic ( = 561), respectively, 36% ( = 254) and 46% ( = 260) of children were infected with rotavirus, enterotoxigenic (ETEC), , or . When excluding mixed rotavirus-bacterial infections, for the first and second clinic, 23% and 10% had rotavirus-associated diarrhea, and 14% and 17% had ETEC-associated diarrhea, respectively. -associated diarrhea was 1% and 3%, and -associated diarrhea was 2% and 1%, respectively, for the two clinics. Rotavirus-associated diarrhea peaked in late summer to early winter, while bacterial agents were prevalent during summer. Rotavirus-associated cases presented with dehydration, vomiting, and were often hospitalized. Children with or -associated diarrhea reported as watery diarrhea and rarely dysentery. ETEC did not have any clinically distinct characteristics. For vaccine development and/or deployment, our study suggests that rotavirus is of principle concern, followed by ETEC, and .


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  • Received : 08 Apr 2005
  • Accepted : 20 Jun 2005

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