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. 1960;23(1):73–101.

Diarrhoeal disease and its control*

Nelson K Ordway
PMCID: PMC2555303  PMID: 14428996

Abstract

The diarrhoeal diseases are an important cause of illness throughout the world and a leading cause of death among infants and young children. Unfortunately, the greatest wealth of clinical material is found where the facilities for its study are least available. This article deals with a number of the many problems which therefore arise. The etiology is multiple, and often obscure. The relationship between the diarrhoeal diseases and malnutrition is as yet far from being elucidated. Many epidemiological questions require an answer. There is no standard treatment. Prevention, it is universally agreed, depends largely upon improvement in environmental sanitation, especially upon the provision of a safe and adequate supply of piped water, but this apparently simple measure is fraught with difficulties. Much remains to be done before anything like satisfactory control of this group of diseases can be achieved.

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Selected References

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  1. ADASME R., MENEGHELLO J., RODRIGUEZ M. Estudios sobre la Escherichia coli. II. Investigacíon de las cepas 0111, 055 y 026 en lactantes con enterocolitis aguda, toxicosis y en niños sin síndrome diarréico. Rev Chil Pediatr. 1956 May;27(5):197–201. [PubMed] [Google Scholar]
  2. ARCAYA O., COSTA A. Etiología de las diarreas infantiles. XVIII. Escherichia coli enteropatógeno en diarreas agudas y toxicosis del niño menor. Rev Chil Pediatr. 1956 Jun;27(6):233–contd. [PubMed] [Google Scholar]
  3. ARROYAVE G., BEHAR M., SCRIMSHAW N. S., TEJADA C., VITERI F. Characteristics of kwashiorkor (sindrome pluricarencial de la infancia). Fed Proc. 1956 Sep;15(3):977–985. [PubMed] [Google Scholar]
  4. BADGER G. F., CURTISS C., DINGLE J. H., HODGES R. G., JORDAN W. S., Jr, MCCORKLE L. P. A study of illness in a group of Cleveland families. XI. The occurrence of gastrointestinal symptoms. Am J Hyg. 1956 Nov;64(3):349–356. doi: 10.1093/oxfordjournals.aje.a119847. [DOI] [PubMed] [Google Scholar]
  5. BECK M. D., MUNOZ J. A., SCRIMSHAW N. S. Studies on diarrheal diseases in Central America. I. Preliminary findings on cultural surveys of normal population groups in Guatemala. Am J Trop Med Hyg. 1957 Jan;6(1):62–71. doi: 10.4269/ajtmh.1957.6.62. [DOI] [PubMed] [Google Scholar]
  6. BIELICKA I., LACKI M., SZTACHELSKA I. Niektóre zagadnienia organizacji opieki otwartej nad najmłodszym dzieckiem w świetle wycinkowej analizy zachorowalności i umieralności niemowlat z powodu biegunki. Pediatr Pol. 1956 Apr;31(4):449–458. [PubMed] [Google Scholar]
  7. BOZKOWA K. Zewnetrzne wydzielanie trzustki w ostrych stanach biegunkowych u dzieci do drugiego roku zycia. Pediatr Pol. 1956 Dec;31(12):1325–1334. [PubMed] [Google Scholar]
  8. BRAND G., DEL VILLAR A. Tratamiento de la diarrea aguda grave y toxicosis del lactante en el Hospital de Arica. Rev Chil Pediatr. 1957 Sep;28(9):370–374. [PubMed] [Google Scholar]
  9. BUTTIAUX R., GAUDIER B., LE MINOR L., LE MINOR S., NICOLLE P. Etudes sur les E. coli de gastro-entérite infantile. III. Etude epidémiologique dans un service hospitalier du nord de la France. Ann Inst Pasteur (Paris) 1956 Dec;91(6):799–809. [PubMed] [Google Scholar]
  10. CHANDLER A. C. A comparison of helminthic and protozoan infections in two Egyptian villages two years after the installation of sanitary improvements in one of them. Am J Trop Med Hyg. 1954 Jan;3(1):59–73. doi: 10.4269/ajtmh.1954.3.59. [DOI] [PubMed] [Google Scholar]
  11. CHANDLER A. C. An evaluation of the effects, after two years, of sanitary improvements in an Egyptian village. J Egypt Med Assoc. 1953;36(5-6):357–367. [PubMed] [Google Scholar]
  12. CHANDLER A. C. Interrelations between nutrition and infectious disease in the tropics. Am J Trop Med Hyg. 1957 Mar;6(2):195–208. doi: 10.4269/ajtmh.1957.6.195. [DOI] [PubMed] [Google Scholar]
  13. CHANDLER A. C. The relation of nutrition to parasitism. J Egypt Med Assoc. 1953;36(9):533–552. [PubMed] [Google Scholar]
  14. CLYDE W. A., Jr Salmonellosis in infants and children; a study of 100 cases. Pediatrics. 1957 Feb;19(2):175–183. [PubMed] [Google Scholar]
  15. COETZEE J. N., PRETORIUS P. J. The incidence of certain strains of E. coli, Shigella and Salmonella in kwashiorkor in the Pretoria area. S Afr Med J. 1956 Jul 21;30(29):688–689. [PubMed] [Google Scholar]
  16. DE LA MAZA V., AGLIATI J. El servicio de hidratación del Hospital de Niños Roberto del Rio; experiencia de 3 períodos (noviembre 1954-abril 1957). Rev Chil Pediatr. 1957 Oct-Nov;28(10-11):459–463. [PubMed] [Google Scholar]
  17. DE LA TORRE J. A. Mortalidad por diarrea infecciosa en niños hospitalizados menores de 2 años. Bol Med Hosp Infant Mex. 1956 Aug 1;13(4):785–792. [PubMed] [Google Scholar]
  18. DE SILVA C., RAFFEL O. C., SOYSA P. Pattern of children's disease and death as seen in a children's hospital, Colombo, Ceylon. Acta Paediatr. 1953 Sep;42(5):453–473. doi: 10.1111/j.1651-2227.1953.tb03643.x. [DOI] [PubMed] [Google Scholar]
  19. DEARING W. H. Micrococcic enteritis and pseudomembranous enterocolitis as complications of antibiotic therapy. Ann N Y Acad Sci. 1956 Aug 31;65(3):235–242. doi: 10.1111/j.1749-6632.1956.tb36641.x. [DOI] [PubMed] [Google Scholar]
  20. DINGLE J. H., BADGER G. F., FELLER A. E., HODGES R. G., JORDAN W. S., Jr, RAMMELKAMP C. H., Jr A study of illness in a group of Cleveland families. I. Plan of study and certain general observations. Am J Hyg. 1953 Jul;58(1):16–30. doi: 10.1093/oxfordjournals.aje.a119587. [DOI] [PubMed] [Google Scholar]
  21. DODD K., BUDDINGH J., RAPOPORT S. The etiology of ekiri, a highly fatal disease of Japanese children. Pediatrics. 1949 Jan;3(1):9–19. [PubMed] [Google Scholar]
  22. DRIEUX J., RAYNAUD DE FITTE E. Etude sur les diarrhées estivales infantiles en 1956; aspect biologique et clinique. Maroc Med. 1957 Apr;36(383):379–381. [PubMed] [Google Scholar]
  23. EICHENWALD H. F., ABABIO A., ARKY A. M., HARTMAN A. P. Epidemic diarrhea in premature and older infants caused by ECHO virus type 18. J Am Med Assoc. 1958 Mar 29;166(13):1563–1566. doi: 10.1001/jama.1958.02990130023005. [DOI] [PubMed] [Google Scholar]
  24. FLOYD T. M., HIGGINS A. R., KADER M. A. Studies in shigellosis. V. The relationship of age to the incidence of Shigella infections in Egyptian children, with special reference to shigellosis in the newborn and in infants in the first six months of life. Am J Trop Med Hyg. 1956 Jan;5(1):119–130. doi: 10.4269/ajtmh.1956.5.119. [DOI] [PubMed] [Google Scholar]
  25. FLOYD T. M. The incidence of Shigella organisms in a group of Egyptian village children. Am J Trop Med Hyg. 1954 Mar;3(2):294–302. doi: 10.4269/ajtmh.1954.3.294. [DOI] [PubMed] [Google Scholar]
  26. FRENK S., METCOFF J., GOMEZ F., RAMOS-GALVAN R., CRAVIOTO J., ANTONOWICZ I. Intracellular composition and hemostatic mechanisms in severe chronic infantile malnutrition. II. Composition of tissues. Pediatrics. 1957 Jul;20(1 Pt 1):105–120. [PubMed] [Google Scholar]
  27. GARFINKEL B. T., MARTIN G. M., WATT J., PAYNE F. J., MASON R. P., HARDY A. V. Antibiotics in acute bacillary dysentery; observations in 1,408 cases with positive cultures. J Am Med Assoc. 1953 Apr 4;151(14):1157–1160. doi: 10.1001/jama.1953.02940140001001. [DOI] [PubMed] [Google Scholar]
  28. Gordon I., Ingraham H. S., Korns R. F. TRANSMISSION OF EPIDEMIC GASTROENTERITIS TO HUMAN VOLUNTEERS BY ORAL ADMINISTRATION OF FECAL FILTRATES. J Exp Med. 1947 Oct 31;86(5):409–422. doi: 10.1084/jem.86.5.409. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. HALLMAN N., RANTASALO I., TUUTERI L., KOTILAINEN M. Incidence of dyspepsia coli (O--26; O--55; O--111) in sporadic infantile gastroenteritis. Ann Paediatr Fenn. 1954;1(1):27–33. [PubMed] [Google Scholar]
  30. HARDY A. V. Control of infant diarrheas in the light of recent scientific progress. Bol Oficina Sanit Panam. 1954 Dec;37(6):765–806. [PubMed] [Google Scholar]
  31. HIGGINS A. R., FLOYD T. M., KADER M. A. Studies in shigellosis. II. Observations on incidence and etiology of diarrheal disease in Egyptian village children. Am J Trop Med Hyg. 1955 Mar;4(2):271–280. [PubMed] [Google Scholar]
  32. HIGGINS A. R., FLOYD T. M., KADER M. A. Studies in shigellosis. III. A controlled evaluation of a monovalent Shigella vaccine in a highly endemic environment. Am J Trop Med Hyg. 1955 Mar;4(2):281–288. [PubMed] [Google Scholar]
  33. HIGGINS A. R., FLOYD T. M., KADER M. A. Studies in shigellosis. IV. A controlled trial of sulfadiazine, dihydrostreptomycin and oxytetracycline as long term prophylaxis agents in a highly endemic environment for shigellosis. Am J Trop Med Hyg. 1955 Mar;4(2):289–300. [PubMed] [Google Scholar]
  34. HOLLISTER A. C., Jr, BECK M. D., GITTELSOHN A. M., HEMPHILL E. C. Influence of water availability on Shigella prevalence in children of farm labor families. Am J Public Health Nations Health. 1955 Mar;45(3):354–362. doi: 10.2105/ajph.45.3.354. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. HUTCHINSON R. I. Some observations on the method of spread of Sonne dysentery. Mon Bull Minist Health Public Health Lab Serv. 1956 Jun;15:110–118. [PubMed] [Google Scholar]
  36. JELLIFFE D. B., BRAS G., STUART K. L. Kwashiorkor and marasmus in Jamaican infants. West Indian Med J. 1954 Mar;3(1):43–55. [PubMed] [Google Scholar]
  37. JELLIFFE D. B. Cultural blocks and protein malnutrition in early childhood in rural West Bengal. Pediatrics. 1957 Jul;20(1 Pt 1):128–138. [PubMed] [Google Scholar]
  38. JELLIFFE D. B., WYNTER-WEDDERBURN L. E., YOUNG V. M., GRANT L. S., CASELITZ F. H. Salmonellosis in Jamaican children. Doc Med Geogr Trop. 1954 Dec;6(4):315–326. [PubMed] [Google Scholar]
  39. JOHNSON R., LANDSMAN J. B. Antibiotic treatment in dysentery. Scott Med J. 1957 Oct;2(10):383–388. doi: 10.1177/003693305700201001. [DOI] [PubMed] [Google Scholar]
  40. JORDAN W. S., Jr, GORDON I., DORRANCE W. R. A study of illness in a group of Cleveland families. VII. Transmission of acute non-bacterial gastroenteritis to volunteers: evidence for two different etiologic agents. J Exp Med. 1953 Nov;98(5):461–475. doi: 10.1084/jem.98.5.461. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. KAHN E. The aetiology of summer diarrhoea. S Afr Med J. 1957 Jan 19;31(3):47–54. [PubMed] [Google Scholar]
  42. KIRBY A. C., HALL E. G., COACKLEY W. Neonatal diarrhoea and vomiting; outbreaks in the same maternity unit. Lancet. 1950 Aug 5;2(6623):201–207. doi: 10.1016/s0140-6736(50)91189-5. [DOI] [PubMed] [Google Scholar]
  43. LINDSAY D. R., STEWART W. H., WATT J. Effect of fly control on diarrheal disease in an area of moderate morbidity. Public Health Rep. 1953 Apr;68(4):361–367. [PMC free article] [PubMed] [Google Scholar]
  44. Light J. S., Hodes H. L. Studies on Epidemic Diarrhea of the New-born: Isolation of a Filtrable Agent Causing Diarrhea in Calves. Am J Public Health Nations Health. 1943 Dec;33(12):1451–1454. doi: 10.2105/ajph.33.12.1451. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. MARBERG K., ALTMANN G., ESHKOLBRUCK A. Observations on resistance to sulfadiazine and antibiotics in shigellosis. Am J Trop Med Hyg. 1958 Jan;7(1):51–57. doi: 10.4269/ajtmh.1958.7.51. [DOI] [PubMed] [Google Scholar]
  46. METCOFF J., FRENK S., GORDILLO G., GOMEZ F., RAMOS-GALVAN R., CRAVIOTO J., JANEWAY C. A., GAMBLE J. L. Intracellular composition and homeostatic mechanisms in severe chronic infantile malnutrition. IV. Development and repair of the biochemical lesion. Pediatrics. 1957 Aug;20(2):317–336. [PubMed] [Google Scholar]
  47. McCABE L. J., HAINES T. W. Diarrheal disease control by improved human excreta disposal. Public Health Rep. 1957 Oct;72(10):921–928. [PMC free article] [PubMed] [Google Scholar]
  48. NETER E., SUSKIND L. The antibody (hemagglutinin) response as a tool for etiologic diagnosis of diarrheal disease; family outbreak associated with paracolobactrum (Escherichia coli 075). J Pediatr. 1958 Jan;52(1):38–41. doi: 10.1016/s0022-3476(58)80007-4. [DOI] [PubMed] [Google Scholar]
  49. OLARTE J., JOACHIN A. La presencia de Salmonella, S. typhi, Shigella y Escherichia coli OIII B4, 055:B5 y 026:B6, en 13 545 muestras de materias fecales examinadas en el Hospital Infantil de la Ciudad de Mexico. Bol Med Hosp Infant Mex. 1957 Jun 1;14(3):249–255. [PubMed] [Google Scholar]
  50. PENIDO H. M. Prevention of mortality from diarrhoeal diseases in Brazil. Bull World Health Organ. 1959;21:368–371. [PMC free article] [PubMed] [Google Scholar]
  51. RAMOS-ALVAREZ M., SABIN A. B. Enteropathogenic viruses and bacteria; role in summer diarrheal diseases of infancy and early childhood. J Am Med Assoc. 1958 May 10;167(2):147–156. doi: 10.1001/jama.1958.02990190001001. [DOI] [PubMed] [Google Scholar]
  52. RIPLEY I., VERHOESTRAETE L. J. La auxiliar de enfermeria de salud pública en el control de las enfermedades diarrélcas. Bol Oficina Sanit Panam. 1958 Feb;44(2):114–116. [PubMed] [Google Scholar]
  53. ROSS C. A., DAWES E. A. Resistance of the breast-fed infant to gastro-enteritis. Lancet. 1954 May 15;266(6820):994–998. doi: 10.1016/s0140-6736(54)92395-8. [DOI] [PubMed] [Google Scholar]
  54. SCRIMSHAW N. S., BEHAR M., PEREZ C., VITERI F. Nutritional problems of children in Central America and Panama. Pediatrics. 1955 Sep;16(3):378–397. [PubMed] [Google Scholar]
  55. SHARMA N. L., GUPTA K. C. Studies in infantile diarrhoea. Indian J Pediatr. 1954 Nov;21(88):270–279. doi: 10.1007/BF02759879. [DOI] [PubMed] [Google Scholar]
  56. SOLIEN N. L., SCRIMSHAW N. S. Public health significance of child feeding practices observed in a Guatemalan village. J Trop Pediatr (1967) 1957 Dec;3(3):99–104. doi: 10.1093/oxfordjournals.tropej.a057473. [DOI] [PubMed] [Google Scholar]
  57. STEIN H. Antibiotic efficacy in gastroenteritis. S Afr Med J. 1955 Nov 12;29(46):1061–1063. [PubMed] [Google Scholar]
  58. STEWART W. H., McCABE L. J., Jr, HEMPHILL E. C., DeCAPITO T. Diarrheal disease control studies; the relationship of certain environmental factors to the prevalence of Shigella infection. Am J Trop Med Hyg. 1955 Jul;4(4):718–724. [PubMed] [Google Scholar]
  59. TANEJA P. N., GHAI O. P. Enteric fever in children. Indian J Pediatr. 1957 Aug;24(114):237–245. doi: 10.1007/BF02753174. [DOI] [PubMed] [Google Scholar]
  60. THOMAS M. E., CHARTER R. E. Aetiology of juvenile diarrhoea; laboratory investigation of specimens referred from general practices in North-East London. Br Med J. 1956 Aug 11;2(4988):339–341. doi: 10.1136/bmj.2.4988.339. [DOI] [PMC free article] [PubMed] [Google Scholar]
  61. THOMAS M. E. Enteritis from tortoises. Mon Bull Minist Health Public Health Lab Serv. 1957 Feb;16:29–31. [PubMed] [Google Scholar]
  62. TRUSWELL A. S. Results of out-patient treatment of infantile gastro-enteritis. S Afr Med J. 1957 May 11;31(19):446–451. [PubMed] [Google Scholar]
  63. VALENZUELA R. H. Las diarreas agudas en el niño. Gac Med Mex. 1956 Nov-Dec;86(6):443-58; discussion, 459-62. [PubMed] [Google Scholar]
  64. VENKATACHALAM P. S., PATWARDHAN V. N. The role of Ascaris lumbricoides in the nutrition of the host; effect of ascariasis on digestion of protein. Trans R Soc Trop Med Hyg. 1953 Mar;47(2):169–175. doi: 10.1016/0035-9203(53)90074-1. [DOI] [PubMed] [Google Scholar]
  65. VERHOESTRAETE L. J., PUFFER R. R. Las enfermedades diarreicas con especial referencia a las Américas. Bol Oficina Sanit Panam. 1958 Feb;44(2):95–113. [PubMed] [Google Scholar]
  66. WATT J., DeCAPITO T. The frequency and distribution of salmonella types isolated from man and animals in Hidalgo County, Texas. Am J Hyg. 1950 May;51(3):343–352. doi: 10.1093/oxfordjournals.aje.a119399. [DOI] [PubMed] [Google Scholar]
  67. WATT J., HOLLISTER A. C., Jr, BECK M. D., HEMPHILL E. C. Diarrheal diseases in Fresno County, California. Am J Public Health Nations Health. 1953 Jun;43(6 Pt 1):728–741. doi: 10.2105/ajph.43.6_pt_1.728. [DOI] [PMC free article] [PubMed] [Google Scholar]
  68. WATT J., WALTON M. Relative familial attack rates as a measure of the pathogenicity of an organism; organisms associated with diarrheal disease. Am J Hyg. 1949 Nov;50(3):263–269. doi: 10.1093/oxfordjournals.aje.a119358. [DOI] [PubMed] [Google Scholar]
  69. WATT J., WEGMAN M. E., BROWN O. W., SCHLIESSMANN D. J., MAUPIN E., HEMPHILL E. C. Salmonellosis in a premature nursery unaccompanied by diarrheal disease. Pediatrics. 1958 Oct;22(4 Pt 1):689–705. [PubMed] [Google Scholar]
  70. WEGMAN M. E. The clinical significance of bacteria in the coliform paracolon, Pseudomonas, and similar groups. Am J Trop Med Hyg. 1955 Jul;4(4):731–738. doi: 10.4269/ajtmh.1955.4.731. [DOI] [PubMed] [Google Scholar]
  71. WENTWORTH F. H., WENTWORTH B. Development of sulfadiazine resistance during an outbreak of shigellosis due to Shigella sonnei form I. AMA J Dis Child. 1957 May;93(5):551–554. doi: 10.1001/archpedi.1957.02060040553009. [DOI] [PubMed] [Google Scholar]
  72. WILSON A., LUDER J. The bacteriology, microscopy and treatment of diarrhoea in children in Uganda. J Trop Pediatr (1967) 1957 Dec;3(3):128–135. doi: 10.1093/oxfordjournals.tropej.a057470. [DOI] [PubMed] [Google Scholar]
  73. YEKUTIEL P. Epidemiological methods used in the study of infantile diarrhoea in Israel. Bull World Health Organ. 1959;21:374–381. [PMC free article] [PubMed] [Google Scholar]
  74. YEKUTIEL P., PERITZ E., MANDIL J. A field study of infantile diarrhoea in Israel. J Trop Pediatr (1967) 1958 Mar;3(4):175–183. doi: 10.1093/oxfordjournals.tropej.a057479. [DOI] [PubMed] [Google Scholar]

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