Table 2.
Exposure or Condition Associated With Pathogens Causing Diarrhea
| Exposure or Condition | Pathogen(s) |
|---|---|
| Foodborne | |
| Foodborne outbreaks in hotels, cruise ships, resorts, restaurants, catered events | Norovirus, nontyphoidal Salmonella, Clostridium perfringens, Bacillus cereus, Staphylococcus aureus, Campylobacter spp, ETEC, STEC, Listeria, Shigella, Cyclospora cayetanensis, Cryptosporidium spp |
| Consumption of unpasteurized milk or dairy products | Salmonella, Campylobacter, Yersinia enterocolitica, S. aureus toxin, Cryptosporidium, and STEC. Listeria is infrequently associated with diarrhea, Brucella (goat milk cheese), Mycobacterium bovis, Coxiella burnetii |
| Consumption of raw or undercooked meat or poultry | STEC (beef), C. perfringens (beef, poultry), Salmonella (poultry), Campylobacter (poultry), Yersinia (pork, chitterlings), S. aureus (poultry), and Trichinella spp (pork, wild game meat) |
| Consumption of fruits or unpasteurized fruit juices, vegetables, leafy greens, and sprouts | STEC, nontyphoidal Salmonella, Cyclospora, Cryptosporidium, norovirus, hepatitis A, and Listeria monocytogenes |
| Consumption of undercooked eggs | Salmonella, Shigella (egg salad) |
| Consumption of raw shellfish | Vibrio species, norovirus, hepatitis A, Plesiomonas |
| Exposure or contact | |
| Swimming in or drinking untreated fresh water | Campylobacter, Cryptosporidium, Giardia, Shigella, Salmonella, STEC, Plesiomonas shigelloides |
| Swimming in recreational water facility with treated water | Cryptosporidium and other potentially waterborne pathogens when disinfectant concentrations are inadequately maintained |
| Healthcare, long-term care, prison exposure, or employment | Norovirus, Clostridium difficile, Shigella, Cryptosporidium, Giardia, STEC, rotavirus |
| Child care center attendance or employment | Rotavirus, Cryptosporidium, Giardia, Shigella, STEC |
| Recent antimicrobial therapy | C. difficile, multidrug-resistant Salmonella |
| Travel to resource-challenged countries | Escherichia coli (enteroaggregative, enterotoxigenic, enteroinvasive), Shigella, Typhi and nontyphoidal Salmonella, Campylobacter, Vibrio cholerae, Entamoeba histolytica, Giardia, Blastocystis, Cyclospora, Cystoisospora, Cryptosporidium |
| Exposure to house pets with diarrhea | Campylobacter, Yersinia |
| Exposure to pig feces in certain parts of the world | Balantidium coli |
| Contact with young poultry or reptiles | Nontyphoidal Salmonella |
| Visiting a farm or petting zoo | STEC, Cryptosporidium, Campylobacter |
| Exposure or condition | |
| Age group | Rotavirus (6–18 months of age), nontyphoidal Salmonella (infants from birth to 3 months of age and adults >50 years with a history of atherosclerosis), Shigella (1–7 years of age), Campylobacter (young adults) |
| Underlying immunocompromising condition | Nontyphoidal Salmonella, Cryptosporidium, Campylobacter, Shigella, Yersinia |
| Hemochromatosis or hemoglobinopathy | Y. enterocolitica, Salmonella |
| AIDS, immunosuppressive therapies | Cryptosporidium, Cyclospora, Cystoisospora, microsporidia, Mycobacterium avium–intercellulare complex, cytomegalovirus |
| Anal-genital, oral-anal, or digital-anal contact | Shigella, Salmonella, Campylobacter, E. histolytica, Giardia lamblia, Cryptosporidium as well as sexually transmitted infections |
Abbreviations: ETEC, enterotoxigenic Escherichia coli; STEC, Shiga toxin–producing Escherichia coli.