NAME: Escherichia coli, enterotoxigenic
SYNONYM OR CROSS REFERENCE: ETEC, traveller's diarrhea, gastroenteritis
CHARACTERISTICS: Gram negative rod; motile, aerobic; produces a heat labile enterotoxin (LT) and a heat stabile enterotoxin (ST)
PATHOGENICITY: Self-limiting cholera-like disease in infants and adults; profuse watery diarrhea without blood or mucous; abdominal cramping, vomiting, acidosis, prostration, malaise and dehydration can occur; fever may or may not be present; symptoms usually lasts fewer than 5 days
EPIDEMIOLOGY: Usually sporadic, particularly in underdeveloped countries; may cause common source outbreaks; one of two major leading causes of diarrhea in children in developing countries; has become the leading bacterial cause of gastroenteritis outbreaks on cruise ships; accounts for 40-60% of all cases of traveller's diarrhea
HOST RANGE: Humans, livestock, most mammals; species specific, no known non - human hosts for human ETEC
INFECTIOUS DOSE: 100,000,000 organisms to 10,000,000,000 organisms (108 to 1010 ) by ingestion
MODE OF TRANSMISSION: Fecal-oral route; poor sanitation; fecal contamination of food, water or fomites; poor personal hygiene
INCUBATION PERIOD: 24-72 hours
COMMUNICABILITY: Communicable for duration of fecal excretion (several weeks)
RESERVOIR: Humans, animals; ETEC infections are largely species specific; humans constitute the reservoir for strains causing diarrhea in humans
ZOONOSIS: No
VECTORS: None
DRUG SUSCEPTIBILITY: Sensitive to wide spectrum of antibiotics; quinolines first choice treatment worldwide
DRUG RESISTANCE: tetracyclines, trimethroprim-sulfamethorazole approximately 40%
SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to many disinfectants - 1% sodium hypochlorite, 70% ethanol, glutaraldehyde, iodines, phenolics, formaldehyde
PHYSICAL INACTIVATION: Inactivated by moist heat (121° C for at least 15 min) and dry heat (160-170° C for at least 1 hour)
SURVIVAL OUTSIDE HOST: Dust 4 to 27 days; feces - up to 84 days; fingertip - 45 min; soil - up to 84 days
SURVEILLANCE: Monitor for symptoms; confirm bacteriologically
FIRST AID/TREATMENT: Electrolyte fluid therapy (oral or IV); antibiotics may be administered in very severe cases
IMMUNIZATION: oral vaccine under development
PROPHYLAXIS: Short term antibiotic therapy with TMP-SMX or doxycycline for travellers going to high-risk areas with no safe food or water
LABORATORY-ACQUIRED INFECTIONS: 2 reported cases of laboratory infections with E. coli
SOURCES/SPECIMENS: Feces; contaminated food, water, fomites
PRIMARY HAZARDS: Ingestion
SPECIAL HAZARDS: None
CONTAINMENT REQUIREMENTS: Biosafety level 2 practices, containment equipment and facilities for activities involving cultures and infected clinical materials
PROTECTIVE CLOTHING: Laboratory coat; gloves when contact with infectious materials is unavoidable
OTHER PRECAUTIONS: Good personal hygiene and frequent handwashing
SPILLS: Allow aerosols to settle; wearing protective clothing, gently cover spill with absorbent paper towel and apply 1% sodium hypochlorite, starting at perimeter and working towards the centre; allow sufficient contact time (30 min) before clean up
DISPOSAL: Decontaminate before disposal; steam sterilization, chemical disinfection
STORAGE: In sealed containers that are appropriately labelled
Date prepared: January, 2001
Prepared by: Office of Laboratory Security, PHAC
Although the information, opinions and recommendations contained in this Material Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.
Copyright ©
Health Canada, 2001