Enterotoxigenic Escherichia coli: Traveler's Diarrhea Comes Home

genic Escherichia coli (ETEC) further documents the emergence of ETEC as a significant diarrheal pathogen in the United States. The main contribution of the article by Beatty and colleagues is that it describes one of the largest foodborne outbreaks ever reported in the United States (an estimated 3600 persons became ill). ETEC is the most common cause of traveler's diarrhea, which is often related to travel to developing countries (commonly referred to as "Montezuma's revenge," "Bali belly," "Tijuana trot," and "Turista"). Recent data, however, suggest that Americans no longer have to travel to developing countries to become exposed to this toxin-mediated, cholera-like infection [2, 3]. ETEC was first recognized as a cause of human illness in the 1960s [4]. The noninvasive organism colonizes the small intestine without causing mucosal damage. ETEC causes acute, self-limited, secretory diarrhea mediated through the action of heat-stable and heat-labile enterotoxins. The duration of illness is typically 3-5