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Waterborne transmission and the evolution of virulence among gastrointestinal bacteria

Published online by Cambridge University Press:  15 May 2009

P. W. Ewald
Affiliation:
Department of Biology, Amherst College, Amherst, Massachusetts 01002, USA
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Diarrhoeal diseases are primary contributors to millions of deaths annually. Yet, little is known about the evolutionary reasons for the differences in virulence among gastrointestinal pathogens. Applying the comparative, cost/benefit approach of evolutionary biology this paper proposes that waterborne transmission should favour evolution towards high virulence. This hypothesis is supported by a cross-specific test, which shows that waterborne transmission is strongly correlated with the virulence of bacterial gastrointestinal pathogens of humans. Alternative explanations of this correlation are not supported by available data. These findings bear on public health policy because they draw attention to a previously unrecognized long-range benefit gained from purification of water supplies: diarrhoeal pathogens may evolve to lower levels of virulence.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1991

References

1.Puffer, RR. Serrano, CV. Patterns of mortality in childhood. Pan Am Health Organization Scientific Publication No. 262, Washington, D.C., 1973.Google Scholar
2.Rohde, JE. Northup, RS. Taking science where the diarrhoea is. In: Acute diarrhoea in childhood. Ciba Foundation Symposium 42, Amsterdam: North Holland. 1976: 339–66.Google Scholar
3.Rowland, MGM, Cole, TJ, Whitehead, RG. A quantitative study into the role of infection in determining nutritional status in Gambian village children. Br J Nutr 1977; 37: 441–50.CrossRefGoogle ScholarPubMed
4.Walsh, J. Warren, K. Selective primary health care: an interim strategy for disease control in developing countries. New Engl J Med 1979; 301: 967–74.CrossRefGoogle ScholarPubMed
5.Roy, SK, Chowdhury, AKMA, Rahaman, MM. Excess mortality among children discharged from hospital after treatment for diarrhoea in rural Bangladesh. Br Med J 1983; 287: 1097–9.CrossRefGoogle ScholarPubMed
6.Ewald, PW. Cultural vectors, virulence, and the emergence of evolutionary epidemiology. Oxford Surv Evol Biol 1988; 5: 215–45.Google Scholar
7.Anderson, RM, May, RM. Coevolution of hosts and parasites. Parasitology 1982; 85: 411–26.Google Scholar
8.Ewald, PW. Host–parasite relations, vectors, and the evolution of disease severity. Ann Rev Ecol Syst 1983; 14: 465–85.CrossRefGoogle Scholar
9.Levin, S Some approaches to modelling of coevolutionary interactions. In: Nitecki, M, ed. Coevolution. Chicago: University of Chicago Press, 1983: 2165.Google Scholar
10.May, RM, Anderson, RM. Epidemiology and genetics in the Coevolution of parasites and hosts. Proc R Soc Lond, Series B 1983; 219: 281313.Google Scholar
11.Williams, GC. Adaptation and natural selection. Princeton, NJ: Princeton University Press, 1964.Google Scholar
12.Hamilton, WD. The genetical evolution of social behavior. I. II. J Theor Biol 1964; 7: 152.Google Scholar
13.Prescott, SC, Horwood, MP. Sedgwick's principles of sanitary science and public health. New York: Macmillan Co., 1935.Google Scholar
14.Seal, SC, Banerjea, RK. Incidence of gastro-intestinal disorders in relation to the drinking-water sources in a rural area in Bengal. J. Indian Med Assoc 1949; 18: 319–26.Google Scholar
15.Pollitzer, K. Cholera. World Health Organization MonographSeries Number 43. World Health Organization: Geneva, 1959.Google Scholar
16.Snow, J. On the mode of communication of cholera. 2nd ed.London: Churchill, 1936 (reprint of 1855 edition).Google Scholar
17.Levine, RJ, Khan, MR, D'Souza, S, Nalin, DR. Cholera transmission near a cholera hospital. Lancet 1976; ii: 84–6.Google Scholar
18.Mhalu, FS, Mmari, PW, Ijumba, J. Rapid emergence of El Tor Vibrio cholerae resistant to antimicrobial agents during first 6 months of 4th cholera epidemic in Tanzania. Lancet 1979; i: 345–7.CrossRefGoogle Scholar
19.Ewald, PW. Evolutionary biology and treatment of signs and symptoms of infectious disease. J Theor Biol 1980; 86: 169–76.Google Scholar
20.Sokal, RR, Rohlf, FJ. Biometry. San Francisco: W. H. Freeman, 1981.Google Scholar
21.Sommers, HM. Infectious diarrhea. In: Youmans, GP, Patterson, PY, Sommers, HM, eds. Biological and clinical basis of infectious disease. 2nd ed.Philadelphia: W. B. Saunders, 1980: 525–53.Google Scholar
22.Rogers, L. Cholera and its treatment. London: Oxford University Press, 1911.Google Scholar
23.Woodworth, JM. The cholera epidemic of 1873 in the United States. U.S. Government Printing Office, Washington D.C., 1875.Google Scholar
24.Oseasohn, R, Ahmad, S, Islam, MA, Rahman, ASMM. Clinical and bacteriological findings among families of cholera patients. Lancet 1966; i: 340–2.Google Scholar
25.Mosley, WH, Ahmad, S, Benenson, AS, Ahmed, A. The relationship of vibriocidal antibody titre to susceptibility to cholera in family contacts of cholera patients. Bull WHO 1968; 38: 777–85.Google ScholarPubMed
26.Bart, KJ, Huq, Z, Khan, M, Mosley, WH. Seroepidemiologic studies during a simultaneous epidemic of infections with El tor, Ogawa. and classical Inaba Vibrio cholerae. J Infect Dis 1970; 121 (suppl): 1724.CrossRefGoogle ScholarPubMed
27.Woodward, WE, Mosley, WH. The spectrum of cholera in rural Bangladesh. II. Comparison of El Tor. Ogawa, and classical Inaba infection. Am J Epidemiol 1972; 96: 342–51.CrossRefGoogle ScholarPubMed
28.Shahid, NS, Samadi, AR, Khan, MU, Huq, MI. Classical and El Tor cholera: a prospective family study of a concurrent outbreak. J Diarrhoeal Dis Res 1984; 2: 73–8.Google Scholar
29.Tamayo, JF, Mosley, WH, Avero, MG et al. , Studies of cholera El Tor In the Philippines. 3. Transmission of infection among household contacts of cholera patients. Bull WHO 1965; 33: 645–9.Google ScholarPubMed
30.Sinha, R, Deb, BC, De, SPM, Agou-Gareeb, AH, Shrivastava, DL. Cholera carrier studies in Calcutta in 1966–67. Bull WHO 1967; 37: 89100.Google Scholar
31.Khan, M, Shahidullah, M. Contrasting epidemiology of Shigella dysenteriae and Shigellae flexneri. Trans R Soc Trop Med Hyg 1980; 74: 528–33.CrossRefGoogle ScholarPubMed
32.Hughes, JM, Boyce, JM, Levine, RJ et al. , Epidemiology of El Tor cholera in rural Bangladesh: importance of surface water in transmission. Bull WHO 1982; 60: 395404.Google Scholar
33.Bhatty, MA. Cholera in South Asia. 1961–1966. [M.D. thesis.] University of Heidelberg, 1969.Google Scholar
34.Murphy, WJ, Petne, LM, Morris, . Incidence of typhoid fever in a population exposed to contaminated industrial water supply. Industrial Med 1944; 13: 995–7.Google Scholar
35.Whipple, GC. Typhoid fever: its causation, transmission, and prevention. New York: Wiley, 1908.Google Scholar
36.Ridlion, JR. Investigation of typhoid fever at Texarkana, Ark-Tex (milk outbreak). Public Health Rep 1912; 27: 219–27.CrossRefGoogle Scholar
37.Jordan, EO, Irons, EE. The Rockford Illinois typhoid epidemic. J Infect Dis 1912; 11: 2143.CrossRefGoogle Scholar
38.Hunt, CJ. Epidemiologic diagnosis and management of typhoid fever. J Infect Dis 1913; 12: 415–31.Google Scholar
39.Sawyer, WA. 93 persons infected by a typhoid carrier at a public dinner. JAMA 1914; 63: 1537–42.CrossRefGoogle Scholar
40.Rich, ED. A typhoid fever epidemic traced to cheese. Am J Public Health 1923; 13: 210–5.Google Scholar
41.Anonymous. Another water supply accident. JAMA 1920; 74: 606–7.Google Scholar
42.Christian, HA. Osler's principles and practice of medicine, 14th ed.New York and London: D. Appleton-Century, 1938: 154.Google Scholar
43.Sears, FW. A water-borne typhoid fever outbreak with unusual epidemiological features. Am J Public Health 1931; 21: 1019–23.Google Scholar
44.Wolman, A, Gorman, AE. The significance of waterborne typhoid fever outbreaks. 1920–1930. Baltimore: Williams & Wilkins, 1931.CrossRefGoogle Scholar
45.Dean, AS. Olean City epidemic of typhoid fever in 1928. Am J Public Health 1931; 21: 390402.CrossRefGoogle ScholarPubMed
46.Ritchie, J, Armstrong, E. A waterborne epidemic of typhoid fever. J Hyg 1932; 32: 417–30.CrossRefGoogle ScholarPubMed
47.Huckstep, R. Typhoid fever and other salmonella infections. Edinburgh: Livingstone, 1962.Google Scholar
48. Anonymous. Outbreak of typhoid. JAMA 1939; 113: 1885.Google Scholar
49. Anonymous. Typhoid near Winnipeg. JAMA 1940; 114: 2042.Google Scholar
50.Shiga, K. Observations on the epidemiology of dysentery in Japan. J Philippine Science 1906; 1: 485500.Google Scholar
51.Buchanan, WJ. A study of the outbreak of bacillary dysentery. Lancet 1918; ii: 166–8.CrossRefGoogle Scholar
52.Stokes, A, Bigger, JW. A short account of dysentery in Dublin in the autumn of 1919. Dublin J Med Sci. 4th Series 1920; 1: 38.CrossRefGoogle Scholar
53.Block, NB, Ferguson, W. An outbreak of Shiga dysentery in Michigan, 1938. Am J Public Health 1940; 30: 4352.Google Scholar
54.Felsen, J. Dysentery colitis and enteritis. Philadelphia: W. B. Saunders, 1945.Google Scholar
55.Caudill, FW, Teague, RE, Duncan, JT. A rural Shiga dysentery epidemic. JAMA 1942; 116: 1402–6.CrossRefGoogle Scholar
56.Levine, MM, Dupont, H, Formal, SP, Gangarosa, EJ. Epidemic Shiga dysentery in Central America. Lancet 1970; ii: 607.CrossRefGoogle Scholar
57.Rahaman, MM, Khan, MU, Aziz, KMS, Islam, MS, Kibirya, AKMG. An outbreak of dysentery caused by Shigella dysenteriae 1 on a coral island in the Bay of Bengal. J Infect Dis 1975; 132: 15–9.CrossRefGoogle ScholarPubMed
58.Fitz-Gerald, WE. An outbreak of bacillary dysentery in a boys' school. Lancet 1931; ii: 1051–2.Google Scholar
59.Wade, TW. Report on a dysentery epidemic at Ogmore Vale in 1921. Ministry of Health Reports on Public Health and Medical Subjects, London, No. 14, 1922.Google Scholar
60.Severn, AGM, Evans, EW. A localized outbreak of bacillary dysentery in Smethwick. Lancet 1982; i: 126–7.Google Scholar
61.Bojlen, K. Dysentery in Denmark. Bianco Lunos Bogtrykkeri: Copenhagen, 1934.Google Scholar
62.Charles, JA, Warren, SH. Bacillary dysentery in an industrial area. Lancet 1929; ii: 626–31.CrossRefGoogle Scholar
63.Boyd, JSK. Further investigations into the characters and classification of the mannite-fermenting dysentery bacilli. J Royal Army Medical Corps 1932; 59: 241–51, 331–42.Google Scholar
64.Felsen, J, Osofsky, AG. Sonne dysentery. JAMA 1934; 103: 966–71.CrossRefGoogle Scholar
65.Felsen, J, Rundlett, EV, Sullivan, J, Gorenberg, H. Atypical flexner dysentery. JAMA 1934; 103: 1055–8.Google Scholar
66.Watt, J, Hardy, AV. Studies in the acute diarrheal diseases. XIII. Cultural surveys of normal population groups. Public Health Rep 1945; 60: 261–73.Google Scholar
67.Fyfe, GM. Milk-borne Sonne dysentery. J Hyg 1927; 26: 271–8.CrossRefGoogle ScholarPubMed
68.Large, DTM. Notes on Sonne dysentery in Lahore District. J Royal Army Medical Corps 1929; 52: 110.Google Scholar
69.Nelson, RL. Sonne dysentery: a report of 30 cases of dysentery in children caused by B. dysenteriae Sonne. Am J Dis Child 1931; 41: 1525.Google Scholar
70.Cann, LW, De Navasquez, S. Epidemic dysentery in nursing staff due to B. dysenteriae. J Hyg 1931; 31: 361–73.CrossRefGoogle Scholar
71.Smith, RE. A clinical description of epidemic Sonne dysentery. Lancet 1931; ii: 925–7.Google Scholar
72.MacGill, JS, Downie, AW. Sonne dysentery in an industrial town. Lancet 1932; ii: 2931.Google Scholar
73.Loudon, MER. A localized outbreak of enteritis due to B. dysenteriae. Glasgow Medical J 1933; 120: 100–2.Google Scholar
74.Bowes, GK. Outbreak of Sonne dysentery due to consumption of milk. Br Med J 1938; 1: 1092–4.CrossRefGoogle Scholar
75.Cruickshank, R, Swyer, R. An outbreak of Sonne dysentery. Lancet 1940; ii: 803–5.CrossRefGoogle Scholar
76.Hobbs, BC, Allison, VD. Report on an institutional outbreak of Sonne dysentery and on the value of desoxycholate-citrate agar for the isolation of dysentery organisms. Monthly Bulletin Ministry Health (London) 1942; 2: 16.Google Scholar
77.Khan, MU, Shahidullah, M, Ahmed, WV et al. , Changes in the trend of shigellosis in Dhaka: family study on secondary infection, clinical manifestation and sensitivity pattern: 1980. Trans R Soc Trop Med Hyg 1984; 78: 151–6.CrossRefGoogle Scholar
78.Hardy, AV, Shapiro, R, Chant, HR, Siegel, M. Studies of the acute diarrhoea diseases. IX. A. Shigella dysenteriae among institutional inmates. Public Health Rep 1942; 57: 1079–94.Google Scholar
79.Watt, J, Hardy, AV. Studies in the acute diarrheal diseases. XIII. Cultural surveys of normal population groups. Public Health Rep 1945; 60: 261–73.Google Scholar
80.Davies, JBM. Symptomless carriers in home contacts in Sonne dysentery. Br Med J 1952; 2: 191–2.Google Scholar
81.Keller, MD, Robbing, ML. An outbreak of Shigella gastroenteritis. Public Health Rep 1956; 71: 856–62.CrossRefGoogle ScholarPubMed
82. Anonymous. Campylobacter infections in Britain – 1977. Br Med J 1978; 1: 1357.Google Scholar
83.Smith, GS, Blaser, MJ. Fatalities associated with Campylobacter jejuni infections. JAMA 1985; 253: 2873–5.CrossRefGoogle ScholarPubMed
84.Center for Disease Control. Shigella surveillance, third quarter, 1970. Report No. 25, USPHS, Atlanta, Georgia, 1971.Google Scholar
85.Center for Disease Control. Shigella surveillance, fourth quarter, 1970. Report No. 26, USPHS, Atlanta, Georgia, 1971.Google Scholar
86.Center for Disease Control. Shigella surveillance, first quarter, 1971. Report No. 27, USPHS, Atlanta, Georgia, 1971.Google Scholar
87.Center for Disease Control. Shigella surveillance, second quarter, 1971. Report No. 28, USPHS, Atlanta, Georgia, 1971.Google Scholar
88.Lewis, JN, Loewenstein, MS, Guthrie, LC, Sugi, M. Shigella sonnei on the island of Maui. Am J Epidemiol 1972; 96: 50–8.CrossRefGoogle ScholarPubMed
89.Center for Disease Control. Shigella surveillance, fourth quarter, 1971. Report No. 30, USPHS, Atlanta, Georgia, 1972.Google Scholar
90.Weissman, JB, Gangarosa, EJ, Schmerler, A, Marier, RL, Lewis, N. Shigellosis in day care centres. Lancet 1975, i: 8890.CrossRefGoogle Scholar
91.Center for Disease Control. Shigella surveillance, first quarter, 1972. Report No. 31, USPHS, Atlanta, Georgia, 1972.Google Scholar
92.Center for Disease Control. Shigella surveillance, third and fourth quarter and annual summary for 1974. Report No. 37, USPHS, Atlanta, Georgia, 1972.Google Scholar
93.Rosenberg, ML, Hazlet, KK, Schaefer, J, Willis, JG, Pruneda, RC. Shigellosis from swimming. JAMA 1976; 236: 1849–52.CrossRefGoogle ScholarPubMed
94.Blaser, MJ, Reller, LB. Campylobacter enteritis. New Engl J Med 1981; 305: 1444–52.CrossRefGoogle ScholarPubMed
95.Vogt, RL, Sours, HE, Banet, T, Feldman, RH, Dickenson, RJ, Witherall, L. Campylobacter enteritis associated with contaminated water. Ann Intern Med 1982; 96: 292–6.CrossRefGoogle ScholarPubMed
96.Blaser, MJ, Taylor, DN, Feldman, RA. Epidemiology of Campylobacter jejuni infections. Epidemiol Rev 1983; 5: 157–76.Google Scholar
97.Chowdhury, MNH. Campylobacter jejuni enteritis. Trop Geogr Med 1984; 36: 215–22.Google Scholar
98.Weil, AJ, Saphra, I. Salmonella and Shigellae: Laboratory diagnosis correlated with clinical manifestations and epidemiology. Springfield, Illinois: Thomas, 1953.Google Scholar
99.Saphra, I, Winter, JW. Clinical manifestations of salmonellosis in man: evaluation of 7779 human infections identified at New York Salmonella Center. New Engl J Med 1957; 256: 1128–34.Google Scholar
100.Fuerst, HY. The epidemiology of salmonella in the City of New York. Bull New York Acad Med 1964; 40: 948–60.Google ScholarPubMed
101.Center for Disease Control. Salmonella surveillance summary for 1976. Report No. 127, USPHS, Atlanta, Georgia, 1976.Google Scholar
102.National Academy of Sciences. An evaluation of the salmonella problem. Publication 1683, Washington D.C., National Academy of Science Printing & Publication Office, 1969.Google Scholar
103.Foote, SC, Hook, EW. Salmonellosis species. In: Mandell, GL, Douglas, RG, Bennet, JE, eds. Principles and practice of infectious disease. New York: Wiley, 1979: 1730–50.Google Scholar
104.Long-Krug, SA, Weikel, CS, Tiemens, KT, Hewlett, EL, Levine, MM, Guerrant, RL. Does enteropathogenic Escherichia coli produce heat-labile enterotoxin, heat stable enterotoxins a or b or Cholera toxin A subunits ? Infect Immun 1984; 46: 612–4.Google Scholar
105.Levine, MM, Edelman, R. Enteropathogenic Escherichia coli of classic serotypes associated with infant diarrhea: epidemiology and pathogenesis. Epidemiol Rev 1984; 6: 3151.Google Scholar
106.Skerman, FH, Formal, SBM, Falkow, S. Plasmid-associated enterotoxin production in a strain of Escherichia coli from humans. Infect Immun 1972; 5: 622–4.Google Scholar
107.Echeverria, P, Seriwatana, J, Taylor, DN et al. , Plasmids coding for colonization factor antigens I and II, heat-labile enterotoxin, and heat-stable enterotoxin A2 in Escherichia coli. Infect Immun 1986; 51: 626–30.Google Scholar
108.De Rance, CE. The water supply of England and Wales. E. London: E. Stanford, 1882.Google Scholar
109.Lara, H. Interesting features of a rural outbreak of cholera due to infected drinking water. Am J Hyg 1977: 606–13.Google Scholar
110.Saha, AL, Pain, GC, Chowdhury, K, Mukheyce, S, Basu, BK. Cholera epidemics (1966–65) in Biahmaputra Valley of Assam. J Indian Med Assoc 1970; 55: 299307.Google Scholar
111.Levine, RJ, Khan, MR, D'Souza, S, Nalin, DR. Failure of sanitary wells to protect against cholera and other diarrheas in Bangladesh. Lancet 1976; ii: 86–9.CrossRefGoogle Scholar
112.Khan, M, Mosley, WH, Chakraborty, J, Sarder, AM, Khan, MR. Water sources and the incidence of cholera in rural Bangladesh. Int Centre Diarr Dis Res, Dacca, Scientific Report No. 16, 1978.Google Scholar
113.Sommer, A, Woodward, WE. The influence of protected water supplies on the spread of classical/Inaba and El Tor/Ogawa cholera in rural East Bengal. Lancet 1972; ii: 985–7.Google Scholar
114.Demoor, CE. Paracholera (El tor). Bull WHO 1949; 2: 517.Google Scholar
115.Felsenfeld, O, Jatanasen, S, Buspavanich, S et al. , El tor vibrios of the Ogawa subtype occurring in an epidemic of diarrhoea with vomiting in Ubol, Thailand. J Trop Med Hyg 1961; 64: 207–10.Google Scholar
116.Joseph, PR, Tamayo, JF, Mosley, WH, Alvero, MG, Dizon, JJ, Henderson, DA. Studies of cholera El Tor in the Philippines. 2. A retrospective investigation of an explosive outbreak in Bacolod City and Talisay, Nov. 1961. Bull WHO 1965; 33: 637–43.Google Scholar
117.Mosley, WH, Alvero, MB, Joseph, PR et al. , Studies of cholera in the Philippines. 4. Transmission of infection among neighborhood and community contacts of cholera patients. Bull WHO 1965; 33: 651–60.Google Scholar
118.Forbes, GI, Lockhart, JDF, Robertson, MJ, Allan, WGL. Cholera case investigation and the detection and treatment of cholera carriers in Hong Kong. Bull WHO 1968; 39: 381–8.Google Scholar
119.MacKenzie, DJM. Cholera and its control. In: Proceedings Cholera Res. Symp. (24–29 Jan 1965, Honolulu), Public Health Services Publication, No. 1328, U.S. Government Printing Office, Washington, D.C., 1965.Google Scholar
120.Forbes, GI. An outbreak of cholera El tor in Hong Kong: the Temple Street Well. Public Health 1966; 80: 188–93.Google Scholar
121.Philippines Cholera Committee. Study on the transmission of El Tor cholera during an outbreak in Can-Itom community in the Philippines. Bull WHO 1970; 43: 413–9.Google Scholar
122.World Health Organization, Joint ICMR-GWB-WHO Cholera Study Group. Cholera carrier studies in Calcutta 1968. Bull WHO 1970; 43: 379–87.Google Scholar
123.Dutt, AK. Alwi, S, Velauthan, T. A shellfish-borne cholera outbreak in Malaysia. Trans R Soc Trop Med Hyg 1971; 65: 815–8.Google Scholar
124.Feachem, RG. Environmental aspects of cholera epidemiology, I: A review of selected reports of endemic and epidemic situations during 1961–1980. Trop Dis Bull 1981; 78: 675–95.Google Scholar
125.Dodin, A, Felix, H. Du rôle de la sueur dans l'épidémiologie du cholera en pays sec. Bull Acad Natl Med 1972; 156: 845–52.Google Scholar
126.Sutton, RGA. An outbreak of cholera in Australia due to food served in flight on an international aircraft. J Hyg 1974; 72: 441–51.Google Scholar
127.Mendis, NMP, De La Motte, PU, De Silva, AVKV, Maheswaran, K. The spread of cholera El Tor in Sri Lanka in 1974. Ceylon Med J 1977; 22: 440.Google Scholar
128.Isaacson, M, Clarke, KR, Ellacombe, GH et al. , The recent cholera outbreak in the South African gold mining industry. A preliminary report. South Afr Med J 1974; 48: 2557–60.Google Scholar
129.Blake, PA, Rosenberg, ML, Bandeira, Costa J, Soares, Ferreira P, Levy, Guimaraes C. Gangarosa, EJ. Cholera in Portugal, 1974. I. Modes of transmission. Am J Epidemiol 1977: 105: 337–43.Google Scholar
130.Blake, PA, Rosenberg, ML, Costa, J, Do Prado, Quintino L, Gangarosa, EJ. Cholera in Portugal, 1974. II. Transmission by bottled mineral water. Am J Epidemiol 1977; 105: 337–43.Google Scholar
131.Spira, WM, Khan, MU, Saeed, YA, Sattar, MA. Microbiological surveillance of intra-neighbourhood El Tor cholera transmission in rural Bangladesh. Bull WHO 1980; 58: 731–40.Google Scholar
132.McIntyre, RC, Tira, T, Flood, T, Blake, PA. Modes of transmission of cholera in a newly infected population on an atoll: implications for control measures. Lancet 1979; i: 311–4.Google Scholar
133.Mhalu, FS, Mmari, PW, Ijumba, J. Rapid emergence of El Tor Vibrio cholerae resistant to antimicrobial agents during first 6 months of 4th cholera epidemic in Tanzania. Lancet 1979; i: 345–7.Google Scholar
134.Webber, RH, Mwakalukwa, J. The epidemiology of south-west Tanzania. East Afr Med J 1983; 60: 848–56.Google Scholar
135.Kumazawa, NH, Takai, R. A cholera epidemic in North Sumatra, Indonesia. Hiroshima J Med Sciences 1985; 34: 451–3.Google Scholar
136.Gunn, RA, Kimball, AM, Mathew, PP, Dutta, SR, Rifaat, AHM. Cholera in Bahrain: epidemiological characteristics of an outbreak. Bull WHO 1981; 59: 61–6.Google ScholarPubMed
137.Yala, F, Dodin, A, Diana, Y. Rôle de la contamination interhumaine pendant l'épidémie de cholera en République populaire du Congo (1978–1979). Bull Soc Pathol Exot Filiales Exotique 1982; 75: 345–51.Google Scholar
138.Sinclair, GS, Mphahlele, Duuenhoge H, Nichol, R, Whitehorn, A, Kustner, HGV. Determination of the mode of transmission of cholera in Lebowa. South Afr Med J 1982; 62: 753–5.Google Scholar
139.Lasch, EE, Abed, Y, Marcus, O, Shbeir, M, El Alem, A, Ali Hassan, N. Cholera in Gaza in 1981: epidemiological characteristics of an outbreak. Trans R Soc Trop Med Hyg 1984; 78: 554–7.CrossRefGoogle ScholarPubMed
140.Holmberg, SD, Harris, JR, Kay, DE et al. , Foodborne transmission of cholera in Micronesian households. Lancet 1984; i: 325–8.Google Scholar
141.Feachem, RG. Environmental aspects of cholera epidemiology. III. Transmission and control. Trop Dis Bull 1982; 79: 147.Google Scholar
142.Fuertes, JH. Water and public health; the relative purity of waters from different sources. New York: John Wiley & Sons, 1897.Google Scholar
143.Osler, W. Principles and practice of medicine, 8th ed.New York and London: D. Appleton & Co., 1912; 146.Google Scholar
144.Gay, FP. Typhoid fever considered as a problem of scientific medicine. New York: Macmillan, 1918.Google Scholar
145.Maxwell, WH. Water supply problems and developments. London: Pitman & Sons, 1934.Google Scholar
146.Soper, GA. The curious career of Typhoid Mary. Bull NY Acad Med; 15: 698712.Google Scholar
147.Steel, EW. Water supply and sewerage. New York and London: McGraw-Hill, 1938.Google Scholar
148.Lumsden, LL. Report on an outbreak of typhoid fever at Des Moines, Iowa, in 1910. Public Health Rep 1911; 27: 6382.Google Scholar
149.Grover, AL. An outbreak of typhoid fever in Cedar Falls, Iowa. J Infect Dis 1912; 10: 388403.Google Scholar
150.Lumsden, LL. Report on an outbreak of typhoid fever at Lincoln, Nebr., in 1911. Public Health Rep 1912; 27: 793804.Google Scholar
151.Lumsden, LL. An outbreak of typhoid fever caused by milk-borne infection. Public Health Rep 1925; 40: 1302–15.Google Scholar
152. Anonymous. Typhoid epidemic in Manteno State Hospital. JAMA 1939; 113: 1041.Google Scholar
153. Anonymous. Another typhoid outbreak at Manteno Hospital. JAMA 1940; 114: 1937.Google Scholar
154.Rubin, RH, Weinstein, L. Salmonellosis: microbiologic, pathologic, and clinical features. New York: Stratton Intercontinental Medical Book Corporation, 1977.Google Scholar
155.Center for Disease Control. Foodborne and waterborne disease outbreaks. Annual Summary for 1973. USPHS, Atlanta, Georgia, 1974.Google Scholar
156.Feldman, RE, Baine, WB, Nitzkin, JL. Epidemiology of Salmonella typhi infections in a migrant labor camp in Dade County, Florida. J Infect Dis 1974; 130: 334–41.CrossRefGoogle Scholar
157.Center for Disease Control. Foodborne and waterborne disease outbreaks. Annual Summary for 1975, 1976.Google Scholar
158.Sathe, PV, Karandikar, VN, Gapte, MD et al. , Investigation report of an epidemic of typhoid fever. Int J Epidemiol 1983; 12: 215–9.Google Scholar
159.Center for Disease Control. Foodborne and waterborne disease surveillance. Annual Summary for 1977. USPHS, Atlanta, Georgia, 1979.Google Scholar
160.Center for Disease Control. Typhoid fever – San Antonio, Texas, 1981. MMWR 1981; 30: 540, 545–6.Google Scholar
161.Weibel, SR, Dixon, FR, Weidner, RB, McCabe, LJ. Waterborne disease outbreaks, 1946–1960. J Am Water Works Assoc 1964; 56: 947–58.Google Scholar
162.Craun, GF, McCabe, LJ. Review of the causes of water-borne disease outbreaks. J Am Water Works Assoc 1973; 65: 7484.CrossRefGoogle Scholar
163.Cochran, WG. Some methods for strengthening the common χ2 tests. Biometrics 1954; 10: 417–51.Google Scholar
164.Garbat, AL. Typhoid carriers and typhoid immunity. Monograph No. 16, Rockefeller Institute for Medical Research, 1922.Google Scholar
165.World Health Organization. The international drinking water supply and sanitation decade directory, 1st ed (World Water Magazine in collaboration with World Health Organization), 1981.Google Scholar
166.Gordon, JE, Ascoli, W, Pierce, V, Guzman, MA, Mata, LJ. Studies of diarrhea in a Guatemalan highland village, with a component due to Shigella dysenteriae Type 1. Am J Trop Med Hyg 1965; 14: 404–11.Google Scholar
167.Mata, LJ, Gangarosa, EJ, Caceres, A, Parera, DR, Mejicanos, ML. Epidemic Shiga bacillus dysentery in Central America. I. Etiologic investigations in Guatemala. 1969. J Infect Dis 1970; 122: 170–80.Google Scholar
168.Mendizabal-Morris, CA, Mata, CJ, Gangarosa, EJ, Gazman, G. Epidemic Shiga bacillus dysentery in Central America. Derivation of the epidemic its progression in Guatemala. 1968–1969. Am J Trop Med Hyg 1971; 20: 927–33.Google Scholar
169.Khan, MU, Roy, CN, Islam, MDR, Huq, MDI, Stoll, B. Fourteen years of shigellosis in Dhaka: an epidemiological analysis. Int J Epidemiol 1986; 14: 607–13.Google Scholar
170.Weissman, JB, Murton, KI, Lewis, JN, Friedemann, CTH, Gangarosa, EJ. Impact in the U.S. of the Shiga dysentery pandemic of Central America and Mexico: a review of surveillance data through 1972. J Infect Dis 1974; 129: 218–23.Google Scholar
171.Lapp, TS. An institutional outbreak of Shiga dysentery and its control. J Missouri Med Assoc 1936; 33:90–4.Google Scholar
172.Cahill, KM, Davies, JA, Johnson, R. Report an an epidemic due to Shigella dysenteriae type 1, in the Somali interior. Am J Trop Med Hyg 1966; 15: 52–6.Google Scholar
173.Gangarosa, EJ, Perera, DR, Mata, LJ, Merdizabal-Morris, C, Guzman, G, Reller, LB. Epidemic Shiga bacillus dysentery in Central America. II.a. Epidemiological studies in 1969. J Infect Dis 1970; 122: 181–90.Google Scholar
174.Reller, LB, Rivas, EN, Masfener, R, Block, M, Gangarosa, EJ. Epidemic Shiga bacillus dysentery in Central America; Evolution of the outbreak in El Salvador. 1969–70. Am J Trop Med Hyg 1971; 20: 934–40.Google Scholar
175.Khan, M, Curlin, GT, Huq, I. Epidemiology of Shigella dysenteriae 1 infections in Dacca urban area. Trop Geogr Med 1979; 31: 213–23.Google Scholar
176.Mathan, VI, Bhat, P, Capadia, CR, Ponniah, J, Baker, SJ. Epidemic dysentery caused by the Shiga bacillus in a southern Indian village. J Diarr Dis Res 1984; 2: 2732.Google Scholar
177.Gettings, HS. Bacillary dysentery. Trans R Soc Trop Med Hyg 1915; 3: 111–36.Google Scholar
178.Stookey, GE. An epidemic of waterborne dysentery. J Infect Dis 1919; 25: 331–4.Google Scholar
179.Dawson, WS, Moodie, W. The etiology of bacillary dysentery in asylums. Lancet 1921; 201: 225–6.Google Scholar
180.Kinlock, JP. The Aberdeen epidemic of milk-borne bacillary dysentery, March to May, 1919. J Hyg 1923; 21: 451–9.Google Scholar
181.Charles, JA. Sporadic dysentery in a large city. Lancet 1982; ii: 616–9.Google Scholar
182.Djordjevic, D, Sokolovski, B, Miladinovic, T. Waterborne epidemics of dysentery in the Garrison N, during 1962–1964. Vojnosanit Pregl, 1965; 22: 406–12.Google Scholar
183.Sigoloff, E, Baron, ME. An outbreak of bacillary dysentery at the St Louis City Hospital. J Missouri Med Assoc 1935; 32: 194–6.Google Scholar
184.Turner, HMS. Ulcerative colitis. What is it? Guy's Hospital Gazette 1936; 50: 64–7.Google Scholar
185.Block, LH, Simon, A. Epidemic of bacillary dysentery in Elgin State Hospital: preliminary report. Am J Dig Dis Nutrition 1936; 3: 305.Google Scholar
186.Foley, AR. An epidemic of bacillary dysentery in Matane, Quebec, Canada. J Public Health 1936; 27: 113–7.Google Scholar
187.Gorman, AE, Wolman, A. Waterborne outbreaks in the United States and Canada, and their significance. J. Am Water Works Assoc 1939; 31: 225373.CrossRefGoogle Scholar
188.Godfrey, EJ, Pond, MA. A hospital epidemic of Flexner dysentery caused by contaminated ice. JAMA 1940; 114: 1151–4.Google Scholar
189.Kinnaman, CH, Beelman, FC. An epidemic of 3,000 cases of bacillary dysentery involving a war industry and members of the armed forces. Am J Public Health 1944; 34: 948–54.Google Scholar
190.Cheever, FS. Dysentery outbreak aboard naval vessels in San Pedro Bay, Philippine Islands. U.S. Naval Med Bull 1946; 46: 479–94.Google Scholar
191.Muller, G. Eine trinkwasser-gebunde Ruhrepidemie. Zentralbl Bakteriol, Abteil I, 1947; 152: 133–5.Google Scholar
192.Mount, RA, Floyd, TM. A dysentery outbreak aboard a cruiser in Apia Harbor, Guam, Marinas Islands. U.S Naval Med Bull 1948; 48: 240–9.Google Scholar
193.Djordjevic, D, Sokolovski, B, Miladinovic, T. Waterborne epidemics of dysentery in the Garrison N, during 1962–1964. Vojnosanit Pregl 1965, 22: 406–12.Google Scholar
194.Nikodemusz, , Ormay, L. Results des examens bactériologiques au cours d'une épidémie de dysenterie due a l'eau de consummation. Arch Inst Pasteur Tunis 1959; 36: 4351.Google Scholar
195.Drachman, RH, Payne, FJ, Jenkins, AA et al. , An outbreak of waterborne Shigella. Am J Hyg 1960; 72: 321–34.Google Scholar
196.Mosley, WH, Adams, B, Lyman, ED. Epidemiologic and sociologic features of a large urban outbreak of Shigellosis. JAMA 1962; 182: 1307–11.Google Scholar
197.Reller, LB, Gangarosa, EJ, Brachman, PS. Shigellosis in the United States: Five-year review of nationwide surveillance. 1964–1968. Am J Epidemiol 1970; 91: 161–9.Google Scholar
198.Center for Disease Control. Shigella surveillance, fourth quarter, 1968. Report No. 18, USPHS, Atlanta, Georgia, 1969.Google Scholar
199.Center for Disease Control. Shigella surveillance, first quarter, 1969. Report No. 19, USPHS, Atlanta, Georgia, 1969.Google Scholar
200.Center for Disease Control. Shigella surveillance, second quarter, 1969. Report No. 20, USPHS, Atlanta, Georgia, 1969.Google Scholar
201.Dupont, HL, Gangarosa, EJ, Reller, LB et al. , Shigellosis in custodial institutions. Am J Epidemiol 1970; 92: 172–9.Google Scholar
202.Center for Disease Control. Shigella surveillance, fourth quarter, 1969. Report No. 22, USPHS, Atlanta, Georgia, 1970.Google Scholar
203.Center for Disease Control. Shigella surveillance, second quarter, 1970. Report No. 24, USPHS, Atlanta, Georgia, 1970.Google Scholar
204.Jones, JW. Outbreak of Shigella flexneri. Diseases Report, Scotland, No. 35, 1972.Google Scholar
205.Merson, MH, Tenny, JH, Meyers, JD et al. , Shigellosis at sea: an outbreak aboard a passenger cruise ship. Am J Epidemiol 1975; 101: 165–75.CrossRefGoogle Scholar
206.Center for Disease Control. Foodborne and waterborne disease surveillance. Annual Summary for 1976, USPHS, Atlanta, Georgia, 1977.Google Scholar
207.Center for Disease Control. Foodborne disease surveillance. Annual Summary for 1981, USPHS, Atlanta, Georgia, 1983.Google Scholar
208.Boyce, JM, Huges, JM, Alim, AR et al. , Patterns of Shigella in families in rural Bangladesh. Am J Trop Med Hyg 1982; 31: 1015–20.Google Scholar
209.Hutchinson, RL. Some observations on the method of spread of Sonne dysentery. Monthly Bulletin Ministry Health (London) 1956; 15: 110–8.Google Scholar
210.Andre, DA, Weiser, HH, Malaney, GW. Survival of bacterial enteric pathogens in farm pond water. J Am Water Works Assoc 1967; 59: 503–8.Google Scholar
211.Saisawa, K, Tanabe, B. Notes on the health carriers of dysentery bacilli. In: Transactions of the 6th Congress of Far Eastern Association of Tropical Medicine, Tokyo, 1925, vol. II, pp. 445455. Warbunsha Ptg Co.: Kagomachi, Koishikawa-Ku, 1926.Google Scholar
212.Fraser, AM, Smith, J. Endemic bacillary dysentery in Aberdeen. Q J Med 1930; 23: 245–59.Google Scholar
213.Thomson, S. The numbers of pathogenic bacilli in faeces in intestinal diseases. J Hyg 1955; 53: 217–24.Google Scholar
214.Dale, D, Mata, LJ. Studies of diarrheal disease in Central America. XI. Intestinal bacterial flora in malnourished children with shigellosis. Am J Trop Med 1968; 17; 397403.Google Scholar
215.Hay, HR. Fatal epidemic enteritis due to B. dysenteriae. J Hyg 1940; 30: 2531.Google Scholar
216.Laws, JJ. Sonne dysentery in mental hospital. Lancet 1936; i: 192–3.Google Scholar
217.Quinlivan, JJ. Milk-borne bacillary dysentery. Report of an outbreak in New York State. J Med 1940; 40: 1027.Google Scholar
218.Nordenankar, R. En vattenepidemi av paradysenteri i Falkoping under Januari 1939. Nord Hyg Tidskr 1940; 21: 4956.Google Scholar
219.Faulds, JS, Gavin, FW. Outbreak of Sonne dysentery at Penrith. Monthly Bulletin Ministry Health (London) 1942; 1: 56.Google Scholar
220.Faulds, JS. Milk-borne outbreak of Sonne dysentery. Monthly Bulletin Ministry Health (London) 1942; 1: 67.Google Scholar
221.Green, CS, MacLeod, Me. Explosive epidemic of Sonne dysentery. Br Med J 1943; 2: 259–61.Google Scholar
222.Sorvinoi, LE, Zaidenberg, EG, Dzuba, MI. Waterborne epidemic of dysentery, 1939. Vrach Delo 1946; 26: 743–6.Google Scholar
223.Thomas, MEM, Tillett, HE. Dysentery in general practice: a study of cases and their contacts in Enfield and an epidemiological comparison with salmonellosis. J Hyg 1973; 71: 373–89.Google Scholar
224.Ross, AI, Gillespie, . An outbreak of waterborne gastroenteritis and Sonne dysentery. Monthly Bull Ministry Health (London) 1952; 11: 3646.Google Scholar
225.Rickarby, GA, Cooper, GN, McAvan, T, Cockerill, JE. Outbreak of bacillary dysentery. Med J Aust 1960; 47: 81–5.Google Scholar
226.Freitag, JL. A water-borne outbreak of dysentery. Health News 1960; 37: 411, 19.Google Scholar
227.Reller, LB, Gangarosa, EJ, Brachman, PS. Shigellosis in the United States. 1964–1968. J Infect Dis 1969; 120: 393–6.Google Scholar
228.Green, DM, Scott, SS, Mowatt, DAE, Shearer, EJM. Thomson, JM. Waterborne outbreak of viral gastroenteritis and Sonne dysentery. J Hyg 1968; 66: 383–92.Google Scholar
229.Center for Disease Control. Shigella surveillance, third quarter, 1969. Report No. 21. USPHS, Atlanta, Georgia, 1969.Google Scholar
230.Center for Disease Control. Foodborne outbreaks. Annual summary for 1969, USPHS, Atlanta, Georgia, 1970.Google Scholar
231.Center for Disease Control. Foodborne outbreaks. Annual summary for 1970, USPHS, Atlanta, Georgia, 1971.Google Scholar
232.Center for Disease Control. Foodborne outbreaks. Annual summary for 1971. USPHS, Atlanta, Georgia, 1972.Google Scholar
233.Center for Disease Control. Foodborne outbreaks. Annual summary for 1972, USPHS, Atlanta, Georgia, 1973.Google Scholar
234.Thomas, MEM. Recurrent gastroenteritis in a preparatory school caused by Shigella sonnei and another agent. Lancet, 1974; i: 978–81.Google Scholar
235.Center for Disease Control. Foodborne and waterborne disease outbreaks. Annual summary for 1974, USPHS, Atlanta, Georgia, 1976.Google Scholar
236.Centre for Disease Control. Shigella surveillance, first and second quarter of 1974. Report No. 36, USPHS, Atlanta, Georgia, 1975.Google Scholar
237.Center for Disease Control. Shigellosis in a children's hospital – Pennsylvania. MMWR 1979; 28:498–9.Google Scholar
238.Center for Disease Control. Foodborne disease. Annual Summary for 1978, USPHS. Atlanta, Georgia, 1979.Google Scholar
239.Khan, M. Shahidullah, M. Interruption of shigellosis by hand washing. Trans R Soc Trop Med Hyg 1982; 76: 164–8.Google Scholar
240.Stoll, BJ, Glass, RI, Huq, MI, Khan, MO, Banu, H, Holt, J. Epidemiologic and clinical features of patients infected with Shigella who attended a diarrheal disease hospital in Bangladesh. J Infect Dis 1982; 146: 177–83.Google Scholar
241.Taylor, PR, Weinstein, WM, Bryner, JH. Campylobacter fetus infection in human subjects: association with raw milk. Am J Med 1979; 66: 779–83.Google Scholar
242.Skirrow, MB. Campylobacter enteritis: a ‘new’ disease. Br Med J 1977; 2: 911.Google Scholar
243.Mentzing, LO. Waterborne outbreaks of Campylobacter enteritis in central Sweden. Lancet 1981; ii: 352–4.Google Scholar
244.Blaser, MJ, Berkowitz, ID, Laforce, FM, Cravens, J, Reller, LB, Wang, WLL. Campylobacter enteritis: clinical and epidemiological features. Ann Intern Med 1979; 91: 179–85.Google Scholar
245.Robinson, DA, Jones, DM. Milk-borne Campylobacter infection. Br Med J 1981; 282: 1374–6.Google Scholar
246.Robinson, DA, Edgar, WJ, Gibson, GL, Matchett, AA, Robertson, L. Campylobacter enteritis associated with consumption of unpasteurized milk. Br Med J 1979; 1: 1171–3.Google Scholar
247.Mouton, RP, Veltkamp, JJ, Lauwers, S, Butzler, JP. Analysis of a small outbreak of Campylobacter infections with high morbidity. In: Newell, DG, ed. Campylobacter. Lancaster, Boston, The Hague: MTP Press, 1982; 129–34.Google Scholar
248.Porter, IA, Reid, TMS. A milk-borne outbreak of Campylobacter infection. J Hyg 1980; 84: 415–9.Google Scholar
249.Jones, PH, Willis, AT, Robinson, DA, Skinow, MB, Josephs, DS. Campylobacter enteritis associated with the consumption of free school milk. J Hyg 1981; 87: 155–62.Google Scholar
250.Brouwer, R, Mertens, MJA, Stein, TH, Katchaki, J. An explosive outbreak of Campylobacter enteritis. Antonie Van Leeuwenkoek 1979; 45: 517–9.Google Scholar
251.Severin, WPJ. Epidemiology of Campylobacter. In: Newell, DG, ed. Campylobacter. Epidemiology, pathogenesis and biochemistry. Lancaster, Boston, The Hague: MTP Press, 1982.Google Scholar
252.Itoh, T, Saito, K, Yanagawa, Y, Sakai, S, Ohashi, M. Campylobacter enteritis in Tokyo. In: Newell, DG, ed. Campylobacter. Lancaster, Boston, The Hague: MTP Press, 1982; 512.Google Scholar
253.Norkrans, G, Svedhem, A. Epidemiological aspects of Campylobacter jejuni enteritis. J Hyg 1982; 89: 163–70.Google Scholar
254.Kist, M. Campylobacter enteritis: epidemiological and clinical data from recent isolations in the region of Freiburg, West Germany. In: Newell, DG, ed. Campylobacter. Lancaster, Boston, The Hague: MTP Press, 1982; 138–43.Google Scholar
255.Blaser, MJ, Berkowitz, ID, Laforce, FM, Cravens, J, Reller, LB, Wang, WLL. Campylobacter enteritis: clinical and epidemiological features. Ann Intern Med 1979; 91: 179–85.Google Scholar
256.Finch, MJ, Blake, PA. Foodborne outbreaks of Campylobacteriosis: the United States experience. Am J Epidemiol 1985; 122: 262–8.Google Scholar
257.Taylor, DN, McDermott, KT, Little, JR, Wells, JR, Blaser, MJ. Campylobacter enteritis from untreated water in the Rocky Mountains. Ann Intern Med 1983; 99: 3840.Google Scholar
258.Skirrow, MB, Fidoe, RG, Jones, DM. An outbreak of presumption food-borne Campylobacter enteritis. J Infect 1981; 3: 234–6.CrossRefGoogle Scholar
259.McNaughton, RD, Leyland, R, Mueller, L. Outbreak of Campylobacter enteritis due to consumption of raw milk. Can Med Assoc J 1982; 126: 657–8.Google Scholar
260.Potter, ME, Blaser, MJ, Sikes, RK, Kaufmann, AF, Wells, JG. Human Campylobacter infection associated with certified raw milk. Am J Epidemiol 1983; 117: 475–83.Google Scholar
261.Center for Disease Control. Outbreak of Campylobacter enteritis associated with raw milk, Kansas. MMWR 1981; 30: 218–20.Google Scholar
262.Kornblatt, AN, Barrett, T, Morris, GK, Tosh, FE. Epidemiologic and laboratory investigation of an outbreak of Campylobacter enteritis associated with raw milk. Am J Epidemiol 1985; 122: 884–9.Google Scholar
263.Hopkins, RS, Olmsted, R, Istre, GR. Endemic Campylobacter jejuni infection in Colorado – Identified risk factors. Am J Public Health 1984; 74: 249–50.Google Scholar
264.Korlath, JA, Osterholm, MT, Judy, LA, Forfang, JC, Robinson, RA. A point-source outbreak of Campylobacteriosis associated with consumption of raw milk. J Infect Dis 1985; 152: 592–6.Google Scholar
265.Palmer, SR, Gully, PR, White, JM et al. , Waterborne outbreak of Campylobacter gastroenteritis. Lancet 1983; i: 287–90.Google Scholar
266.Wilson, PG, Davies, JR, Hoskins, TW et al. , Epidemiology of an outbreak of milk-borne enteritis in a residential school. In Pearson, AD, Skirrow, MB, Rowe, B, Davies, J, Jones, DM, eds. Campylobacter II, Proceedings of the Second International Workshop on Campylobacter Infections. London: Public Health Laboratory Service (Great Britain) 1983: 143.Google Scholar
267.Hopkins, RS, Scott, AS. Handling raw chicken as a source for sporadic Campylobacter jejuni infections. J Infect Dis 1983; 148: 770.Google Scholar
268.Istre, GR, Blaser, MJ, Shillam, P, Hopkins, RS. Campylobacter enteritis associated with undercooked barbecued chicken. Am J Public Health 1984; 74: 1265–7.Google Scholar
269.Klein, BS, Vergeront, JM, Blaser, MJ et al. , Campylobacter infection associated with raw milk. JAMA 1986; 255: 361–4.Google Scholar
270.Oosterom, J, Den Uyl, CH, Banffer, JRJ, Huisman, J. Epidemiological investigations on Campylobacter jejuni in households with a primary infection. J Hyg 1984; 93: 325–32.Google Scholar
271.Stalder, H, Isler, R, Stutz, W, Salfinger, M. Lauwers, S, Vischer, W. Outbreak of Campylobacter enteritis involving over 500 participants in a jogging rally. In: Pearson, AD, Skirrow, MB, Rowe, B, Davies, J, Jones, DM, eds. Campylobacter II, Proceedings of the Second International Workshop on Campylobacter Infections. London: Public Health Laboratory Service (Great Britain) 1983: 142.Google Scholar
272.Hudson, PJ, Vogt, RL, Brodnum, J, Patton, CM. Isolation of Campylobacter jejuni from milk during an outbreak of Campylobacteriosis. J Infect Dis 1984; 150: 789.Google Scholar
273.Hutchinson, DN, Bolton, FJ, Hinchcliffe, PM et al. , Evidence of udder excretion of Campylobacter jejuni the cause of milk-borne Campylobacter. J Hyg 1985; 94: 205–16.Google Scholar
274.Terrier, A, Altwegg, M, Bader, P, Von Graevenitz, A. Hospital epidemic of neonatal Campylobacter jejuni infection. Lancet 1985; ii: 1182.Google Scholar
275.Center for Disease Control. Salmonella surveillance reports. USPHS, Atlanta, Georgia, 19681977.Google Scholar
276.Boyer, KM, Peterson, NJ, Pattison, CP, Hart, MC, Maynard, JE. An outbreak of gastroenteritis due to E. coli 0142 in a neonatal nursery. J Pediatr 1975; 86: 919–27.Google Scholar
277.Gorbach, SL, Kean, BH, Evans, DG, Bessudo, D. Traveler's diarrhea and toxigenic Escherichia coli. New Engl J Med 1975; 292: 933–6.Google Scholar
278.Merson, MH, Morris, GK, Sack, DA et al. , Traveler's diarrhea in Mexico: a prospective study of physicians and family members attending a congress. New Engl J Med 1976; 294: 12991305.Google Scholar
279.Guerrant, RL, Dickens, MD, Wenzel, Rp, Kapikian, AZ. Toxigenic bacterial diarrhoea: nursery outbreak involving multiple bacteria strains. J Pediatr 1976: 89: 885–92.Google Scholar
280.Ryder, RW, Wachsmuth, IK, Buxton, AE et al. , Infantile diarrhoea produced by heat stable enterotoxigenic Escherichia coli. New England J Med 1976; 295: 849–53.Google Scholar
281.Kudoh, Y, Yori, Z, Matsushita, S, Sakai, S, Maruyama, T. Outbreaks of acute enteritis due to heat-stable enterotoxin-producing strains of Escherichia coli. Microbiol Immunol 1977; 21: 175–8.Google Scholar
282.Rosenberg, ML, Koplan, Wachsmith IK, Wells, JG, Gangarosa, EJ, Guerrant, RL, Sack, DA. Epidemic diarrhea at Crater Lake from enterotoxigenie E. coli. Ann Intern Med 1977; 86: 714–8.Google Scholar
283.Tjoa, W, Dupont, HL, Sullivan, P et al. , Location of food consumption and traveller's diarrhea. Am J Epidemiol 1977; 106: 61–6.Google Scholar
284.Ericcson, CD, Pickering, LK, Sullivan, P, Dupont, HL. The role of location of food consumption in the prevention of traveller's diarrhea in Mexico. Gastroenterology 1980; 76: 812–6.Google Scholar
285.Taylor, WR, Schell, WL, Wells, JG et al. , A foodborne outbreak of enterotoxigenic Escherichia coli. New Engl J Med 1982; 306: 1093–5.Google Scholar
286.Wood, LV, Wolfe, WH, Ruiz-Palacios, G et al. , An outbreak of gastroenteritis due to a heat-labile enterotoxin-producing strain of Escherichia coli. Infect Immun 1983; 41: 931–4.Google Scholar
287.Riordan, T, Gross, RJ, Rowe, B, Scotland, SM, Johnston, SM. An outbreak of food-borne enterotoxigenie Escherichia coli diarrhoea in England. J Infection 1985; 11: 167–71.Google Scholar
288.MacDonald, KL, Eidson, M, Strohmeyer, C et al. , A multistate outbreak of gastrointestinal illness caused by enterotoxigenie Escherichia coli in imported semisoft cheese. J Infect Dis 1985; 151: 716–20.Google Scholar
289.Dudgeon, LS, Urquhart, AL, Logan, WR et al. , Study of bacillary dysentery occurring in the British forces in Macedonia. Medical Research Committee Special Report Series, No. 40, London, 1919.Google Scholar
290.Manson-Bahr, P. The correlation of the pathology and bacteriology of Bacillary Dysentery. J Royal Army Medical Corps 1919; 33: 117–39.Google Scholar
291.Floyd, TM. The incidence of Shigella organisms in agroup of Egyptian village children. Am J Trop Med Hyg 1954; 3: 294302.Google Scholar
292.Sapero, JJ, Butler, FA. Highlights on epidemic diseases occurring in military forces in the early phase of the war in the South Pacific. JAMA 1945; 127: 502–6.Google Scholar
293.Watt, J, Lindsay, D. Diarrheal disease control studies. 1. Effect of fly control in a high morbidity area. Public Health Rep 1948; 63: 1319.Google Scholar
294.Lindsay, DR, Stewart, WH, Watt, J. Effect of fly control on diarrheal disease in an area of moderate morbidity. Public Health Rep (Washington) 1953; 68: 361–7.Google Scholar
295.Stewart, WH, McCabe, LJ, Hemphill, EC, Decapito, T. Diarrheal disease control studies: the relationship of certain environmental factors to the prevalence of Shigella infection. Am J Trop Med Hyg 1955; 4: 719–24.Google Scholar
296.Manson-Bahr, P. The dysenteric disorders, 2nd ed.London: Cassell, 1944.Google Scholar
297.Greenberg, B. Flies and disease, volume 2, Biology and disease transmission. Princeton. N.J.: Princeton University Press, 1973.Google Scholar
298.Khan, AR, Huq, F. Disease agents carried by flies in Dacca city. Bull Bangladesh Med Council 1978; 4: 8693.Google Scholar
299.Echeverria, P, Harrison, BA, Tirapat, C, MoFarland, A. Flies as a source of enteric pathogens in a rural village in Thailand. Appl Environ Microbiol 1983; 46: 32–6.Google Scholar
300.Wolff, HL, Van Zijl, WJ. Houseflies, the availability of water, and diarrheal diseases. Bull WHO 1969; 41: 952–9.Google Scholar
301.Feachem, R, Miller, C, Drasar, B. Environmental aspects of cholera epidemiology, II. Occurrence and survival of Vibrio cholerae in the environment. Trop Dis Bull 1981; 78: 865–80.Google Scholar
302.Kolvin, JL, Roberts, D. Studies on the growth of Vibrio cholerae biotype el tor and biotype classical in foods. J Hyg 1982; 89: 243–52.Google Scholar
303.Sansonetti, PJ, Hale, TL, Dammin, GJ, Kapfer, C, Collins, HH, Formal, SB. Alterations in the pathogenicity of Escherichia coli K-12 after transfer of plasmid and chromosomal genes from Shigella flexneri. Infect Immun 1983; 39: 13921402.Google Scholar
304.Hale, TL, Oaks, EV, Formal, SB. Identification and antigenic characterisation of virulence-associated, plasmid-coded proteins of shigella and enteroinvasive Escherichia coli. Infect Immun 1985; 50: 620–9.Google Scholar
305.Khan, AA, Srivastava, R, Sinha, VB, Srivastava, BS. Regulation of toxin biosynthesis by plasmids in Vibrio cholerae. J Gen Microbiol 1985; 131: 2653–7.Google Scholar
306.Levine, MM, Nataro, JP, Karch, H et al. , The diarrheal response of humans to some classic serotypes of enteropathogenic Escherichia coli is dependent on a plasmid encoding an enteroadhesiveness factor. J Infect Dis 1985; 152: 550–9.Google Scholar
307.Clerc, P, Baudry, B, Sansonetti, PJ. Plasmid-mediated contact haemolytic activity in shigella correlation with penetration into HeLa cells. Ann Inst Pasteur Microbiologie 1986; 137A: 267–8.Google Scholar
308.Seltman, G, Pal, T, Tschape, H. Surface hydrophobicity of plasmid-carrying virulent Shigella flexneri their avirulent variants. J Basic Microbiol 1986; 26: 283–7.Google Scholar
309.Watanabe, J, Nakamura, A. Identification of Shigella sonnei I plasmid genes necessary for cell invasion and their conservation among Shigella and enteroinvasive Escherichia coli. Infect Immun 1986; 53: 352–8.Google Scholar
310.Hamood, AN, Sublett, RD, Parker, CD. Plasmid-mediated changes in virulence of Vibrio cholerae. Infect Immun 1986; 52: 476–83.Google Scholar
311.Basu, S, Bhattacharya, P, Mukerjee, S. Interaction of Vibrio cholerae and Vibrio El Tor. Bull WHO 1966; 34: 371–8.Google Scholar
312.Huq, MI, Sanyal, SC, Samadi, AR, Monsur, KA. Comparative behaviour of classical and El Tor biotypes of Vibrio cholerae 01 isolated in Bangladesh during 1982. J diarr Dis Res 1983; 1: 59.Google Scholar
313.Turnbull, PCB, Lee, JV, Miliotis, MD, Still, CS, Isaacsib, M, Ahmad, QS. In vitro and in vivo cholera toxin production by classical and El Tor isolates of Vibrio cholerae. J Clin Microbiol 1985; 21: 884–90.Google Scholar
314.Sasakawa, C, Kamata, K, Sakai, T, Murayama, SY, Makino, S, Yoshikawa, M. Molecular alteration of the 140-megadalton plasmid associated with loss of virulence and congo red binding activity in Shigella flexneri. Infect Immun 1986; 51: 470–5.Google Scholar
315.Hale, TL, Formal, SB. Protein synthesis in HeLa or Henle 407 cells infected with Shigella dysenteriae 1, Shigella flexneri 2a, or Salmonella typhimurium W118. Infect Immun 1981; 32: 137–44.Google Scholar
316.Brenner, DJ, Fanning, GR, Miklos, GV, Steigerwalt, AG. Polynucleotide sequence relatedness among Shigella species. Int J Syst Bact 1973; 23: 17.Google Scholar
317.Esrey, SA, Habicht, J-P. Epidemiologic evidence for health benefits from improved water and sanitation in developing countries. Epidemiol Rev; 8: 117–28.Google Scholar
318.Cairncross, S. The benefits of water supply. In: Pickford, J, ed. Developing world water. II. London: Grosvenor Press, 1987.Google Scholar
319.Henry, FJ, Huttly, SRA, Patwary, Y, Aziz, KMA. Environmental sanitation, food and water contamination and diarrhoea in rural Bangladesh. Epidemiol Infect 1990; 104: 253–9.Google Scholar
320.Briscoe, J. Water supply and health in developing countries – selective primary health care revisited. Am J Public Health 1984; 74; 1009–13.Google Scholar