Prevention of Enteric Diseases

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Abstract
Estimates of diarrheal disease mortality suggest that at least 2 million persons succumb annually to diarrhea, and in countless others, the infections aggravate malnutrition and its attendant ills. Though enteric diseases are nearly always spread by the fecal-oral route, prevention of enteric illness by improvement of water and food quality is impractical in most developing countries. Yet, the diversity of enteric pathogens presents a formidable obstacle to prevention by more specific means, such as vaccination. We would argue, however, that for certain specific infections, immunization is both feasible and the most efficient means of prevention. Calculations of disease burden can assist in identifying problems for which specific interventions should be pursued. We review four enteric infections for which vaccine development strategies have received wide attention. However, in none of these cases is a cheap and effective vaccine yet available.

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