Studies of the Acute Diarrheal Diseases XII. Etiology

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Abstract
The acute diarrheal diseases were studied in 4 widely separated regions. Both bacillary and protozoan causes of these disorders were sought and attention was given to the study of organisms not previously described as pathogenic. The newer, highly selective culture media for Shigella were employed for the bacteriological examination. In all areas investigated the S. paradysenteriae group was found most commonly in these diseases. No other recognized pathogen was identified in a significant proportion of the cases studied. The relative importance of Shigellae as causative agents varied according to the age of the patient, the locality involved, and the severity of the illness. Shigellae were isolated from an increasing % of cases with increasing age up to the 3d year of life. Thereafter the % remained relatively constant and uniform in all areas. Under 2 yrs. of age these organisms played a lesser role in the causation of diarrheal diseases in New York than in New Mexico and Georgia. The severe cases had a higher % of positive observations than the milder ones. Multiple examinations increased the % of positive findings. Examination during the acute phase of the disease revealed a higher proportion of positive cases than was found in those first tested in convalescence or after recovery. Reported data must be evaluated with respect to these and other variables.