Summary: The etiology of acute cholera-like disease in adults has been investigated by determination of the toxigenicity of strains of Escherichia coli isolated in large numbers from jejunal aspirates and stools of patients in Calcutta. To date, 16 of 27 isolates from four patients have been found to produce an enterotoxin in vitro that is similar to the one produced by V ibrio cholerae. This toxin, which is found in cultures grown in Syncase medium, causes the accumulation of fluid in the ligated ileal loop of rabbits, is heat-labile and nondialyzable, is precipitated in 40% ammonium sulfate, and is antigenic in rabbits, in which it leads to the production of neutralizing antitoxic antibodies. However, the preparation of enterotoxin does not contain permeability factor, as measured in the rabbit skin. None of the toxin-producing strains of E. coif was found to belong to the enteropathogenic serotypes that are commonly recognized. It is postulated that toxin-producing strains of E, coli may be the causative agents in a significant number of acute cholera-like diarrheal syndromes in adults living in the tropics.
Reference Material:
https://www.jstor.org/stable/30108756?seq=1#page_scan_tab_contents
