SPECIAL ARTICLE Cholera and Other Enterotoxin-related Diarrheal Diseases

The enterotoxin responsible for fluid loss through the intestines in cholera has been purified, its mechanism of action has been determined and its antigenic properties have been carefully studied. On the basis of the information obtained, a simple and uniformly effective therapeutic approach has been delineated, and the development of a better vaccine appears likely. Since enterotoxins are pro-duced by a number of enteric bacteria, other than Vibrio cholerae, and since diseases produced by such noncholera bacteria appear to be responsible for greater world-wide morbidity and mortality than cholera itself, the investigative approaches that have been applied to cholera are now being employed in the study of such choleralike diseases. Data to date have indicated that the entero-toxin of Escherichia coli has certain similarities to cholera enterotoxin, both in its mechanism of action and its antigenic properties. The mechanism of action of the shigella enterotoxin appears, on the other hand, to be radically different from that of V. cholerae and E. coli enterotoxins. Further studies of the entero-toxins of E. coli, Shigella, Clostridium perjringens and Vibrio parahemolyticu