Diarrhea Etiology and Risk Factor Study

Children who report to the Children's Hospital and Regional Medical Center Emergency Department and Gastroenterology Clinic with diarrhea will be invited to enroll in this study. Stool will be evaluated thoroughly for the presence of definite, plausible, and candidate pathogens. Controls will be solicited so that they are age-, geographically-, and temporally-matched. In the second arm of the study, children with reportable enteric infections in three counties in King, Whatcom, and Yakima Counties, Washington, will be administered a thorough questionnaire, and age-, geographically-, and temporally-matched controls will be sought, to study likely vehicles and environmental modes of acquisition, using a case-control analysis.
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This proposal strives to fill gaps in our knowledge that are critically important to food safety in the United States. First, the cause of most episodes of diarrhea remains unknown. Second, the sources of many infections are unknown, because cases occur sporadically, without being linked to an identifiable food or other source. In this study, we will attempt to fill these voids in our knowledge, by studying children in Washington State. First, we will try to find the causes of unexplained childhood diarrhea by thoroughly and systematically studying children with diarrhea in Seattle, in a population that can be easily and thoroughly studied (children with this problem who are evaluated at the Children's Hospital and Regional Medical Center), using classical and modern, complete, diagnostic techniques. Second, we will attempt to determine by, case-control study, the likely source of reportable, and potentially food-borne infections. In this study, we will combine classic and molecular microbiology with intensive case-control analyses, using an established infrastructure and expertise in our institution and in collaborating health departments.