Perspectives on acute enteric disease epidemiology and control

This paper reviews the major epidemiologic features of the acute enteric diseases and outlines a plan for their prevention and control in developing countries. Annual mortality from enteric diseases ranges from 10 per 1000,000 in highly developed countries to as much as 500 per 100,000 in developing countries. Most agents of enteric disease are spread by one of two routes: direct person-to-person contact or ingestion of contaminated vehicles (food or water). An effective control program should therefore focus on common epidemiologic factors, rather than on agent-specific remedies such as vaccines or antibiotics. The major operational components of such a program should include oral fluid replacement therapy, improvements in environmental sanitation, health education to promote personal hygiene and proper food handling, and epidemiologic surveillance to monitor public health needs and evaluate the impact of health measures.