Epidemic enteropathogenic Escherichia coli, Newfoundland, 1963: autopsy study of 16 cases

The autopsy findings and certain other features are described in 16 fatal cases of infantile diarrhea associated with enteropathogenic Escherichia coli infection during the 1963 epidemic in Newfoundland which resulted in 100 deaths. Age is an important factor in the severity of the infection and in the outcome. Almost one-half the patients were under 4 months and a third under 2 months. Pathological changes in the gastrointestinal tract were meagre and were not pathognomonic. Other pathological findings and their possible role in the severity and fatal outcome in enteropathogenic Escherichia coli gastroenteritis are discussed. Such conditions as prematurity, congenital anomaly, trauma, neoplasm and metabolic disorders were, no doubt, also important factors in the outcome. Severe respiratory tract infection was the leading terminal cause of death. No sex, seasonal or geographic variation was found. Enteropathogenic Escherichia coli serotype 0111:B4 was the prevalent infecting organism.