Etiology of summer diarrhea among the Navajo

The etiology of diarrhea in children and adults on the Navajo Indian Reservation was investigated in August 1975. Fifty-six ill individuals and 37 controls were included in the study. Shigella was most commonly associated with diarrhea, and was isolated from 32% of ill children and adults. Fifty percent of Shigella isolates tested were resistant to ampicillin. Heat-stable enterotoxin-(ST)-producing organisms were associated with noninflammatory diarrhea in adults (27% of these cases had ST-producing strains) but not in children. Heat-labile enterotoxin-producing organisms were found among controls as well as individuals with diarrhea. No children had evidence of rotavirus infection. These findings suggest that ST-producing organisms are important causes of sporadic cases of noninflammatory summer diarrhea among Navajo adults and confirm the importance of Shigella in inflammatory diarrhea among adults and children in this setting.