by Rabi Biswas. / Publication date from spine. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 122-143). / PREFACE --- p.2 / ACKNOWLEDGEMENTS --- p.3 / CONTENTS --- p.4 / GLOSSARY --- p.9 / ABSTRACT --- p.11 / INTRODUCTION --- p.12 / Chapter 1.1. --- OVERVIEW --- p.12 / Chapter 1.2. --- OBJECTIVES OF THE STUDY --- p.14 / LITERATURE REVIEW --- p.15 / Chapter 2.1. --- BACKGROUND OF THE STUDY --- p.15 / Chapter 2.2. --- ESCHERICHIA COLI : OVERVIEW --- p.17 / Chapter 2.2.1. --- Morphology --- p.18 / Chapter 2.2.2. --- Cultural characteristics --- p.18 / Chapter 2.2.3. --- Biochemical reactions --- p.19 / Chapter 2.2.4. --- Antigenic Structure --- p.19 / Chapter 2.2.5. --- Identification --- p.20 / Chapter 2.2.6. --- Classification of coli --- p.20 / Chapter 2.3. --- HISTORY OF EPEC --- p.22 / Chapter 2.3.1. --- E. coli as a cause of diarrhoea --- p.22 / Chapter 2.3.2. --- The first use of the term EPEC --- p.23 / Chapter 2.3.3. --- EPEC as a separate category of E. coli --- p.24 / Chapter 2.4. --- PATHOGENESIS OF EPEC --- p.25 / Chapter 2.4.1. --- Plasmid encoded virulence properties --- p.25 / Chapter 2.4.2. --- Characteristic interaction with intestinal mucosa --- p.26 / Chapter 2.4.3. --- Production of toxins --- p.28 / Chapter 2.5. --- EPIDEMIOLOGY OF EPEC --- p.29 / Chapter 2.6. --- EPIDEMIOLOGY OF EPEC IN CHINA AND HONG KONG --- p.32 / Chapter 2.7. --- CLINICAL INFECTION BY EPEC AND MANAGEMENT --- p.33 / Chapter 2.7.1. --- Epidemiological syndromes --- p.33 / Chapter 2.7.2. --- Infective dose --- p.33 / Chapter 2.7.3. --- Incubation period --- p.33 / Chapter 2.7.4. --- Host factors --- p.33 / Chapter 2.7.5. --- Reservoirs of infection --- p.33 / Chapter 2.7.6. --- Routes of transmission --- p.34 / Chapter 2.7.7. --- Seasonal variation --- p.34 / Chapter 2.7.8. --- Mechanism of diarrhoea --- p.34 / Chapter 2.7.9. --- Histology --- p.35 / Chapter 2.7.10. --- Clinical features --- p.35 / Chapter 2.7.11. --- Treatment --- p.35 / Chapter 2.7.12. --- Prevention --- p.36 / Chapter 2.8. --- DETECTION OF EPEC: LABORATORY METHODS --- p.36 / Chapter 2.8.1. --- O/H Serotyping --- p.36 / Chapter 2.8.2. --- Adhesion assay --- p.37 / Chapter 2.8.3. --- EAF probe --- p.37 / Chapter 2.8.4. --- FAS (Fluorescein Actin Staining) test --- p.37 / Chapter 2.8.5. --- ELISA (Enzyme Linked Immunosorbent Assay) --- p.38 / Chapter 2.8.6. --- eaeA gene probe --- p.38 / Chapter 2.8.7. --- bfpA probe --- p.39 / Chapter 2.8.8. --- PCR (Polymerase Chain Reaction) --- p.39 / MATERIALS AND METHODS --- p.41 / Chapter 3.1. --- PATIENT RECRUITMENT AND DATA COLLECTION --- p.41 / Chapter 3.1.1. --- Study site --- p.41 / Chapter 3.1.2. --- Study design --- p.41 / Chapter 3.1.3. --- Study period --- p.42 / Chapter 3.1.4. --- Study population --- p.42 / Chapter 3.1.5. --- Selection of patients --- p.42 / Chapter 3.1.6. --- Inclusion criteria for cases --- p.43 / Chapter 3.1.7. --- Exclusion criteria --- p.43 / Chapter 3.1.8. --- Selection of control group --- p.43 / Chapter 3.1.9. --- Collection of stool specimens --- p.44 / Chapter 3.1.10. --- Treatment of the study-patients --- p.45 / Chapter 3.1.11. --- Collection of date --- p.45 / Chapter 3.1.12. --- Ethical approval --- p.46 / Chapter 3.2. --- LABORATORY METHODS --- p.47 / Chapter 3.2.1. --- IN PWHLABORATORY --- p.47 / Chapter 3.2.2. --- IN AFRIMS LABORATORY --- p.48 / Chapter 3.3. --- DATA MANAGEMENT AND STATISTICAL METHODS --- p.63 / RESULT --- p.64 / Chapter 4.1. --- DEMOGRAPHY OF THE PATIENTS --- p.64 / Chapter 4.1.1. --- Age distribution of the patients --- p.64 / Chapter 4.1.2. --- Sex distribution of the patients --- p.64 / Chapter 4.1.3. --- Ethnic origin of the patients --- p.65 / Chapter 4.1.4. --- Distribution of area of abode in Hong Kong --- p.66 / Chapter 4.1.5. --- School attendance of the patients --- p.66 / Chapter 4.2. --- PREDISPOSING FACTORS FOR DIARRHOEA --- p.67 / Chapter 4.2.1. --- History of breast feeding of the patients --- p.67 / Chapter 4.2.2. --- History of contact with diarrhoea --- p.68 / Chapter 4.2.3. --- Travel history within last two weeks preceding onset of diarrhoea --- p.68 / Chapter 4.2.4. --- Source of drinking water --- p.69 / Chapter 4.3. --- CLINICAL FEATURES --- p.70 / Chapter 4.3.1. --- Duration of diarrhoea at the time of admission --- p.70 / Chapter 4.3.2. --- Frequency of stool --- p.71 / Chapter 4.3.3. --- Nature and contents of stool --- p.72 / Chapter 4.3.4. --- Condition of the perineum --- p.72 / Chapter 4.3.5. --- Duration of vomiting at the time of admission --- p.73 / Chapter 4.3.6. --- Frequency of vomiting --- p.73 / Chapter 4.3.7. --- Level of dehydration in cases --- p.74 / Chapter 4.3.8. --- Urine output during illness --- p.74 / Chapter 4.3.9. --- Fever associated with illness --- p.75 / Chapter 4.4. --- HISTORY OF HOME- MANAGEMENT --- p.77 / Chapter 4.4.1. --- Main food taken at home during illness --- p.77 / Chapter 4.4.2. --- Supplementary fluid taken at home during illness --- p.77 / Chapter 4.4.3. --- Duration of hospital stay --- p.78 / Chapter 4.4.4. --- Recruitment of patients in different months --- p.79 / Chapter 4.5. --- RESULTS OF GENE PROBING FOR E. COLI --- p.80 / Chapter 4.6. --- DETAILS OF THE EAF+ EPEC CASES --- p.82 / Chapter 4.6.1. --- Associated infections in EAF+ cases --- p.83 / Chapter 4.7. --- AETIOLOGY OF DIARRHOEA --- p.84 / Chapter 4.7.1. --- Age distribution --- p.85 / Chapter 4.7.2. --- Seasonal distribution --- p.86 / Chapter 4.7.3. --- Clinical features --- p.87 / Chapter 4.7.4. --- Different groups of Salmonella --- p.88 / Chapter 4.7.5. --- Dual infection among enteropathogens isolated --- p.89 / DISCUSSION --- p.90 / Chapter 5.1. --- RISK FACTORS ASSOCIATED WITH DIARRHOEA --- p.91 / Chapter 5.1.1. --- Age and sex of the patients --- p.91 / Chapter 5.1.2. --- Nutritional status --- p.91 / Chapter 5.1.3. --- Breast feeding --- p.92 / Chapter 5.1.4. --- Travelling --- p.93 / Chapter 5.2. --- SEVERITY OF DIARRHOEA IN HONG KONG --- p.93 / Chapter 5.3. --- MOLECULAR EPIDEMIOLOGY OF EPEC IN HONG KONG --- p.94 / Chapter 5.3.1. --- EAF probe --- p.94 / Chapter 5.3.2. --- EAF and EPEC virulence --- p.95 / Chapter 5.3.3. --- eaeA probe --- p.96 / Chapter 5.3.4. --- FAS test --- p.97 / Chapter 5.3.5. --- bfpA probe --- p.97 / Chapter 5.3.6. --- Comparison and contrast among the probes --- p.97 / Chapter 5.3.7. --- Probes in the present study --- p.99 / Chapter 5.3.8. --- Role of serogrouping at present --- p.100 / Chapter 5.3.9. --- EPEC in Hong Kong --- p.100 / Chapter 5.4. --- PREVALENCE OF OTHER CATEGORIES OF E. COLI --- p.101 / Chapter 5.5. --- COMMON AETIOLOGY OF DIARRHOEA IN HONG KONG --- p.102 / Chapter 5.5.1. --- Rotavirus as the most common cause --- p.102 / Chapter 5.5.2. --- Non-typhoid Salmonella as the major bacterial pathogen --- p.102 / Chapter 5.5.3. --- Campylobacter and Shigella as cause of diarrhoea --- p.103 / Chapter 5.5.4. --- Role of parasites in childhood diarrhoea in Hong Kong --- p.104 / Chapter 5.6. --- CONTROL MEASURES FOR DIARRHOEAL DISEASES --- p.105 / Chapter 5.6.1. --- Prevention of diarrhoea through improved nutrition --- p.105 / Chapter 5.6.2. --- Fluid supplementation in diarrhoea --- p.106 / Chapter 5.6.3. --- Strategies to control diarrhoea --- p.106 / Chapter 5.6.4. --- Health education --- p.107 / CONCLUSION --- p.108 / APPENDIX --- p.109 / Chapter 7.1. --- QUESTIONNAIRE --- p.109 / Chapter 7.2. --- LABORATORY METHODS --- p.111 / Chapter 7.2.1. --- Routine culture of stool specimens for bacteria --- p.111 / Chapter 7.2.2. --- "Serotyping of Salmonella, Shigella and Vibrio cholerae" --- p.114 / Chapter 7.2.3. --- Microscopic examination of ova and cysts --- p.117 / Chapter 7.2.4. --- Laboratory diagnosis of rotavirus --- p.118 / Chapter 7.3. --- INVESTIGATION REQUISITION FORM --- p.121 / REFERENCES --- p.122 / GRADUATE SEMINARS & PUBLICATIONS --- p.144 / Chapter a. --- Graduate seminars --- p.144 / Chapter b. --- Publications --- p.144