Mechanisms and impact of enteric infections

The increased recognition of both old and new enteric pathogens and their p otential impact requires an improved understanding of pathogenesis and effe ctive interventions. While the overwhelming mortality (>3 million children per year) due to diarrheal diseases is well-recognized, the potential long- term impacts of enteric infections and early childhood diarrhea morbidity a re just beginning to be appreciated. Furthermore, several enteric infection s are now being recognized as causes of growth shortfalls with or without d iarrhea; i.e., malnutrition may be one of the greatest yet of the "emerging infectious diseases." The increased appreciation of this extended impact calls for further quanti fication and improved understanding of the deranged physiology. In particul ar, persistent diarrheal illnesses exhibit common themes of blunted villi, disruption of intestinal barrier function and varying degrees of sub-mucosa l inflammation for which lactulose/mannitol permeability and fecal lactofer rin provide respective quantification. Finally, such improved understanding will allow targeted interventions among those most vulnerable, which will enable further documentation of cost effectiveness and the potential for im proved human development which is critical to reducing the widening dispari ty and population overgrowth which increasingly threaten our global securit y.