NONSEASONAL VIRAL AND BACTERIAL EPISODE OF DIARRHEA IN THE JORDAN VALLEY, WEST OF JORDAN

A non-seasonal diarrhoeal episode in the Jordan Valley occurred over a 2-month period, during which no traditional enteropathogens were dete cted by the health authority laboratories. ii total of 17 diarrhoeal s tool specimens from infants, young children and adults were randomly c ollected and delivered to our laboratories to investigate the presence of unusual aetiological agents. Stools were examined for parasites, o va, viruses and cultured for bacterial pathogens. A multiplex polymera se chain reaction was developed to investigate the involvement of diar rhoeagenic Escherichia coli in this episode; Recognised pathogenic org anisms were detected in 8 out of 17 of the diarrhoeatic patients, one patient of whom had a mixed infection with two agents. Rotavirus, ente roinvasive E. coil (EIEC), enteropathogenic E. coli (EPEC), and entero toxigenic E. coli (ETEC) were found to be associated with the diarrhoe a. EIEC was the most common enteropathogen detected (4 out of 17) foll owed by rotavirus (3 out of 17). One of the EIEC isolates detected in one patient was associated with rotavirus. The clinical features of th e diarrhoeatic patients were remarkably similar, regardless of aetiolo gy. This study reveals the identity of pathogenic agents that are not detected by traditional methods employed by the health authority labor atories, which emphasise the urgent need for developing the current di agnostic techniques.