These periods recur with increasing severity and frequency. Diarrhea becomes marked, with soft or liquid stools containing mucus, pus, and often blood. Rectal prolapse and consequent fecal incontinence may result from severe tenesmus. Significant dehydration and electrolyte loss with circulatory collapse and death is limited mainly to infants Secondary bacterial infections may occur, especially in debilitated and dehydrated patients. The bacillus is found in the stools.
Diagnosis is facilitated by a high index of suspicion during outbreaks and in endemic areas.
The most common form, watery diarrhea, is indistinguishable from other bacterial, viral and protozoan infections that induce secretory activity of intestinal epithelial cells. Prophylaxis Preventing spread by contaminated food, water, and flies requires good sanitation. A live oral vaccine is being developed, and field trials in endemic areas seem successful. Treatment Diarrhea usually causes isotomic dehydration with metabolic acidosis and significant potassium loss. Thirst from dehydration can lead to a proportionately excessive water intake, causing hypotonicity.