We are currently involved in delineating the functions of the protein products of these genes as well as examining cells for changes induced by infection with bacteria. It is hoped that these studies might impact not only our understanding and approach to infectious diseases, but also our appreciation for normal and abnormal cellular physiology. Among the attaching and effacing E. coli EPEC are distinguished from enterohemorrhagic E. coli by the fact that EPEC do not produce Shiga toxins. Typical EPEC also possess a large plasmid that mediates the ability of these strains to adhere to host cells in a pattern known as localized adherence . Atypical EPEC strains lack this plasmid and do not perform localized adherence.
EPEC strains are a leading cause of diarrhea in developing countries throughout the world.
In some locations EPEC is the most common bacterial cause of diarrhea in infants. Disease due to EPEC is rare in developed countries. In poorer countries where EPEC is prevelant it causes disease almost exclusively in infants, especially those under 6 months of age. Diarrhea due to EPEC is frequently accompanied by vomiting, making oral rehydration difficult. In addition, EPEC is one of the few recognized causes of protracted diarrhea.