The relationship between enterotoxigenic {\it Escherichia coli\/} infection and environmental risk factors in Bilbeis, Egypt, 1981--1983

Diarrheal disease associated with enterotoxigenic Escherichia coli (ETEC) infection is one of the major public health problems in many developing countries, especially in infants and young children. Because tests suitable for field laboratories have been developed only relatively recently, the literature on the environmental risk factors associated with ETEC is not as complete as for many other pathogens or for diarrhea of unspecified etiology.^ Data from a diarrheal disease surveillance project in rural Egypt in which stool samples were tested for a variety of pathogens, and in which an environmental questionnaire was completed for the same study households, provided an opportunity to test for an association between ETEC and various risk factors present in those households. ETEC laboratory-positive specimens were compared with ETEC laboratory-negative specimens for both symptomatic and asymptomatic children less than three years of age at the individual and household level using a case-comparison design.^ Individual children more likely to have LT infection were those who lived in HHs that had cooked food stored for subsequent consumption at the time of the visit, where caretakers used water but not soap to clean an infant after a diarrheal stool, and that had an indoor, private water source. LT was more common in HHs where the caretaker did not clean an infant with soap after a diarrheal stool, and where a sleeping infant was not covered with a net. At both the individual and HH level, LT was significantly associated with good water supply in terms of quantity and storage.^ ST was isolated more frequently at the individual level where a sleeping infant was covered with a net, where large animals were kept in or around the house, where water was always available and was not potable, and where the water container was not covered. At the HH level, the absence of a toilet or latrine and the indiscriminate disposal of animal waste decreased risk. Using animal feces for fertilizer, the presence of large animals, and poor water quality were associated with ST at both the individual and HH level.^ These findings are mostly consistent with those of other studies, and/or are biologically plausible, with the obvious exception of those from this study where poorer water supplies are associated with less infection, at least in the case of LT. More direct observation of how animal ownership and feces disposal relates to different types of water supply and usage might clarify mechanisms through which some ETEC infection could be prevented in similar settings. ^

Reconnaissance survey of Galveston Bay sediments for selective nonresidual trace metals

The nonresidual concentrations of five trace metals were determined for 322 sediments that were the product of a systematic sampling program of the entire Galveston Bay system. The nonresidual component of the trace metal concentration (e.g. that fraction of the metals that can be relatively easily removed from the sediments without complete destruction of the sediment particle) was considered to be more indicative of the anthropogenic metal pollution that has impacted the Galveston Bay ecosystem.^ For spatial analysis of the metal concentrations, the Galveston Bay system was divided into nine bay-areas, based on easily definable geological and geographical characteristics. Isopleth mapping analyses of these metal concentrations indicated a direct relationship with the $<$63$\mu$m fraction of the sediment (%FINE) in all of the bay areas. Covariate regression analyses indicated that position of the sediment within the Galveston Bay system (e.g. bay-area) was a better predictor of metal concentration than %FINE. Analysis of variance of the metals versus the bay-areas indicated that the five metals maintained a relatively constant order and magnitude of concentration for all the bay-areas.^ The major shipping channels of the Galveston Bay system, with their associated vessels and transported materials, are a likely source of metal pollution. However, these channels were not depositional corridors of high metal concentration. All metal concentration highs were found to be located away from the channels and associated with %FINE highs in the deeper portions of the bay-areas.^ Disturbance of the sediments, by the proposed widening and deepening of these channels, is not predicted to remobilize the trace metals. A more likely adverse effect on the health of the Galveston Bay ecosystem would come from the increase in turbidity of the water due to the dredging and in an extension of the salt water wedge farther north into the bay system. ^