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Sir.—The article by Rudoy and Nelson (129:668-672, 1975) and the editorial comments of Neter (129:666, 1975) regarding the diarrheas apparently produced by enteropathogenic Escherichia coli do not address themselves to the clinical observation that many cases of gastroenteritis behave like viral illnesses in that they persist for five to seven days before resolving spontaneously. Mild epidemics of these diarrheas also occur each summer with monotonous regularity. I am curious as to whether anyone has investigated the possibility of a virus inducing enterotoxin production in both typable and nontypable E coli. Such a system is well delineated in the production of toxin by the diphtheria bacillus, and viral induction of toxin by bacteria might explain why many diarrheas behave like viral diseases despite a largely unrewarding search for pathogenic enteroviruses.
O'DONOVAN JC. Enteropathogenic Escherichia coli. Am J Dis Child. 1976;130(3):336. doi:10.1001/archpedi.1976.02120040114024