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In December, 1974, three cases of botulism occurred in a family; two were fatal. The first patient died after a 10-day illness without botulism being suspected. 4 days later, after a 2-day illness, the second patient was diagnosed as having botulism after a cardiorespiratory arrest; she died 3 days later. In the third patient, the only symptom was dysphagia. Clostridium botulinum type B was found in stool specimens from all three patients. Home-canned (bottled) mushrooms, which were found to contain C. botulinum type B and its toxin, were believed to be responsible for the outbreak; mushrooms were found at necropsy in the gastrointestinal tracts of both patients who died. Heat treatment of the mushrooms during canning had been inadequate.

Of 57 male children, aged 5 months to 2 1/2 years with rotavirus diarrhoea, 28 were given oral therapy with sucrose electrolyte solution and 29 were given glucose electrolyte solution in a randomised double-blind trial. All were rehydrated and remained so on oral therapy alone. These patients were compared with 44 children, also with rotavirus, who were treated only with intravenous hydration. The oral therapy and intravenous therapy groups did not differ clinically in the rate of rehydration or the rate of purging. Vomiting did not prevent the giving of oral therapy during hospital admission. Bangladeshi children with rotavirus diarrhoea have a defect of carbohydrate digestion but this defect does not prevent the use of a sugar electrolyte solution for oral hydration.

In a 1 year study of diarrhoea in a village in rural Bangladesh, enterotoxigenic Escherichia coli (ETEC) were the most frequently detected enteropathogens; shigellae were the second most commonly detected enteropathogens and rotaviruses the third. ETEC and rotavirus were found in 31% of diarrhoea episodes experienced by children aged less than 2 years and in 70% of episodes associated with dehydration. Furthermore these two pathogens were identified in the stools of 77% of young children with life-threatening dehydration seen at a diarrhoea treatment centre. The association of ETEC and rotavirus with such a substantial proportion of cases of dehydrating diarrhoea suggests that immunoprophylaxis to reduce the high incidence of deaths from diarrhoea in developing countries may be feasible and that vaccine development should concentrate on these two enteropathogens.

Rat and canine hepatocyte suspensions were exposed to toxic concentrations of ethyl methanesulfonate (EMS) and ionophore A-23187 in the presence and absence of extracellular calcium (Ca2+) and alpha-tocopheryl succinate (alpha-TS). The exogenous administration of alpha-TS (25 microM) completely protected hepatocytes from chemically-induced toxicity when exposed to 'physiological' free extracellular calcium concentrations (0.8-1.5 mM). Under these protective conditions the cellular accumulation of both alpha-TS (2.8 nmol/10(6) cells) and alpha-T (0.91 nmol/10(6) cells) were observed. Hepatocytes exposed to unesterified alpha-tocopherol (alpha-T, 25 microM) or alpha-tocopheryl acetate (alpha-TA, 25 microM), however, were not protected from the toxic effect of chemicals even though these treatments resulted in the marked accumulation of cellular alpha-T (2.65 nmol/10(6) cells) and alpha-TA (2.3 nmol/10(6) cells), respectively. Our findings suggest that the supplementation of endogenous stores of alpha-T or alpha-TA does not promote protection against chemical toxicity and that alpha-TS cytoprotection results not from the accumulation of alpha-T but rather from the cellular presence of the intact alpha-TS molecule. Thus alpha-TS appears to possess cytoprotective properties that differ from other vitamin E congeners.

Five patients who developed acute watery diarrhoea while travelling in Mexico in October, 1974, were found to have enterotoxigenic Escherichia coli in their stool which produced heat-stable enterotoxin (S.T.) without producing heat-labile enterotoxin (L.T.). These S.T.-only E. coli, which have previously been described as causing diseases in animals, must now be regarded as pathogenic for humans as well.

The usual methods for identifying enterotoxigenic Escherichia coli (ETEC) strains involve testing for production of heat-labile enterotoxins. To simplify the identification of ETEC, antisera against common ETEC O serogropus were used to identify ETEC in the stools from 618 patients with acute diarrhoea and dehydration (greater than or equal to 5% loss of body-weight) receiving treatment at a hospital in Dacca, Bangladesh. Compared with enterotoxin testing the antisera had a sensitivity of 64%, a specificity of 96%, and a predictive accuracy of 89%. These antisera may be useful in the identification ETEC in clinical laboratories which are unable to perform toxin testing and should be evaluated in other geographical areas.