Michael H Merson

Interim Chair of the Department of Social and Behavioral Sciences

Clinical Professor of Global and Environmental Health

Professional overview

Michael Merson is Interim Chair of the Department of Social and Behavioral Sciences and a Clinical Professor of Global and Environmental Health at NYU. He also the William Joklik Emeritus Professor of Medicine and Global Health at Duke University, where he served as the founding director of the Duke Global Health Institute and as Vice President and Vice Provost for Global Affairs. His current research is focused on policy issues related to the response to pandemics, evaluating the rollout of Paxlovid in low-income countries and on ways to regain trust in public health.

Prior to NYU, he joined the faculty at Yale University as its first Dean of Public Health. Before entering academia, between 1980 and 1995, Dr. Merson served as director of the World Health Organization (WHO) programs on Diarrheal Diseases and Acute Respiratory Infections, and subsequently the WHO Global Program on AIDS. He has authored over 150 articles, is the senior editor of a leading global health textbook “Global Health: Disease, Programs, Systems, and Policies” and lead author of The AIDS Pandemic: Searching for a Global Response on the history of the global response to AIDS. He has served in advisory capacities for UNAIDS, WHO, the Global Fund to Fight AIDS, TB and Malaria, World Bank, World Economic Forum, Bill & Melinda Gates Foundation, and was an advisor to various private sector entities on the COVID-19 pandemic. He has two honorary degrees and is a member of the National Academy of Medicine.

Education

B.A., 1966, cum laude, Amherst College, Amherst, Massachusetts

M.D., 1970, summa cum laude, SUNY, Health Sciences Center at Brooklyn, New York

Honors and awards

Consortium of Universities for Global Health (CUGH) Distinguished Leadership Award (2018)

Duke Medical Alumni Association Distinguished Faculty Award (2017)

Master Teacher Award in Preventive Medicine, Downstate Medical Center (2010)

Outstanding Contribution to the Campaign Against HIV/AIDS, Russian Association Against AIDS (2000)

Connecticut Health Commissioner’s AIDS Leadership Award (1998)

Connecticut Health Commissioner’s AIDS Leadership Award (1997)

Frank Babbott Alumni Award (1995)

Surgeon General's Exemplary Service Medal (1993)

Commendation Medal, US Public Health Service; (1986)

Arthur S. Flemming Award for Outstanding Federal Service (1983)

Commendation Medal, US Public Health Service (1975)

Publications

Publications

Programma VOZ po bor'be s diareǐnymi bolezniami : sostoianie i perspektivy razvitiia--organizatsionno-operativnyǐ komponent programmy.

Merson, M. H., Litvinov, S. K., Merson, M. H., Oblapenko, G. P., Herniman, R., & Lishnevskiǐ, M. S. (n.d.).

Publication year

1985

Journal title

Zhurnal Mikrobiologii Epidemiologii i Immunobiologii

Issue

6

Page(s)

93-98

Abstract

Abstract

~

Nutritional status, body size and severity of diarrhoea associated with rotavirus or enterotoxigenic Escherichia coli

Merson, M. H., Black, R. E., Merson, M. H., Eusof, A., Huq, I., & Pollard, R. (n.d.).

Publication year

1984

Journal title

Journal of Tropical Medicine and Hygiene

Volume

87

Issue

2

Page(s)

83-89

Abstract

Abstract

Children with severe malnutrition have an increased risk of death from diarrhoea. To determine if the clinical manifestations of specific types of diarrhoea differed according to the nutritional status or size (weight and length) of the patient, we studied children with acute diarrhoea associated with rotavirus or enterotoxigenic Escherichia coli. In this study we found that a child's body size, which was determined by his age and nutritional status, was a significant predictor of his rate of stool output per kilogram of body weight. Thus, children who are small because of young age and/or malnutrition appear to lose a greater proportion of their total fluid volume during diarrhoea and might be expected to have a higher frequency of severe dehydration and death, if untreated.

Diarrhoeal disease control : Reviews of potential interventions

Merson, M. H., Feachem, R. G., Hogan, R. C., & Merson, M. H. (n.d.).

Publication year

1983

Journal title

Bulletin of the World Health Organization

Volume

61

Issue

4

Page(s)

637-640

Abstract

Abstract

Diarrhoeal diseases are a major cause of sickness and death among young children in most developing countries. Since effective interventions to control these diseases are available, they are a priority target for the primary health care programmes being planned or implemented in many countries. Governments and international agencies, including the World Health Organization, have emphasized oral rehydration as an effective intervention for reducing diarrhoeal disease mortality. Other interventions are, however, needed to reduce morbidity, to reduce mortality not averted by oral rehydration, and to develop a multifaceted approach in which oral rehydration is one of several anti-diarrhoea measures being implemented simultaneously with mutally reinforcing and complementary impacts. This paper presents a classification of potential interventions for the control of diarrhoeal disease morbidity and/or mortality among children under 5 years of age and introduces a series of reviews of these interventions. The first of these reviews, on measles immunization, also appears in this issue of the Bulletin of the World Health Organization.

ORAL TYPHOID VACCINE Ty21a

Merson, M. H., Sutton, R. G., & Merson, M. H. (n.d.).

Publication year

1983

Journal title

The Lancet

Volume

321

Issue

8323

Page(s)

523

10.1016/S0140-6736(83)92205-5

Abstract

Abstract

~

Prevention of Traveler's Diarrhea

Merson, M. H., & Merson, M. H. (n.d.).

Publication year

1983

Journal title

Gastroenterology

Volume

84

Issue

2

Page(s)

424-426

10.1016/S0016-5085(83)80145-0

Abstract

Abstract

~

Serologic differentiation between antitoxin responses to infection with Vibrio cholerae and enterotoxin-producing Escherichia coli

Svennerholm, A. M., Holmgren, J., Black, R., Levine, M., & Merson, M. H. (n.d.).

Publication year

1983

Journal title

Unknown Journal

Volume

147

Issue

3

Page(s)

514-522

10.1093/infdis/147.3.514

Abstract

Abstract

A ganglioside enzyme-linked immunosorbent assay (ELISA) was used to study and attempt to differentiate between antitoxin responses in persons infected with either Vibrio cholerae or Escherichia coli producing heat-labile enterotoxin. In most cases (69%-94%), experimentally infected North Americans and naturally infected Bangladeshis responded to either infection with significant (greater than twofold) increases in serum antibody titer to both heat-labile enterotoxin and cholera toxin. In all but one instance, the response was higher to the homologous than to the heterologous toxin, and for the Americans the homologous antitoxin titers remained significantly higher for at least one year. Determination of levels of antibodies to purified subunits A and B of cholera toxin by an ELISA showed that V. cholerae infection in most instances induced a significant response to subunit B but rarely to subunit A. E. coli infection, on the other hand, induced only slight increases in antibody titer to either subunit.

Contamination of weaning foods and transmission of enterotoxigenic Escherichia coli diarrhoea in children in rural Bangladesh

Black, R. E., Black, R. E., Brown, K. H., Becker, S., Alim, A. R., Merson, M. H., Black, R. E., Brown, K. H., Brown, K. H., & Brown, K. H. (n.d.).

Publication year

1982

Journal title

Transactions of the Royal Society of Tropical Medicine and Hygiene

Volume

76

Issue

2

Page(s)

259-264

10.1016/0035-9203(82)90292-9

Abstract

Abstract

In longitudinal studies of infectious diseases and nutrition in Bangladesh, we determined the degree of bacterial contamination of traditional weaning foods and evaluated the role of these foods in the transmission of diarrhoeal diseases. 41% of samples of food items fed to weaning aged children contained Escherichia coli; these organisms were used as indicators of faecal contamination. Milk and foods prepared particularly for infants were more frequently and heavily contaminated with E. coli than was boiled rice, and E. coli levels were found to be related to the storage of cooked foods at high environmental temperatures. 50% of drinking water specimens also contained E. coli, but colony counts were approximately 10-fold lower than in food specimens. The proportion of a child’s food samples that contained E. coli was significantly related to the child’s annual incidence of diarrhoea associated with enterotoxigenic E. coli. This observation underscores the importance of seeking locally available foods that are hygienic as well as nutritious to supplement the diets of breastfeeding children in developing countries.

Endemic cholera in rural Bangladesh, 1966-1980

Glass, R. I., Becker, S., Huq, M. I., Stoll, B. J., Khan, M. U., Merson, M. H., Lee, J. V., & Black, R. E. (n.d.).

Publication year

1982

Journal title

American Journal of Epidemiology

Volume

116

Issue

6

Page(s)

959-970

10.1093/oxfordjournals.aje.a113498

Abstract

Abstract

Since 1963, the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR.B), formerly the Cholera Research Laboratory, has maintained a field station in Matlab to treat patients from a surveillance population of 240,000 who have cholera and other diarrheal diseases. Since 1966, the authors have analyzed hospital records of 7141 surveillance-area patients culture-positive for V. cholerae 01 to relate the seasonally, age and sex distribution, and geographic trends with hypotheses concerning transmission, immunity, and risk groups. From this review, they have found that: 1) children 2-9 years old and adult women are most commonly hospitalized for cholera; 2) V. cholerae 01 emerges simultaneously throughout the area of surveillance, with the early cases being of different phage types; 3) three patients were hospitalized twice for cholera compared with 29 expected on the basis of life-table analysis (p < 0.01), suggesting that Immunity to severe disease conferred by previous Illness may be stable and long-lasting; 4) no constant relationship was found between the times of onset or peaks of the yearly cholera epidemic and the times of onset or peaks of the monsoon rains or river water levels; and 5) an outbreak of multiply antibiotic-resistant V. cholerae 01 infection documented in 1979 raises questions about the dissemination of resistance plasmids, antibiotic-use patterns, and the need for other drugs in addition to tetracycline. While little progress has been made in understanding the mode of transmission of V. cholerae 01, and in Identifying practices for prevention, fluid therapy in this area has decreased the case fatality rate significantly and provides guidance for similar programs elsewhere.

The magnitude of the global problem of acute diarrhoeal disease : A review of active surveillance data

Merson, M. H., Snyder, J. D., & Merson, M. H. (n.d.).

Publication year

1982

Journal title

Bulletin of the World Health Organization

Volume

60

Issue

4

Page(s)

605-613

Abstract

Abstract

Data from 24 published studies were analysed in order to estimate the annual morbidity and mortality from acute diarrhoeal disease in the developing world. Twenty-two of the studies involved frequent surveillance through home visits to families in communities; the other two were multi-country studies in which diarrhoea mortality was calculated on the basis of death certificate information. Morbidity rates were found to be highest in the 6-11 month age group, while the mortality rates were greatest in infants under 1 year of age and children 1 year old. For children under 5 years old, the median incidence of diarrhoea was 2.2 episodes per child per year for all studies and 3.0 episodes per child per year for the studies that had the smallest populations and most frequent surveillance. Using 1980 population estimates, the estimated total yearly morbidity and mortality from diarrhoeal disease for children under 5 years of age in Africa, Asia (excluding China), and Latin America were 744-1000 million episodes and 4.6 million deaths.

Clinical features of types A and B food-borne botulism

Merson, M. H., Hughes, J. M., Blumenthal, J. R., Merson, M. H., Lombard, G. L., Dowell, V. R., & Gangarosa, E. J. (n.d.).

Publication year

1981

Journal title

Unknown Journal

Volume

95

Issue

4

Page(s)

442-445

10.7326/0003-4819-95-4-442

Abstract

Abstract

Medical records of 55 patients with type A and type B food-borne botulism reported to the Centers for Disease Control during 2 years were reviewed to assess the clinical features and severity of illness, diagnostic test results, nature of complications, and causes of death. Some patients had features not usually associated with botulism including paresthesia (14%), asymmetric extremity weakness (17%), asymmetric ptosis (8%), slightly elevated cerebrospinal fluid protein values (14%), and positive responses to edrophonium chloride (26%). Several observations suggest that type A was more severe than type B disease. Although the case-fatality ratio was not significantly greater, patients with type A disease saw a physician earlier in the course of illness, were more likely to need ventilatory support, and were hospitalized longer. Patients who died were older than those who survived. Deaths within the first 2 weeks resulted from failure to recognize the severity of the disease or from pulmonary or systemic infection whereas the three late deaths were related to respirator malfunction.

Enterotoxigenic Escherichia coli diarrhoea : Acquired immunity and transmission in an endemic area

Merson, M. H., Black, R. E., Merson, M. H., Rowe, B., Taylor, P. R., Abdul Alim, A. R., Gross, R. J., & Sack, D. A. (n.d.).

Publication year

1981

Journal title

Bulletin of the World Health Organization

Volume

59

Issue

2

Page(s)

263-268

Abstract

Abstract

Enterotoxigenic Escherichia coli (ETEC) are an important cause of diarrhoea in developing countries. Studies were made, in an endemic area of Bangladesh, of household contacts of patients with diarrhoea associated with E. coli producing heat-stable and heat-labile toxins (ST/LT) or heat-stable toxin (ST) only. It was found that 11% of contacts were infected in the 10-day study period, and that both the rate of infection and the proportion of infected persons with diarrhoea decreased with increasing age, suggesting the development of immunity. ETEC of the same serotype as that of the index patient were found in 9% of water sources used by index households, in a small number of food and drinking water specimens from the index homes, and in faeces from 3 healthy calves. The rate of infection of household members was highest in houses where there was contaminated food or water which suggests that infection may take place in the home when contaminated water is brought in.

Glucose vs sucrose in oral rehydration solutions for infants and young children with rotavirus-associated diarrhea

Merson, M. H., Black, R. E., Merson, M. H., Taylor, P. R., Yolken, R. H., & Sack, D. A. (n.d.).

Publication year

1981

Journal title

Pediatrics

Volume

67

Issue

1

Page(s)

79-83

Abstract

Abstract

The use of oral dehydration solutions containing essential electrolytes and either glucose or sucrose of equal osmolality was compared in a double-blind sequential trial of 784 children with rotavirus-associated diarrhea treated at a center in rural Bangladesh. The oral fluid failure rate was 11.5% for the sucrose-containing group (P = NS). Vomiting was a significantly more common cause of failure for the group treated with sucrose-containing oral rehydration solution and was associated with an increased rate of intake of the sweeter sucrose-containing solution. The purging rate was not different for the two groups. The oral fluid failure rates for children in the most underweight category (

INCIDENCE AND SEVERITY OF ROTAVIRUS AND ESCHERICHIA COLI DIARRHOEA IN RURAL BANGLADESH. Implications for Vaccine Development

Black, R. E., Huq, I., Merson, M. H., Alim, A. R., & Yunus, M. (n.d.).

Publication year

1981

Journal title

The Lancet

Volume

317

Issue

8212

Page(s)

141-143

10.1016/S0140-6736(81)90719-4

Abstract

Abstract

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.

Oral rehydration therapy : Recent advances

Merson, M. H., Mahalanabis, D., Merson, M. H., & Barua, D. (n.d.).

Publication year

1981

Journal title

World Health Forum

Volume

2

Issue

2

Page(s)

245-249

Abstract

Abstract

~

A two-year study of bacterial, viral, and parasitic agents associated with diarrhea in rural Bangladesh

Merson, M. H., Black, R. E., Merson, M. H., Rahman, A. S., Yunus, M., Alim, A. R., Huq, I., Yolken, R. H., & Curlin, G. T. (n.d.).

Publication year

1980

Journal title

Unknown Journal

Volume

142

Issue

5

Page(s)

660-664

10.1093/infdis/142.5.660

Abstract

Abstract

Enteric pathogens associated with diarrhea were studied for two years at a diarrhea treatment center in rural Bangladesh. Enterotoxigenic Escherichia coli (ETEC) was the most frequently identified pathogen for patients of all ages. Rotavirus and ETEC were isolated from ~50% and ~25%, respectively, of patients less than two years of age. A bacterial or viral pathogen was identified for 70% of these young children and for 56% of all patients with diarrhea. Most ETEC isolates were obtained in the hot dry months of March and April and the hot wet months of August and September. Rotavirus identification peaked in the cool dry months of December and January, but infected patients were found year-round. The low case-fatality rates for patients with watery diarrhea and substantial dehydration further document the usefulness of treating patients with diarrhea with either a glucose- or sucrose-base electrolyte solution such as those used in this treatment center.

Detection of Escherichia coli enterotoxins in stools

Merson, M. H., Yolken, R. H., Bradley Sack, R., Froehlich, J. L., Greenberg, H. B., Huq, I., & Black, R. W. (n.d.).

Publication year

1980

Journal title

Infection and Immunity

Volume

29

Issue

1

Page(s)

108-113

10.1128/iai.29.1.108-113.1980

Abstract

Abstract

We determined whether enterotoxigenic Escherichia coli diarrhea could be diagnosed by direct examination of stools for heat-labile (LT) and heat-stable (ST) enterotoxins. The Y-1 adrenal cell and an enzyme-linked immunosorbent assay (ELISA) detected LT in 85 and 93%, respectively, of stool specimens obtained from adults with acute diarrhea from whom an LT- and ST-producing organism had been isolated. Furthermore, the ELISA assay detected LT in 8 of 35 stool specimens from which no LT-producing E. coli had been isolated. The infant mouse assay was utilized to detect ST in these stool specimens and was found to be an insensitive method, showing positive results in only 36% of the specimens from which an ST-producing organism was isolated. Further studies are warranted to determine the diagnostic value of direct detection of LT in stools, especially by the ELISA method.

Diarrhoeal disease in Bangladesh epidemiology, mortality averted and costs at a rural treatment centre

Oberle, M. W., Merson, M. H., Islam, M. S., Rahman, A. S., Huber, D. H., & Curlin, G. (n.d.).

Publication year

1980

Journal title

International Journal of Epidemiology

Volume

9

Issue

4

Page(s)

341-348

10.1093/ije/9.4.341

Abstract

Abstract

Oberle M W (Bureau of Epidemiology, Center for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia 30333, USA), Merson M H, Islam M S, Rahman A S M M, Huber D H and Curlin G. Diarrhoeal disease in Bangladesh: Epidemiology, mortality averted and costs at a rural treatment centre. International Journal of Epidemiology 1980, 9: 341-348.The basic epidemiology of acute diarrhoeal disease seen at a rural Bangladesh hospital in 1975 is reviewed. V.cholerae 01 was isolated from 28% of 1 964 patients. Significant differences in hospltalisation rates were observed between males and females in several age groups. Overall hospital case fatality was 9/1000 cases. We estimate that approximately a quarter to half of the hospitalised patients would have died had no rehydration therapy been available. The region's total mortality was reduced by approximately 7%-15%, at a cost of United States $0.14 per capita. Mortality from acute diarrhoeal diseases was greatly reduced for all age groups, and total mortality and mortality from all diarrhoeal diseases were particularly reduced for young children and young adults. Rehydration therapy used in a field hospital was apparently highly effective in reducing general mortality and mortality from acute diarrhoeal diseases.

Disease due to enterotoxigenic Escherichia coli in Bangladeshi adults : Clinical aspects and a controlled trial of tetracycline

Merson, M. H., Merson, M. H., Sack, R. B., Islam, S., Saklayen, G., Huda, N., Huq, I., Zulich, A. W., Yolken, R. H., & Kapikian, A. Z. (n.d.).

Publication year

1980

Journal title

Journal of Infectious Diseases

Volume

141

Issue

6

Page(s)

702-711

10.1093/infdis/141.6.702

Abstract

Abstract

The clinical characteristics of disease due to enterotoxigenic Escherichia coli (ETEC) were determined in 88 adult males admitted to a hospital in Dacca, Bangladesh, with moderate to severe dehydration. Persons infected with ETEC strains producing both heat-labile toxin (LT) and heat-stable (ST) toxin had more dehydration and acidosis, longer duration of illness, and greater stool volume than persons infected with strains producing only ST. Tetracycline therapy, evaluated in 63 cases, resulted in slightly earlier termination of illness in the patients with LT-ST strains but had no effect on illness in the patients with ST strains. In both groups of patients tetracycline shortened the duration of excretion of organisms. Because of its limited effectiveness and the generally excellent response of ETEC diarrhea to rehydration therapy alone, tetracycline is not warranted for use in treatment of ETEC diarrhea in adults in this population.

Foodborne outbreak of shigellosis caused by an unusual Shigella strain

Merson, M. H., Huq, I., Alam, A. K., Morris, G. K., Wathen, G., & Merson, M. (n.d.).

Publication year

1980

Journal title

Journal of Clinical Microbiology

Volume

11

Issue

4

Page(s)

337-339

10.1128/jcm.11.4.337-339.1980

Abstract

Abstract

A family outbreak of foodborne shigellosis caused by an unusual strain of Shigella is described. The strain was a mannitol-positive variant of Shigella dysenteriae and agglutinated in antiserum prepared against provisional serotype 3341-55.

Increase in antibiotic resistance among isolates of salmonella in the united states, 1967-1975

Merson, M. H., Ryder, R. W., Blake, P. A., Murlin, A. C., Carter, G. P., Pollard, R. A., Merson, M. H., Allen, S. D., & Brenner, D. J. (n.d.).

Publication year

1980

Journal title

Journal of Infectious Diseases

Volume

142

Issue

4

Page(s)

485-491

10.1093/infdis/142.4.485

Abstract

Abstract

To study temporal changes in the antibiotic resistance of Salmonella in the United States, a study design similar to that of a 1967 study was used to determine the antibiotic sensitivity of 754 human nontyphoid Salmonella isolates sent to the Center for Disease Control, Atlanta, Georgia, in 1975. The frequency of resistance to one or more of the same nine antibiotics used in both studies increased significantly during the eight years in Salmonella typhimurium (40%-59%; P = 0.004), other serotypes (14%-23%; P = 0.001), and all serotypes combined (21%-31%; P` 0.001). The increase in frequency of resistance was significant for streptomycin (P = 0.022), sulfonamides (P` 0.001), am- picillin (P ` 0.001), and kanamycin (P ` 0.001). No chloramphenicol-resistant isolates were found in the 1967 study, whereas six isolates (0.8%) were resistant in 1975. The frequency of strains resistant to six or more antibiotics increased greatly (0.8%-5.0%; P` 0.001). These data document a continuing increase in antimicrobial resistance among Salmonella isolates.

MATERNAL CHOLERA IMMUNISATION AND SECRETORY IgA IN BREAST MILK

Merson, M. H., Black, R. E., Sack, D. A., Svennerholm, A. M., & Holmgren, J. (n.d.).

Publication year

1980

Journal title

The Lancet

Volume

315

Issue

8174

Page(s)

931-932

10.1016/S0140-6736(80)90860-0

Abstract

Abstract

~

Oral rehydration therapy for treatment of rotavirus diarrhea in a rural treatment center in Bangladesh

Merson, M. H., Taylor, P. R., Merson, M. H., Black, R. E., Mizanur Rahman, A. S., Yunus, M. D., Alim, A. R., & Yolken, R. H. (n.d.).

Publication year

1980

Journal title

Archives of Disease in Childhood

Volume

55

Issue

5

Page(s)

376-379

10.1136/adc.55.5.376

Abstract

Abstract

In November 1977, an enzyme-linked immunosorbent assay for detecting rotavirus antigen was introduced in the laboratory of a rural treatment center in Bangladesh. During the next 40 days rotavirus without other pathogens was found in the stools of 216 (45%) of 480 children under age 5 yr who visited the center with a gastrointestinal illness. One hundred and eighty-eight (87%) of these children were treated with oral rehydration alone, using the solution currently recommended by the World Health Organization, while 28 (13%) also required some intravenous rehydration; there were no deaths. Oral rehydration treatment was judged successful in 205 (95%) of the rotavirus patients and was not associated with any serious side effects. Oral rehydration treatment, with this solution, has been used extensively and successfully in the treatment of enterotoxin-mediated diarrhea and can also safely be used for treating rotavirus diarrhea in infants and young children.

USE OF ANTISERA FOR IDENTIFICATION OF ENTEROTOXIGENIC ESCHERICHIA COLI

Merson, M. H., Black, R. E., Gross, R. J., Rowe, B., Huq, I., & Eusof, A. (n.d.).

Publication year

1980

Journal title

The Lancet

Volume

316

Issue

8188

Page(s)

222-224

10.1016/S0140-6736(80)90118-X

Abstract

Abstract

The usual methods for identifying enterotoxigenic Escherichia coli (ETEC) strains involve testing for production of heat-labile and heat-stable enterotoxins. To simplify the identification of ETEC, antisera against common ETEC O serogroups were used to identify ETEC in the stools from 618 patients with acute diarrhœa and dehydration (≽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.

Village-based distribution of oral rehydration therapy packets in Bangladesh

Merson, M. H., Chen, L. C., Black, R. E., Sarder, A. M., Merson, M. H., Bhatia, S., Yunus, M., & Chakraborty, J. (n.d.).

Publication year

1980

Journal title

American Journal of Tropical Medicine and Hygiene

Volume

29

Issue

2

Page(s)

285-290

10.4269/ajtmh.1980.29.285

Abstract

Abstract

The distribution of sucrose-electrolyte oral therapy packets (1 liter)by community-based workers in a rural Bangladesh population of 157,000 was evaluated. A similar population of 134,000 served as comparison group. The locally-produced packets showed satisfactory chemical composition with a shelf-life of up to 3 months and a cost of U.S. $0.05. After 4 months the workers were distributing an average of 70 packets/1,000 population per month. Most patients used one packet for each episode of diarrhea; 13% of children used two packets, and 15% and 8% of adults used, respectively, two and three packets. The electrolyte composition of the oral fluids prepared by field workers and mothers showed substantial variation, but no hyperconcentrated solutions were noted. A comparison of the hospitalization rate from the two study areas suggested a 29% reduction in hospitalization for diarrhea during the 4 months of distribution.

Comparison of four plating media for isolating Vibrio cholerae

Merson, M. H., Morris, G. K., Merson, M. H., Huq, I., Kibrya, A. K., & Black, R. (n.d.).

Publication year

1979

Journal title

Journal of Clinical Microbiology

Volume

9

Issue

1

Page(s)

79-83

Abstract

Abstract

Two brands of thiosulfate citrate bile salts sucrose agar and Monsur taurocholate tellurite gelatin (TTG) agar were compared with two newly developed media, sucrose tellurite teepol agar and Vibrio parahaemolyticus agar for isolation and identification of Vibrio cholerae. The thiosulfate citrate bile salts sucrose and TTG agars were the best selective media, whereas sucrose tellurite teepol agar was the poorest. Both TTG and sucrose tellurite teepol agars were good for use in follow-up serological tests, whereas only TTG agar could be used for follow-up oxidase tests. In our opinion, TTG agar has more advantages for cholera research laboratories routinely culturing large numbers of patients for cholera on a daily basis and where media needs can be accurately predicted. In contrast, in smaller clinical laboratories or in laboratories investigating epidemics, thiosulfate citrate bile salts sucrose agar is best because it is commercially available and easy to prepare and can be used to distinguish colonies of suspect V. cholerae from V. parahaemolyticus.