Epidemiological data suggest that Enterotoxigenic Escherichia coli (ETEC) strains which secrete heat-stable toxin (ST), alone or in combination with heat-labile toxin (LT), induce the most severe disease among children in developing countries. ETEC is also considered the most common cause of travelers’ diarrea. ETEC is transmitted by the fecal-oral route, whereupon it colonizes the small intestine. The heat-stable toxins of ETEC are encoded on transmissible plasmids and are expressed as 72-amino-acid prepropeptides.
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