Redo of The 2017 ISDA Guidelines For The Diagnosis and Management Of Infectious Diarrhea In Adults And Children

The tables in my post 2017 ISDA Guidelines For Infectious Diarrhea In Adults And Children were mostly unreadable [copies from the PDF of the Guidelines]. Therefore, I redid the post today making the tables readable by using the HTML tables excerpted from the article.

The Executive Summary of Resource (1) [HTML] runs from p e45 to e55 of the PDF. You can also easily read the Executive Summary in the HTML. Please read the executive summary first [note to myself when reviewing again].

Only after reading the executive summary should you go ahead and review the Figures and Tables I’ve included in my study notes will give you an adequate quick review [Again just a note to myself].

But the reading the full text and the Additional Resources after the post will give you the complete picture of Infectious Diarrhea.

The following Figures And Tables are from Resource (1) below, The 2017 IDSA Infectious Diarrhea Guidelines:

 

Table 1.

Modes of Acquisition of Enteric Organisms and Sources of Guidelines

Mode	Title	URL	Author/Issuing Agency
International travel	Expert Review of the Evidence Base for Prevention of Travelers’ Diarrhea	https://www.ncbi.nlm.nih.gov/pubmed/19538575	DuPont et al [113]
	Medical Considerations Before International Travel	https://www.ncbi.nlm.nih.gov/pubmed/27468061	Freedman et al [207]
	The Yellow Book	https://wwwnc.cdc.gov/travel/page/ yellowbook-home-2014	CDC
	Travelers Health	https://wwwnc.cdc.gov/travel	CDC
Immunocompromised hosts	Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents	https://aidsinfo.nih.gov/contentfiles/lvguidelines/ adult_oi.pdf	CDC/NIH/HIVMA/IDSA
	Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children	https://aidsinfo.nih.gov/contentfiles/lvguidelines/ oi_guidelines_pediatrics.pdf	CDC/NIH/HIVMA/IDSA
Foodborne and waterborne	Surveillance for Foodborne Disease Outbreaks—United States, 2009–2010	https://www.cdc.gov/mmwr/preview/mmwrhtml/ mm6203a1.htm?s_cid=mm6203a1_w	CDC
	Food Safety	https://www.cdc.gov/foodsafety/	CDC
	Healthy Water	https://wwwnc.cdc.gov/healthywater	CDC
Antimicrobial-associated (C. difficile)	Clinical Practice Guidelines for Clostridium difficileInfection in Adults and Children 2017 Update (in press)	https://www.jstor.org/stable/10.1086/651706	IDSA/SHEA
	2010 Clinical Practice Guidelines for Clostridium difficileInfection in Adults	https://www.idsociety.org/ Organ_System/#Clostridiumdifficile	IDSA/SHEA
Healthcare-associated	Healthcare-Associated Infections	https://www.cdc.gov/hai/	CDC
Child care settings	Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs	https://nrckids.org.	AAP, APHA, NRC
	Recommendations for Care of Children in Special Circumstances—Children in Out- of-Home Child Care (pp 132–51)	https://redbook.solutions.aap.org/redbook.aspx	AAP
	Managing Infectious Diseases in Child Care and Schools	https://ebooks.aappublications.org/content/managing-infectious-diseases-in-child-care-and-schools- 3rd-edition	AAP
Long-term care settings	Nursing Homes and Assisted Living (Long- term Care Facilities)	https://www.cdc.gov/longtermcare/	CDC
	Infection Prevention and Control in the Long-term Care Facility	https://www.shea-online.org/assets/files/position-papers/ic-ltcf97.pdf	SHEA/APIC
Zoonoses	Compendium of Measures to Prevent Disease Associated With Animals in Public Settings	https://www.cdc.gov/mmwr/preview/mmwrhtml/ rr6004a1.htm?s_cid=rr6004a1_w	CDC
	Exposure to Nontraditional Pets at Home and to Animals in Public Settings: Risks to Children	https://pediatrics.aappublications.org/ content/122/4/876	Pickering et al [51]
	Review of Institute of Medicine and National Research Council Recommendations for One Health Initiative	https://wwwnc.cdc.gov/eid/article/19/12/12-1659_ article.htm	Rubin et al [208]

Abbreviations: AAP, American Academy of Pediatrics; APHA, American Public Health Association; APIC, Association for Professionals in Infection Control and Epidemiology; CDC, Centers for Disease Control and Prevention; HIV, human immunodeficiency virus; HIVMA, HIV Medicine Association; IDSA, Infectious Diseases Society of America; NIH, National Institutes of Health; NRC, National Resource Center for Health and Safety in Child Care and Early Education; SHEA, Society for Healthcare Epidemiology of America.

Table 2.

Exposure or Condition Associated With Pathogens Causing Diarrhea

Exposure or Condition	Pathogen(s)
Foodborne
Foodborne outbreaks in hotels, cruise ships, resorts, restaurants, catered events	Norovirus, nontyphoidal Salmonella, Clostridium perfringens, Bacillus cereus, Staphylococcus aureus, Campylobacter spp, ETEC, STEC, Listeria, Shigella, Cyclospora cayetanensis, Cryptosporidium spp
Consumption of unpasteurized milk or dairy products	Salmonella, Campylobacter, Yersinia enterocolitica, S. aureus toxin, Cryptosporidium, and STEC. Listeria is infrequently associated with diarrhea, Brucella (goat milk cheese), Mycobacterium bovis, Coxiella burnetii
Consumption of raw or undercooked meat or poultry	STEC (beef), C. perfringens (beef, poultry), Salmonella (poultry), Campylobacter (poultry), Yersinia (pork, chitterlings), S. aureus(poultry), and Trichinella spp (pork, wild game meat)
Consumption of fruits or unpasteurized fruit juices, vegetables, leafy greens, and sprouts	STEC, nontyphoidal Salmonella, Cyclospora, Cryptosporidium, norovirus, hepatitis A, and Listeria monocytogenes
Consumption of undercooked eggs	Salmonella, Shigella (egg salad)
Consumption of raw shellfish	Vibrio species, norovirus, hepatitis A, Plesiomonas
Exposure or contact
Swimming in or drinking untreated fresh water	Campylobacter, Cryptosporidium, Giardia, Shigella, Salmonella, STEC, Plesiomonas shigelloides
Swimming in recreational water facility with treated water	Cryptosporidium and other potentially waterborne pathogens when disinfectant concentrations are inadequately maintained
Healthcare, long-term care, prison exposure, or employment	Norovirus, Clostridium difficile, Shigella, Cryptosporidium, Giardia, STEC, rotavirus
Child care center attendance or employment	Rotavirus, Cryptosporidium, Giardia, Shigella, STEC
Recent antimicrobial therapy	C. difficile, multidrug-resistant Salmonella
Travel to resource-challenged countries	Escherichia coli (enteroaggregative, enterotoxigenic, enteroinvasive), Shigella, Typhi and nontyphoidal Salmonella, Campylobacter, Vibrio cholerae, Entamoeba histolytica, Giardia, Blastocystis, Cyclospora, Cystoisospora, Cryptosporidium
Exposure to house pets with diarrhea	Campylobacter, Yersinia
Exposure to pig feces in certain parts of the world	Balantidium coli
Contact with young poultry or reptiles	Nontyphoidal Salmonella
Visiting a farm or petting zoo	STEC, Cryptosporidium, Campylobacter
Exposure or condition
Age group	Rotavirus (6–18 months of age), nontyphoidal Salmonella (infants from birth to 3 months of age and adults >50 years with a history of atherosclerosis), Shigella (1–7 years of age), Campylobacter (young adults)
Underlying immunocompromising condition	Nontyphoidal Salmonella, Cryptosporidium, Campylobacter, Shigella, Yersinia
Hemochromatosis or hemoglobinopathy	Y. enterocolitica, Salmonella
AIDS, immunosuppressive therapies	Cryptosporidium, Cyclospora, Cystoisospora, microsporidia, Mycobacterium avium–intercellulare complex, cytomegalovirus
Anal-genital, oral-anal, or digital-anal contact	Shigella, Salmonella, Campylobacter, E. histolytica, Giardia lamblia, Cryptosporidium as well as sexually transmitted infections

Abbreviations: ETEC, enterotoxigenic Escherichia coli; STEC, Shiga toxin–producing Escherichia coli.

Table 3.

Clinical Presentations Suggestive of Infectious Diarrhea Etiologies

Finding	Likely Pathogens
Persistent or chronic diarrhea	Cryptosporidium spp, Giardia lamblia, Cyclospora cayetanensis, Cystoisospora belli, and Entamoeba histolytica
Visible blood in stool	STEC, Shigella, Salmonella, Campylobacter, Entamoeba histolytica, noncholera Vibrio species, Yersinia, Balantidium coli, Plesiomonas
Fever	Not highly discriminatory—viral, bacterial, and parasitic infections can cause fever. In general, higher temperatures are suggestive of bacterial etiology or E. histolytica. Patients infected with STEC usually are not febrile at time of presentation
Abdominal pain	STEC, Salmonella, Shigella, Campylobacter, Yersinia, noncholera Vibrio species, Clostridium difficile
Severe abdominal pain, often grossly bloody stools (occasionally nonbloody), and minimal or no fever	STEC, Salmonella, Shigella, Campylobacter, and Yersinia enterocolitica
Persistent abdominal pain and fever	Y. enterocolitica and Y. pseudotuberculosis; may mimic appendicitis
Nausea and vomiting lasting ≤24 hours	Ingestion of Staphylococcus aureus enterotoxin or Bacillus cereus(short-incubation emetic syndrome)
Diarrhea and abdominal cramping lasting 1–2 days	Ingestion of Clostridium perfringens or B. cereus (long-incubation emetic syndrome)
Vomiting and nonbloody diarrhea lasting 2–3 days or less	Norovirus (low-grade fever usually present during the first 24 hours in 40% if infections)
Chronic watery diarrhea, often lasting a year or more	Brainerd diarrhea (etiologic agent has not been identified); postinfectious irritable bowel syndrome

Abbreviation: STEC, Shiga toxin–producing Escherichia coli.

Table 4.

Postinfectious Manifestations Associated With Enteric Pathogens

Manifestation	Organism(s)
Erythema nodosum	Yersinia, Campylobacter, Salmonella, Shigella
Glomerulonephritis	Shigella, Campylobacter, Yersinia
Guillain-Barré syndrome	Campylobacter
Hemolytic anemia	Campylobacter, Yersinia
Hemolytic uremic syndrome	STEC, Shigella dysenteriae serotype 1
Immunoglobulin A nephropathy	Campylobacter
Reactive arthritisa	Salmonella, Shigella, Campylobacter, Yersinia, rarely Giardia, and Cyclospora cayetanensis
Postinfectious irritable bowel syndrome	Campylobacter, Salmonella, Shigella, STEC, Giardia
Meningitis	Listeria, Salmonella (infants ≤3 months of age are at high risk)
Intestinal perforation	Salmonella including Salmonella Typhi, Shigella, Campylobacter, Yersinia, Entamoeba histolytica
Ekiri syndrome (lethal, toxic encephalopathy) and/or seizure	Shigella
Aortitis, osteomyelitis, extravascular deep tissue focus	Salmonella, Yersinia

Abbreviation: STEC, Shiga toxin–producing Escherichia coli.

^aIncludes Reiter syndrome.

Table 5.

Laboratory Diagnostics for Organisms Associated With Infectious Diarrhea

Etiologic Agent	Diagnostic Procedures	Optimal Specimen
Clostridium difficile	NAAT	Stool
	GDH antigen with or without toxin detection followed by cytotoxin or Clostridium difficile toxin or toxigenic C. difficilestrain
Salmonella enterica, Shigella spp, Campylobacterspp	Routine stool enteric pathogen culturea or NAAT	Stool
Salmonella enterica serovars Typhi and Paratyphi (enteric fever)	Routine culture	Stool, blood, bone marrow, and duodenal fluid
Shiga toxin–producing Escherichia coli	Culture for E. coliO157:H7b and Shiga toxin immunoassay or NAAT for Shiga toxin genes	Stool
Yersinia spp, Plesiomonas spp, Edwardsiella tarda, Staphylococcus aureus, E. coli (enterotoxigenic, enteroinvasive, enteropathogenic, enteroaggregative)	Specialized stool culture or molecular assaysc or NAAT	Stool
Clostridium perfringens	Specialized procedure for toxin detectiond	Stool
Bacillus cereus, S. aureus	Specialized procedure for toxin detectiond	Food
Clostridium botulinum	Mouse lethality assay (performed at a state public health laboratory, or CDC) e,f,g	Serum, stool, gastric contents, vomitus
Entamoebahistolytica; Blastocystis hominih; Dientamoeba fragilish; Balantidium coli; Giardia lamblia; nematodes (generally not associated with diarrhea) including Ascaris lumbricoides, Strongyloides stercoralisi, Trichuris trichiura, hookworms; cestodes (tapeworms); trematodes (flukes)	Ova and parasite examination including permanent stained smeari or NAAT	Stool Duodenal fluid for Giardia and Strongyloides
E. histolytica	E. histolytica species-specific immunoassay or NAAT	Stool
G. lambliaj	EIA or NAAT	Stool
Cryptosporidium spp [121]j	Direct fluorescent immunoassay, EIA, or NAAT	Stool
Cyclospora cayetanensis, Cystoisospora bellik	Modified acid-fast stainkperformed on concentrated specimen, ultraviolet fluorescence microscopy, or NAAT	Stool
Microsporidia (now classified as a fungus)	Modified trichrome stainkperformed on concentrated specimen	Stool
	Histologic examination with electron microscopic confirmation	Small bowel biopsy
Calicivirus (norovirus, sapovirus)k; enteric adenovirus; enterovirus/ parechovirusk; rotavirus	NAAT	Stool
Rotavirus, enteric adenovirus	EIA	Stool
Enteric adenovirusl; enterovirus/parechovirus	Viral culture	Stool
Cytomegalovirus	Histopathological examination	Biopsy
	Cytomegalovirus culture	Biopsy

The field of rapid diagnostic testing is rapidly expanding. We expect that additional diagnostic assays will become available following publication of these guidelines, specifically panel-based molecular diagnostics, including NAAT. Contact the laboratory for instructions regarding container, temperature, and transport guidelines to optimize results.

Abbreviations: CDC, Centers for Disease Control and Prevention; EIA, enzyme immunoassay; GDH, glutamate dehydrogenase; NAAT, nucleic acid amplification test.

^aRoutine stool culture in most laboratories is designed to detect Salmonella spp, Shigella spp, Campylobacter spp, and E. coli O157 or Shiga toxin–producing E. coli, but this should be confirmed with the testing laboratory.

^bIt is recommended that laboratories routinely process all stool specimens submitted for bacterial culture for the presence of Shiga toxin–producing strains of E. coli including O157:H7. However, in some laboratories, O157:H7 testing is performed only by specific request.

^cSpecialized cultures or molecular assays may be required to detect these organisms in stool specimens. The laboratory should be notified whenever there is a suspicion of infection due to one of these pathogens.

^dBacillus cereus, Clostridium perfringens, and Staphylococcus aureus are associated with diarrheal syndromes that are toxin mediated. An etiologic diagnosis is made by demonstration of toxin in stool for C. perfringens and demonstration of toxin in food for B. cereus and S. aureus.

^eToxin assays are either performed in public health laboratories or referred to laboratories specializing in such assays.

^fTesting for Clostridium botulinum toxin is either performed in public health laboratories or referred to laboratories specializing in such testing. The toxin is lethal and special precautions are required for handling. Class A bioterrorism agent and rapid sentinel laboratory reporting schemes must be followed. Immediate notification of a suspected infection to the state health department is mandated.

^gImplicated food materials may also be examined for C. botulinum toxin, but most hospital laboratories are not equipped for food analysis.

^hThe pathogenicity of Blastocystis hominis and Dientamoeba fragilis remains controversial. In the absence of other pathogens, they may be clinically relevant if symptoms persist. Reporting semiquantitative results (rare, few, many) may help determine significance and is a College of American Pathologists accreditation requirement for participating laboratories.

ⁱDetection of Strongyloides in stool may require the use of Baermann technique or agar plate culture.

^jCryptosporidium and Giardia lamblia testing is often offered and performed together as the primary parasitology examination. Further studies should follow if the epidemiologic setting or clinical manifestations suggest parasitic disease.

^kThese stains may not be routinely available.

^lEnteric adenoviruses may not be recovered in routine viral culture.

Table 6.

Recommended Antimicrobial Agents by Pathogen

Indication	First Choice	Alternative	Comments/Considerations
Bacteriaa
Campylobacter	Azithromycin	Ciprofloxacin
Clostridium difficile	Oral vancomycin	Fidaxomicin	Fidaxomicin not currently recommended for people <18 years of age. Metronidazole is still acceptable treatment for nonsevere CDI in children and as a second-line agent for adults with nonsevere CDI (eg, who cannot obtain vancomycin or fidaxomicin at a reasonable cost).
Nontyphoidal Salmonella entericab	Usually not indicated for uncomplicated infection	NA	Antimicrobial therapy should be considered for groups at increased risk for invasive infection: neonates (up to 3 months old), persons >50 years old with suspected atherosclerosis, persons with immunosuppression, cardiac disease (valvular or endovascular), or significant joint disease. If susceptible, treatment with ceftriaxone, ciprofloxacin, TMP-SMX, or amoxicillin.
Salmonella enterica Typhi or Paratyphib	Ceftriaxone or ciprofloxacin	Ampicillin or TMP-SMX or azithromycin
Shigellaa	Azithromycincor ciprofloxacina, or ceftriaxone	TMP-SMX or ampicillin if susceptible	Clinicians treating people with shigellosis for whom antibiotic treatment is indicated should avoid prescribing fluoroquinolones if the ciprofloxacin MIC is 0.12 μg/ mL or higher even if the laboratory report identifies the isolate as susceptible. See https://emergency. cdc.gov/han/han00401.asp
Vibrio cholerae	Doxycyclined	Ciprofloxacin, azithromycin, or ceftriaxone
Non–Vibrio choleraed	Usually not indicated for noninvasive disease. Single-agent therapy for noninvasive disease if treated. Invasive disease: ceftriaxone plus doxycycline	Usually not indicated for noninvasive disease. Single-agent therapy for noninvasive disease if treated. Invasive disease: TMP-SMX plus an aminoglycoside
Yersinia enterocolitica	TMP-SMX	Cefotaxime or ciprofloxacin
Parasites
Cryptosporidiumspp	Nitazoxanide (HIV-uninfected, HIV-infected in combination with effective cART):	Effective cART: Immune reconstitution may lead to microbiologic and clinical response [154, 209, 210]	NA
Cyclospora cayetanensis	TMP-SMX	Nitazoxanide (limited data)	Patients with HIV infection may require higher doses or longer durations of TMP-SMX treatment
Giardia lamblia	• Tinidazole Note: Based on data from HIV-uninfected children • Nitazoxanide	Metronidazole Note: Based on data from HIV- uninfected children	• Tinidazole is approved in the United States for children aged ≥3 years. It is available in tablets that can be crushed. • Metronidazole has high frequency of gastrointestinal side effects. A pediatric suspension of metronidazole is not commercially available but can be compounded from tablets. Metronidazole is not FDA approved for the treatment of giardiasis.
Cystoisospora belli	TMP-SMX	Pyrimethamine Potential second-line alternatives: • Ciprofloxacin • Nitazoxanide
Trichinellaspp	Albendazole	Alternative: mebendazole	• Therapy less effective in late stage of infection, when larvae encapsulate in muscle
Fungus
Microsporidia	For disseminated (not ocular) and intestinal infection attributed to microsporidia other than Enterocytozoon bieneusi or Vittaforma corneae: • Albendazole after initiation of cART and resolution of signs and symptoms For E. bieneusior V. corneaeinfections: • Fumagillin recommended for treatment of infections due to E. bieneusi in HIV-infected adults	NA	Effective cART therapy: • Immune reconstitution may lead to microbiologic and clinical response • Fumagillin for systemic use is unavailable in the United States and data on dosing in children are unavailable. • Consultation with an expert is recommended.

Abbreviations: cART, combination antiretroviral therapy; CDI, Clostridium difficile infection; FDA, US Food and Drug Administration; HIV, human immunodeficiency virus; MIC, minimum inhibitory concentration; NA, not applicable; TMP-SMX, trimethoprim-sulfamethoxazole.

^aFor information on susceptibility patterns in the United States, see the National Antimicrobial Resistance Monitoring System (NARMS; https://www.cdc.gov/narms). Susceptibility testing should be considered when a therapeutic agent is selected.

^bIf invasive disease is suspected or confirmed, ceftriaxone is preferred over ciprofloxacin due to increasing resistance to ciprofloxacin.^cMost clinical laboratories do not test for azithromycin susceptibility.

^dPrimary therapy is aggressive rehydration; antibiotics are adjunctive therapy.

Table 7.

Fluid and Nutritional Management of Diarrhea

Degree of Dehydrationa	Rehydration Therapy	Replacement of Losses During Maintenancec
Mild to moderate dehydration	Infantsb and children: ORS, 50–100 mL/kg over 3–4 hours Adolescents and adults (≥30 kg): ORS, 2–4 L	Infants and children: <10 kg body weight: 60–120 mL ORS for each diarrheal stool or vomiting episode, up to ~500 mL/day >10 kg body weight: 120–240 mL ORS for each diarrheal stool or vomiting episode; up to ~1 L/day Adolescents and adults: Ad libitum, up to ~2 L/day Replace losses as above as long as diarrhea or vomiting continues
Severe dehydration	Infants: Malnourished infants may benefit from smaller-volume, frequent boluses of 10 mL/kg body weight due to reduced capacity to increase cardiac output with larger volume resuscitation. Children, adolescents, and adults: Intravenous isotonic crystalloid boluses, per current fluid resuscitation guidelines, until pulse, perfusion, and mental status return to normal. Adjust electrolytes and administer dextrose based on chemistry values. Administer up to 20 mL/kg body weight until pulse, perfusion, and mental status return to normal.	Infants and children: <10 kg body weight: 60–120 mL ORS for each diarrheal stool or vomiting episode, up to ~500 mL/day >10 kg body weight: 120–240 mL ORS for each diarrheal stool or vomiting episode; up to ~1 L/day Adolescents and adults: Ad libitum, up to ~2 L/day Replace losses as above as long as diarrhea or vomiting continue. If unable to drink, administer either through a nasogastric tube or give 5% dextrose 0.25 normal saline solution with 20 mEq/L potassium chloride intravenously.

Adapted from Centers for Disease Control and Prevention. Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. MMWR Recomm Rep 2003; 52(RR-16):1–16 and World Health Organization. The treatment of diarrhoea: a manual for physicians and other senior health workers (https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5216a1.htm).

Low-osmolarity ORS can be given to all age groups, with any cause of diarrhea. It is safe in the presence of hypernatremia as well as hyponatremia (except when edema is present). Some commercially available formulations that can be used as ORS include Pedialyte Liters (Abbott Nutrition), CeraLyte (Cero Products), and Enfalac Lytren (Mead Johnson). Popular beverages that should not be used for rehydration include apple juice, Gatorade, and commercial soft drinks.

Abbreviation: ORS, oral rehydration solution.

^aA variety of scales are available to grade the severity of dehydration in young children but no single, standard, validated method exists. Note that signs of dehydration may be masked when a child is hypernatremic.

^bBreastfed infants should continue nursing throughout the illness.

^cAfter rehydration is complete, maintenance fluids should be resumed along with an age-appropriate normal diet offered every 3–4 hours. Children previously receiving a lactose-containing formula can tolerate the same product in most instances. Diluted formula does not appear to confer any benefit.

[Organisms that Are Reportable]

All organisms listed in the table of Infectious Diseases Designated as Notifiable at the National Level (https://wwwn.cdc.gov/nndss/) should be reported. The CDC acts as a common repository for states and territories for collecting data and reporting of nationally notifiable diseases. Reports of occurrences of nationally notifiable diseases are transmitted to the CDC each week from the 50 US states, 2 cities (Washington, District of Columbia and New York, New York) and 5 territories (American Samoa, Commonwealth of Northern Mariana Islands, Guam, Puerto Rico, and the US Virgin Islands). Provisional data are published weekly in the Morbidity and Mortality Weekly Report; final data are published each year by the CDC in the annual “Summary of Notifiable Diseases, United States” [206].

The following 13 conditions, which are associated with infectious diarrhea, are included in the table of Infectious Diseases Designated as Notifiable at the National Level—United States, 2017 (https://wwwn.cdc.gov/nndss/conditions/notifiable/2017/):

• Campylobacteriosis
• Cholera
• Cryptosporidiosis
• Cyclosporiasis
• Giardiasis
• Hemolytic-uremic syndrome, postdiarrheal
• Salmonellosis
• Shiga toxin–producing Escherichia coli
• Shigellosis
• Trichinellosis (trichinosis)
• Typhoid fever
• Vibriosis
• Foodborne disease outbreak