Brainerd diarrhea

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Overview

Brainerd diarrhea is a sudden-onset watery, explosive diarrhea that lasts for months and does not respond to antibiotics; the cause of Brainerd diarrhea is unknown. Brainerd diarrhea was first described in Brainerd, Minnesota in 1983.[1]

It has been associated with the consumption of raw milk[1] and untreated water[2][3]. Of the ten outbreaks reported since 1983, nine have been in the US. The characteristics of each outbreak have been similar to that caused by an infectious agent. Although a very large outbreak (117 patients) occurred in 1996 in Fannin County, Texas.[4], the largest outbreak (122 patients) was the original one in Brainerd, MN. There have been no secondary cases reported in any of the outbreaks, suggesting that the causative agent cannot be passed from person to person, but boiling water appears to inactivate the Brainerd agent. Although there is no treatment available, the disease does appear to resolve itself, although this process takes months if not years.[5][6]

References

  1. 1.0 1.1 Osterholm MT, MacDonald KL, White KE, et al. (1986). "An Outbreak of newly recognized chronic diarrhea associated with raw milk consumption". JAMA 256: 484–90.
  2. Parsonnet J, Trock SC, Bopp CA, et al. (1989). "Chronic diarrhea associated with drinking untreated water". Ann Intern Med 110: 985–91.
  3. Mintz ED, Weber JT, Guris D, et al. (1998). "An outbreak of Brainerd diarrhea among travelers to the Galapagos Islands". J Infect Dis 177: 1041–5.
  4. Kimura AC, Mead P, Walsh B, et al. (2006). "A large outbreak of Brainerd diarrhea associated with a restaurant in the Red River Valley, Texas" 43 (1): 55–61.
  5. Mintz ED, Parsonnet J, Osterholm MT (1993). "Chronic idiopathic diarrhea". New Engl J Med 328: 1713–4.
  6. Afzalpurkar RG, Schiller LR, Little KH, et al. (1992). "The self limiting nature of chronic idiopathic diarrhea". New Engl J Med 327: 1849–52.

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