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Causes of acute infectious diarrhea in adults in resource-rich settings

	Likely pathogens	Mean incubation period	Classic/common food sources	Other epidemiologic clues
Watery diarrhea	Norovirus	24 to 48 hours	Shellfish, prepared foods, vegetables, fruit	Outbreaks in: Restaurants Health care facilities Schools and childcare centers Cruise ships Military populations
	Clostridioides (formerly Clostridium) difficile*	N/A	N/A	Antibiotic use Hospitalization Cancer chemotherapy Gastric acid suppression Inflammatory bowel disease
	Clostridium perfringens	8 to 16 hours	Meat, poultry, gravy, home-canned goods
	Enterotoxigenic Escherichia coli	1 to 3 days	Fecally contaminated food or water	Travel to resource-limited settings
	Other enteric viruses (rotavirus, enteric adenovirus, astrovirus, sapovirus)	10 to 72 hours	Fecally contaminated food or water	Daycare centers Gastroenteritis in children Immunocompromised adults
	Giardia lamblia	7 to 14 days	Fecally contaminated food or water	Daycare centers Swimming pools Travel, hiking, camping (particularly when there is contact with water in which beavers reside)
	Cryptosporidium parvum	2 to 28 days	Vegetables, fruit, unpasteurized milk	Daycare centers Swimming pools and recreational water sources Animal exposure Chronic diarrhea in advanced HIV infection
	Listeria monocytogenes	1 day (gastroenteritis)	Processed/delicatessen meats, hot dogs, soft cheese, pâtés, and fruit	Pregnancy Immunocompromising condition Extremes of age
	Cyclospora cayetanensis	1 to 11 days	Imported berries, herbs	Chronic diarrhea in advanced HIV infection
Inflammatory diarrhea (fever, mucoid or bloody stools)^¶	Nontyphoidal Salmonella	1 to 3 days	Poultry, eggs, and egg products, fresh produce, meat, fish, unpasteurized milk or juice, nut butters, spices	Animal contact (petting zoos, reptiles, live poultry, other pets) Travel to resource-limited settings
	Campylobacter spp	1 to 3 days	Poultry, meat, unpasteurized milk	Travel to resource-limited settings Animal contact (young puppies or kittens, occupational contact)
	Shigella spp	1 to 3 days	Raw vegetables	Daycare centers Crowded living conditions Men who have sex with men Travel to resource-limited settings
	Enterohemorrhagic E. coli	1 to 8 days	Ground beef and other meat, fresh produce, unpasteurized milk and juice	Daycare centers Nursing homes Extremes of age
	Yersinia spp	4 to 6 days	Pork or pork products, untreated water	Abnormalities of iron-metabolism (eg, cirrhosis, hemochromatosis, thalassemia) Blood transfusion
	Vibrio parahemolyticus	1 to 3 days	Raw seafood and shellfish	Cirrhosis
	Entamoeba histolytica	1 to 3 weeks	Fecally contaminated food or water	Travel to resource-limited settings Men who have sex with men

* Clostridioides (formerly Clostridium) difficile can also present with inflammatory diarrhea.
¶ Pathogens that are more classically associated with inflammatory diarrhea can also cause watery diarrhea, particularly early in the course of infection.

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