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Selected tests may be useful when food intake becomes very limited or symptoms suggest anemia or deficiency

More importantly, as will be discussed below, because the genome content tends to be highly conserved between bona fide carriage and disease isolates, subtle differences in the ability to modulate gene expression in host microenvironments, to engage in productive cross-talk with the cells also at metabolic level, to elude the host immune defenses, and to evolve over a short period of time have been proposed as major determinants of the hyperinvasive phenotype

Proceedings of the National Academy of Sciences of the United States of America, 1977

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