Changes

**The organisms replicate within the vesicles and are released from the cells  

**The organisms replicate within the vesicles and are released from the cells  

**Stimulate immune response on reaching the lamina propria

**Stimulate immune response on reaching the lamina propria

**Inflammatory response with phagocytosis of bacteria by neutrophils and macrophages

**Acute inflammation, possibly with ulceration; prostaglandin and cytokine production by epithelial cells; enterotoxin production damaging mucosa

**Phagocytosis of bacteria by neutrophils and macrophages

**Bacteria either destroyed by the phagocytic cells or survive and multiply in the cells to cause systemic disease

**Bacteria either destroyed by the phagocytic cells or survive and multiply in the cells to cause systemic disease

**Resistance to phagocytosis and destruction by complement allows spread within the body

**Resistance to phagocytosis and destruction by complement allows spread within the body - bacteraemia and septicaemia

**LPS O antigens prevent damage to bacterial cell wall by complement

**LPS O antigens prevent damage to bacterial cell wall by complement

**LPS also causes endotoxaemia, and may contribute to local inflammatory response damaging intestinal cells to cause diarrhoea

**LPS also causes endotoxaemia, and may contribute to local inflammatory response damaging intestinal cells to cause diarrhoea