The presence and clinical significance of enterotoxins produced by Campylobacter jejuni were investigated. The supernatant of a prototype virulent strain grown in supplemented medium induced intraluminal fluid secretion in rat ileal loop but not in rabbit ileal loop or the infant mouse assay. It induced elongation and increased intracellular cyclic AMP levels in Chinese hamster ovary cells. Toxin activity was blocked by cholera antitoxin and was destroyed by heat and high or low pH; its molecular weight is in the range 10(4)-10(5) daltons. Toxin production was detected in 24 of 32 C jejuni strains from patients with diarrhoea and 1 of 6 from carriers. Antibody response to autologous C jejuni somatic antigen was investigated in 19 subjects for whom serial serum specimens were available. A fourfold rise was observed in all 10 patients with enterotoxigenic C jejuni diarrhoea, in 1 of 3 patients with non-enterotoxigenic C jejuni, and in none of the symptomless carriers of non-enterotoxigenic strains. These findings demonstrate that C jejuni produces an enterotoxin that may be important in pathogenesis of diarrhoea.