E. coli Infection

E. coli is a type of bacteria that normally live in the intestines of people and animals. However, some types of E. coli, particularly E. coli 0157:H7, can cause intestinal infection.

Symptoms of intestinal infection include diarrhea, abdominal pain, and fever. More severe cases can lead to bloody diarrhea, dehydration, or kidney failure. People with weakened immune systems, young children, and the elderly are at increased risk for developing these complications.

Most intestinal infections are caused by contaminated food or water. Proper food preparation and good hygiene can greatly decrease your chances of developing an intestinal infection.

Most cases of intestinal infection can be treated at home. Symptoms generally resolve within a few days to a week.

Symptoms of intestinal infection begin between one to five days after you have been infected with E. coli. Symptoms can include:

• abdominal cramping
• sudden, severe watery diarrhea that may change to bloody stools
• gas
• loss of appetite/nausea
• vomiting (rare)
• fatigue
• fever

Symptoms can last anywhere from a few days to more than a week.

Symptoms of a severe E. coli infection may include:

• bloody urine
• decreased urine output
• pale skin
• bruising
• dehydration

If you experience any of these severe symptoms, call your doctor.

According to the Johns Hopkins Medical Center, about eight percent of those infected develop hemolytic uremic syndrome (HUS), a condition in which the red blood cells are damaged (Johns Hopkins). This can lead to kidney failure. This complication can be life-threatening, especially for children and the elderly. HUS generally begins about five to 10 days following the onset of diarrhea.

People and animals normally have some E. coli in their intestines, but some strains cause infection. The bacteria that cause infection can enter your body in a number of ways.

Improper Food Handling

Whether food is prepared at home, in a restaurant, or in a grocery store, unsafe handling and preparation can cause contamination. Common causes of food poisoning include:

• failing to wash hands completely before preparing or eating food
• using utensils, cutting boards, or serving dishes that are not clean, causing cross-contamination
• consuming dairy products or food containing mayonnaise that have been left out too long
• consuming foods that have not been stored at the right temperature
• consuming foods that are not cooked to the right temperature, especially meats and poultry
• consuming raw seafood products
• drinking unpasteurized milk
• consuming raw produce that has not been properly washed

Food Processing

During the slaughtering process, poultry and meat products can pick up bacteria from the animals’ intestines.

Contaminated Water

Poor sanitation can cause water to contain bacteria from human or animal waste. You can get the infection from drinking contaminated water or from swimming in it.

Person to Person

E. coli can spread when an infected person fails to wash his or her hands after having a bowel movement. The bacteria are then spread when that person touches someone or something else, like food. Nursing homes, schools, and childcare facilities are particularly vulnerable to person-to-person spreading.

Animals

People who work with animals, especially cows, goats, and sheep are at increased risk for infection. Anyone who touches animals or who works in an environment with animals should wash their hands regularly and thoroughly.

Intestinal infection can lead to dehydration and serious complications, such as kidney failure and sometimes death, if not treated. You should see your doctor if:

• You have had diarrhea that is not getting better after five days, or two days for an infant or child.
• You have a fever with diarrhea.
• Abdominal pain does not get better after a bowel movement.
• There is pus or blood in your stools.
• You have trouble keeping liquids down.
• Vomiting has continued for more than 12 hours. For a baby under three months old, contact your pediatrician as soon as symptoms begin.
• You have symptoms of intestinal infection and have recently traveled to a foreign country.
• You have symptoms of dehydration, such as a lack of urine, extreme thirst, or dizziness.

A doctor can confirm an E. coli infection with a simple stool sample.

In most cases, home care is all that is required to treat an E. coli infection. Drink plenty of water, get lots of rest, and keep an eye out for more severe symptoms that necessitate a call to your doctor.

If you have bloody diarrhea or fever, check with your doctor before taking over-the-counter antidiarrheal medications. Also, check with your pediatrician before giving medications to infants or children.

If dehydration is a concern, your doctor may order hospitalization and intravenous fluids.

Most people show improvement within a week to 10 days after the onset of an infection and make a full recovery.

There are a number of ways to decrease your chances of developing an intestinal infection due to E. coli. These include:

• always washing your hands before handling, serving, or eating food and after touching animals or working in animal environments
• washing fruits and vegetables thoroughly
• avoiding cross-contamination by using clean utensils, pans, and serving platters
• keeping raw meats away from other foods and away from other clean items
• using a meat thermometer and cooking meat and poultry to proper temperatures according to USDA guidelines:
• poultry: 165 F
• ground meat, eggs: 160 F
• steaks, pork chops, roasts, fish, shellfish: 145 F
• not defrosting meat on the counter
• always defrosting meat in the refrigerator or microwave
• refrigerating leftovers immediately
• drinking only pasteurized milk products (avoid raw milk)
• not preparing food if you have diarrhea
• washing your hands often, especially after using the bathroom
• not using public swimming facilities