E. Coli

What is E. coli?
E. coli is short for Escherichia coli - a general name for a common germ (bacterium) that usually lives peacefully in the colon (lower digestive tract). There are many different types (strains) of E. coli. Most are harmless or even beneficial, but some can cause severe illness in humans.

Some types of E. coli produce toxins. These are referred to as Shiga Toxin Producing E. coli or STEC. The most common is E. coli 0157:H7. These bacteria are “cousins” to our bodies’ own E. coli, but are acquired from an outside source like contaminated food. Once inside the body the bacteria produce toxins (poisons) that can damage the lining of the intestine and in some cases, the kidneys. Symptoms of E. coli 0157 are very unpleasant. They are likely to be more severe in children, the elderly, and those with weakened immune systems.

How does someone “catch” E. coli 0157?

You can get an E. coli 0157 infection in a variety of ways:
  • Eating undercooked meat; particularly ground meat,
  • Drinking unpasteurized (raw) milk or milk products,
  • Eating unwashed produce,
  • Working with cattle
Healthy beef and dairy cattle sometimes carry the E. coli 0157 germ in their intestines. Contamination can occur during the slaughtering process. The bacteria are then spread through the meat as it is ground to hamburger. Thorough cooking kills E. coli 0157 but those who enjoy their hamburgers rare, risk infection.

People have become infected with E. coli 0157 in their own kitchens after handling raw meat or failing to wash raw produce prior to eating. Leaky packages of raw meat stored on refrigerator shelves above other food items also have caused human infections.

E. coli 0157 is very contagious. It can be passed from person to person in families, day cares, nursing homes, etc. Inadequate hand-washing is a likely mode of transmission in these settings.

What are the symptoms of E. coli infection?

Symptoms usually start 2 to 4 days after exposure, but can take up to 8 days to begin. They include:
  • Sudden onset of severe abdominal cramps,
  • Watery diarrhea that rapidly becomes bloody, and sometimes
  • Low-grade fever, nausea, and vomiting
The toxin (poison) released by the bacteria causes inflammation and bleeding in the intestines. Some people report that their stools appear to be "all blood." Frequent diarrhea can cause dehydration and fatigue.

Are there any complications from E. coli infection?

The most serious complication is hemolytic uremic syndrome (HUS). About 2-7% of those infected with STEC develop this syndrome which includes anemia (low red blood cell count), low platelet count, and kidney failure. It usually begins the week following the onset of diarrhea and is more common in children than adults. HUS is very serious and requires treatment in the hospital.

How is E. coli infection diagnosed?

Like other types of food-borne illnesses, STEC is diagnosed by stool culture. The stool sample should be collected within 48 hours of the onset of bloody diarrhea.

How is the infection treated?

There is no specific treatment for STEC infections. Individuals should rest and drink lots of fluids to prevent dehydration. Some people may need IV fluids and pain medications for their cramping. STEC infections should not be treated with antibiotics or anti-diarrheal medications (Kaopectate, Imodium, etc.). These may increase the risk of developing HUS. Blood and urine tests may be necessary to monitor anemia, electrolytes, and kidney function.

How can I protect myself from E. coli and other foodborne infections?

  • Wash hands prior to eating or preparing food. Wash regularly during the cooking process, especially after handling raw meat.
  • Use a meat thermometer. Cook all meat and poultry to recommended temperatures.
  • Never sample bites of raw ground beef during preparation.
  • Do not put cooked foods on unwashed plates that previously held raw meat.
  • Defrost meats in the refrigerator or the microwave.
  • Store raw meats and poultry in the refrigerator separately from other foods in sealed containers.
  • Use hot water and detergent on cutting boards if raw meat or poultry have touched them. Plastic cutting boards are less porous and more easily cleaned than wooden cutting boards.
  • Do not drink raw (unpasteurized) milk or consume cheese or ice cream made from raw milk.
  • Thoroughly wash all produce prior to eating.
  • Keep hot food hot and cold food cold.
  • Refrigerate leftovers or throw them away.
  • Allow hot leftovers to come to room temperature prior to putting in the refrigerator.

What should I do if I think I have an E. coli infection?

  • Contact your healthcare provider. If you do not have one, go to an emergent care center or emergency room.
  • Wash your hands thoroughly after using the bathroom.
  • Do not prepare food for anyone else.
  • If you work in food service, healthcare, or childcare; stay home and tell your employer that you are sick.
  • Do not take antibiotics or medications for diarrhea.
  • Start thinking about the foods you have eaten in the week prior to your illness. This will be helpful if you are asked for this information by your doctor or the health department.

Will the health department be notified of my illness?

Yes, STEC is a reportable condition in New York State. If your stool culture is positive, your doctor or the lab will notify the local health department. A public health representative will contact you to talk about the foods you have eaten and the places you have visited. Through this investigation perhaps additional cases can be prevented.

What else should I know?

  • Let your doctor know if you are not getting better or if you are feeling worse.
  • Stay home at least until the diarrhea stops.
  • Wash your hands frequently, using warm water, plenty of soap, and 20-30 seconds of friction (rubbing/lathering).
  • Avoid contact with other family members; don’t prepare food for them.
  • Do not use the same bathroom as family members. If you have only one bathroom, try to avoid contaminating the toilet flusher, water faucets, bathroom doorknob, etc. with unwashed hands.
  • Drink enough fluids to keep your urine a light color. Dark urine is a sign of dehydration.
    • Your doctor may recommend clear fluids (any fluid you can read a newspaper through) such as water, tea, Gatorade, Jell-O, broth, etc.
  • When you start to feel better, SLOWLY advance your diet to thin soups, toast and other bland foods.
    • If you are diabetic or on a special diet, be sure to check with for your physician for his/her recommendations about your food intake.
  • If you do not have a private physician and are having symptoms consistent with E. coli infection go to an emergent care center or the emergency room.

Will I recover?

Every spring/summer we see a few cases of STEC in Ontario County. Most individuals recover within a week; a little longer for some. It is difficult to determine how an individual became infected. Though symptoms of STEC infections are extremely unpleasant, most people recover without difficulty. Only a very small percentage develop severe complications.

For more information visit the CDC's website.