E. Coli Infection

What is an E. coli infection?

An E. coli infection is an infection by bacteria that can make you quite sick when you eat food contaminated with them.

How does it occur?

There are many harmless types of E. coli bacteria. However, some types, such as one called O157:H7, produce a strong poison, or toxin, which can make you very sick. The bacteria live in the intestines of cattle. Meat can become contaminated during the slaughter and meat-packing process. The bacteria may also get into a cow's milk. The bacteria can live in other animals as well.

Eating meat, especially ground beef, that has not been cooked long enough to kill E. coli can cause infection. Contaminated meat usually looks and smells normal.

Other possible sources of infection are:

• alfalfa sprouts
• leafy vegetables, such as lettuce and spinach
• salami
• unpasteurized (raw) milk, unpasteurized juice, and soft cheeses made from raw milk
• contaminated water.

People who are infected have the bacteria in their bowel movements. The bacteria can spread from one person to another if an infected person does not carefully wash their hands after using the bathroom. Adults who care for toddlers in diapers or for children who are not toilet trained are at high risk of getting the infection. These children's playmates may also get the infection.

You can become infected by swallowing unchlorinated or underchlorinated water in swimming pools contaminated by human waste. You can also get infected by swimming in sewage-contaminated water.

What are the symptoms?

Symptoms may include:

• nausea
• severe abdominal cramps
• watery or bloody diarrhea
• tiredness
• vomiting
• low-grade fever.

Symptoms usually begin 2 to 5 days after eating contaminated food, but anywhere from 1 to 7 days is normal. The symptoms may last for several days.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. A sample of your bowel movement will be tested in the lab.

How is it treated?

Usually you can get better without treatment. Antibiotics are usually not prescribed.

Ask your healthcare provider if medicines to stop the diarrhea are a good idea in your case.

You need to replace the fluids and body chemicals you lose when you have diarrhea or vomiting. Your healthcare provider may advise you to drink plenty of clear fluids or to drink an oral rehydration solution.

How long will the effects last?

Most people get better in 5 to 10 days without medical treatment.

Rarely, a serious complication called hemolytic uremic syndrome (HUS) can develop. It can lead to kidney failure, especially in children. This life-threatening condition is usually treated in an intensive care unit of a hospital, sometimes with blood transfusions and temporary kidney dialysis.

How can I take care of myself?

If you have been diagnosed with E. coli infection, follow your healthcare provider's instructions. The following are some additional suggestions for taking care of yourself at home while you recover:

• For cramps or stomach pain, it may help to put a hot water bottle or electric heating pad on your stomach. Cover the hot water bottle with a towel or set the heating pad at low to prevent burns.
• Do not take aspirin, ibuprofen, or other NSAIDS without checking first with your healthcare provider. It's OK to take acetaminophen (Tylenol).
• For diarrhea, you may want to let your bowel rest for several hours by drinking only clear liquids such as water, weak tea, bouillon, apple juice, or sports drinks or other oral rehydrating solutions. You may also drink soft drinks without caffeine (such as 7 UP) after letting them lose some of their carbonation (go flat). Make sure you drink often so you do not become dehydrated. Becoming dehydrated can be very dangerous, especially for children, older adults, and some people who have other medical problems. Suck on ice chips or Popsicles if you feel too nauseated to drink fluids.
• When your symptoms are better or have been gone for a few hours, add soft starchy foods to your diet. Foods that are easiest to digest are bananas, cooked cereal, rice, plain noodles, gelatin, eggs, toast or bread with jelly, and applesauce. Avoid milk products and caffeine for a few days. Return to your normal diet after 2 or 3 days, but for several days avoid fresh fruit (other than bananas), alcohol, greasy or fatty foods such as cheeseburgers or bacon, highly seasoned or spicy foods, and most fresh vegetables. Cooked carrots, potatoes, and squash are fine. If eating seems to worsen the diarrhea, let your bowel rest for a few hours by drinking just clear liquids.
• If you keep having symptoms or your symptoms get worse, tell your healthcare provider.
• Be cautious about taking nonprescription antidiarrheal medicines such as Kaopectate or Imodium or the prescription medicine Lomotil. These medicines can actually make the illness more severe, especially if the diarrhea is bloody. If you take one of these medicines, make sure you use only the dose recommended on the package. If you have chronic health problems, always check with your healthcare provider before you use any medicine for diarrhea.

How can I help prevent E. coli infection?

• Cook all meat thoroughly. Because ground beef can brown while cooking before disease-causing bacteria are killed, use a meat thermometer to ensure thorough cooking. Ground beef should be cooked until a thermometer inserted into several parts of the patty reads at least 160°F (71°C).
• Do not eat ground beef patties that are still pink in the middle. If you are served an undercooked hamburger in a restaurant, send it back for further cooking. Ask for a new bun and a clean plate, too.
• Keep raw meat separate from ready-to-eat foods. Wash hands, counters, and utensils with hot soapy water after they touch raw meat. Never place cooked hamburgers or ground beef on an unwashed plate that held raw patties.
• Drink only pasteurized milk, juice, or cider.
• Wash fruits and vegetables thoroughly, especially those that will not be cooked. Children under 5 years of age, people with weakened immune systems, and older adults should avoid eating alfalfa sprouts. There is no way to decontaminate sprouts.
• Drink tap water that has been treated with chlorine or other effective disinfectants.
• Do not swallow lake or pool water while swimming.
• Teach children to wash their hands carefully with soap after bowel movements to reduce the risk of spreading infection. Wash your hands after changing diapers.