Escherichia coli, commonly known as E. coli, live in the intestines of humans and other animals. Along with other bacteria, E. coli help to maintain a proper balance of normal intestinal flora. They also produce the vitamins we need to live. Hundreds of strains of Escherichia coli exist; most of them are harmless. E. coli O157:H7, a food borne bacteria found in food or water, is different because it produces a toxin powerful enough to damage the intestinal wall, cause severe illness, and death. Statistics released in 1999 from the Centers for Disease Control and Prevention (CDC), showed that at least 73,000 cases of infection are reported in the United States each year, along with more than 60 deaths. (The combination of letters and numbers in the name refers to the specific markers found on its surface.)

E. Coli O157:H7 Symptoms include:

• Severe bloody diarrhea
• Stomach cramps and pain (perhaps severe)
• Vomiting
• Nausea
• Little to no fever

Symptoms typically occur within two to four days after ingesting contaminated food or water, but can take as long as eight days. Most people recover from the infection within five to ten days after onset. E. coli infection can be a much more serious illness for the elderly, immune-weakened people, and young children. Because hemolytic uremic syndrome (HUS) is a real possibility when infected with E. coli, you should look for paleness of skin, fatigue, decrease in urination, and swelling in the face, hands, and feet. HUS destroys red blood cells and causes kidneys to fail. Very young children and the elderly are at especially high risk and should be closely monitored for the disease even after diarrhea has stopped. HUS is the most common cause of acute kidney failure in children. Most cases of hemolytic uremic syndrome are caused by E. coli.

How is E. Coli O157:H7 Infection Diagnosed?

Infection with E. coli O157:H7 is diagnosed by checking for the bacterium in the stool. Anyone who suddenly has diarrhea with blood should have a stool test for E. coli. A further test will identify the genetic fingerprint of the strain.

What is the Treatment for an E. Coli O157:H7 Infection?

Most people recover from an E. coli infection within five to ten days. Diarrhea causes the body to lose important fluids, so keeping hydrated is very important. Since there is no evidence that they work against this infection, antibiotics should not be taken. In fact, taking antibiotics during a bout of E. coli may lead to kidney complications or severe shock. Anti-diarrheal medicines should also be avoided. Children under the age of five and the elderly are at much greater risk of developing severe illness from an E. coli infection. If hemolytic uremic syndrome (HUS) is contracted, this life-threatening condition will require time in an intensive care unit. Often kidney dialysis and blood transfusions are needed.

Are There Any Long-term Consequences of an E. Coli O157:H7 Infection?

If a person infected with E. coli does not develop hemolytic uremic syndrome (HUS), there are no long-term consequences. For HUS sufferers, though, the outcome can be complicated. A small percentage may need to have parts of their bowel removed, experience paralysis, develop blindness, and persistent kidney failure. Many with HUS will enjoy better recovery, but may experience kidney abnormalities for years. HUS can be fatal. The established death rate for HUS is 3-5 percent, although some physicians believe the rate is much higher, perhaps as high as 5-15 percent.

What to Watch Out For

For years, when people heard E. coli, they automatically thought of ground beef and undercooked hamburgers. After the dangerous E. coli outbreaks in spinach last year, that has changed. Still, many people don’t know that lettuce is one the most common foods associated with E. coli infections. Contaminated sprouts, roast beef, processed turkey and ham, and salami, along with unpasteurized milk, juice, and apple cider round out the ‘food sources’ that pose a high risk for carrying strains of E. coli bacteria. Unpasteurized cheeses, raw vegetables grown in manure, and drinking contaminated water also increase the likelihood of E. coli infection, and swimming in water contaminated with E. coli makes the list as well. A warning to travelers: E. coli infection is more common in developing countries where sanitation is poor; the infection then is often referred to as “traveler's diarrhea.”

Important Tips About E. Coli O157:H7

• Since meat can become contaminated during slaughter and the E. coli bacteria mixed into beef when it is ground, be sure to cook all ground beef and hamburger thoroughly. Use a thermometer to make sure that the internal temperature reaches at least 160 degrees. Wash the meat thermometer both in between tests and after use.
• Never place cooked hamburgers on a plate that held raw patties.
• Always request that your burger be thoroughly cooked when eating at a restaurant. If it arrives undercooked, send it back. Request a clean plate and new bun.
• Keep raw meat away from other foods.
• Drink only pasteurized milk, juices, and apple cider. For instance, E. coli bacteria on a cow’s udders or on milking equipment can easily find its way into raw milk.
• Eat only pasteurized cheeses.
• Fruits and vegetables should be washed under clean running water using a brush. Always remove the outer leaves from leafy vegetables such as lettuce.
• Always wash lettuce, even if it is packaged as pre-washed.
• To avoid spreading harmful bacteria in your kitchen, always use hot water, soap, and a sanitizer to clean countertops, cutting boards, sinks, dishes, utensils, meat thermometers, and your hands after handling raw meat, poultry, sprouts, spinach, lettuce and other greens.
• Make sure that hands are washed with hot water and soap before preparing food, after changing diapers, using the toilet, and contact with animals to help prevent E. coli.
• Never prepare or handle food for others when ill with diarrhea.
• Only drink water from safe sources such as municipal water supplies, tested wells, and bottled water.
• Defrost food in the refrigerator.
• Make sure that anyone sick with a diarrheal illness carefully washes hands after bowel movements.
• Swallowing lake, ocean, or pool water puts you at risk of getting E. coli. Anyone sick with diarrhea should wait until they recover before swimming in lakes or public pools.
• Make sure that you and your children properly wash your hands after any contact with farm animals or animal feces. Petting zoos have been linked to E. coli outbreaks; E. coli can be found on the fur of animals, feed bins, fence railings, and on the ground.

E. Coli O157:H7 in the News

1. 2004-2005: Three outbreaks of E. coli O157:H7 infections associated with petting zoos were reported in North Carolina, Florida, and Arizona. In these cases, 173 people, most of them children, came down with E. coli. Twenty-two eventually contracted HUS.
2. June 2006: One hundred people attending a conference in Ogden, Utah were exposed to E. coli at a Wendy’s restaurant. Lettuce was tainted with the bacteria.
3. September-October 2006: Multi-state outbreaks of E. coli O157:H7 infections from spinach were reported. More than 200 people in twenty-six states became ill after eating contaminated spinach. Of those, 102 were hospitalized, 31 developed kidney failure, and three died.
4. November-December 2006: Multi-state outbreaks of E. coli O157 infections were linked to Taco Bell restaurants in the Northeastern United States. Seventy-one cases were reported. Of those, 53 people were hospitalized and 8 developed HUS.
5. November-December 2006: More than 80 people fell ill after eating at Taco John restaurants in three states. Twenty-six people were hospitalized, while two suffered from HUS. State health officials used DNA-matching tests to link the source of the E. coli bacteria to lettuce-growing farms in California.

Should I File a Lawsuit If I Come Down With E. Coli?

Not always. See our article on food poisoning lawsuits.