“E. coli” is short for Escherichia coli, which is a naturally occurring and common bacterium in the lower intestinal tracts of humans and other warm-blooded animals. There are many hundreds of strains of E. coli that reside in the gut and that are harmless and even essential for good health. However, there are other strains of E. coli that cause serious poisoning in humans that typically result in intestinal and/or urinary-genital tract infections. “Bad E. coli” strains are responsible for major disease outbreaks from contaminated food and other sources in the U.S. and throughout the world. About 70,000 people in the U.S. are sickened by E. coli every year.
Particularly dangerous types of E. coli, such as E. coliO157:H7, produce one or more kinds of toxins (poisons) called Shiga toxins. Shiga toxins can severely damage the lining of your intestines and kidneys. These types of bacteria are called Shiga toxin-producing E. coli (STEC). STEC often causes bloody diarrhea and can lead to kidney failure in children or in people with weakened immune systems.
Enterotoxigenic E. coli (ETEC), which produce a different toxin, can cause diarrhea. These strains typically cause so-called travelers’ diarrhea because they commonly contaminate food and water in developing countries.
Enteropathogenic E. coli (EPEC) cause persistent diarrhea (lasting 2 weeks or more) and are more common in developing countries where they can be transmitted to humans through contaminated water or contact with infected animals.
Shiga toxin-producing E. coli (STEC) occurs when people consume contaminated foods or liquids. The U.S. Department of Agriculture Food Safety and Inspection Service recall site lists food products contaminated with harmful E. coli. The most common contaminated foods and liquids that have caused E. coli outbreaks include undercooked or raw hamburgers, salami, produce such as spinach, lettuce, and sprouted seeds, unpasteurized milk, apple juice, and apple cider, and contaminated well water or surface water frequented by animals. STEC can also occur by failure to wash your hands thoroughly with soap and water following contact with an infected animal or animal waste, failure to wash your hands thoroughly with soap and water following contact with an infected person, swallowing unchlorinated or underchlorinated water in swimming pools contaminated by human feces, swimming in water with even very low levels of sewage contamination, and consuming contaminated food, water, or ice.
Shiga toxin-producing E. coli (STEC) can cause nausea, severe abdominal cramps, watery or very bloody diarrhea, and fatigue. STEC can cause low-grade fever or vomiting. Symptoms usually begin from 2 to 5 days after eating contaminated food or drinking contaminated liquids. Symptoms may last for 8 days, and most people recover completely from the disease.
Anyone who suddenly develops diarrhea with symptoms of bloody stool should be tested to identify Shiga toxin-producing E. coli in stool samples. There is no evidence that treatment with antibiotics is helpful, and taking antibiotics may increase the risk of hemolytic uremic syndrome (HUS), a serious complication of STEC that can lead to kidney failure.
Recent E. Coli Outbreak In Germany
The CDC has issued a Media Statement regarding the recent outbreak of a particularly virulent strain of E. coli affecting mainly Germany and some other European countries. A large outbreak of Shiga toxin-producing E. coliO104, or STEC O104, infections in Germany has caused 11 deaths and 520 patients with hemolytic uremic syndrome (HUS) (kidney failure), a life-threatening complication of E. coli infections, as of June 2, 2011.
The strain of STEC causing illness, STECO104:H4, is very rare. Any person with recent travel to Germany with signs or symptoms of STEC infection or HUS, should seek medical care and testing. Symptoms of STEC infection include severe stomach cramps, diarrhea, which is often bloody, and vomiting. If there is fever, it usually is not very high. Most people get better within 5–7 days, but some patients go on to develop HUS — usually about a week after the diarrhea starts. Symptoms of HUS include decreased frequency of urination, feeling very tired, and losing pink color to skin and membranes due to anemia.
As of June 1, 2011, the CDC was unaware that a specific food has been confirmed as the source of the infections. Travelers to Germany should be aware that the German public health authorities have recommended against eating raw lettuce, tomatoes or cucumbers, particularly in the northern states of Germany (Hamburg, Bremen, Lower Saxony, Schleswig Holstein). The CDC had no information that any of these suspected foods have been shipped from Europe to the United States as of June 1, 2011.
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