What is E. coli and where does it come from?

Escherichia coli, its full name, is a type of bacteria commonly found in the intestines of animals and
humans. There are hundreds of strains of the bacterium, but E. coli O157:H7 has been identified as
dangerous to people, producing a powerful toxin that can cause severe illness. It was first recognized
in the U.S. in 1982, when an outbreak of severe, bloody diarrhea was traced to contaminated
hamburgers, leading the illness to be dubbed "hamburger disease."E. coli O157:H7 can contaminate
ground beef during the butchering process. If it is present in the intestines of the slaughtered animal, it
can get into the meat as it is ground into hamburger.

How does E. coli spread?

While E. coli is most often found in meat, it is not limited to it. The bacteria are also found in
unpasteurized milk and apple cider, ham, turkey, chicken, roast beef, sandwich meats, raw vegetables,
cheese and contaminated water.Bean and alfalfa sprouts have also been recalled because of E. coli
contamination.

Fruits and vegetables that grow close to the ground are susceptible to E. coli contamination if, for
example, improperly composted cattle manure is used as a fertilizer.

E. coli, salmonella and cryptosporidium can also be found in unpasteurized juice. Children, the elderly
and people with compromised immune systems are encouraged to drink pasteurized juice or boil
unpasteurized juice before consuming it.Once someone has eaten contaminated food, the infection can
be passed from one person to another person by hand-to-mouth contact. The bacteria are most often
spread person to person.

What are the causes of E. coli O157:H7 infection?

Most strains of E. coli are harmless. However, one group, including 0157:H7, produces a potent toxin
- Shiga toxin - that is harmful for the lining of the small intestine.

Humans can become infected by:

Ingesting contaminated water - even though tap water contains chlorine and has undergone ozone
or ultraviolet treatment, some E. coli outbreaks have been caused by contaminated municipal water
supplies. Private wells can be a source of infection, as can some lakes and swimming pools.
Ingesting contaminated food - examples include ground beef, unpasteurized milk, or fresh
vegetables. Infected people who work in restaurants and do not wash their hands properly after
going to the toilet can spread the infection to customers and other members of staff.
Having physical contact with an infected person, known as person-to-person contact. Good hand
hygiene is important in stemming the spread of infection.
Contact with animals - this may not only occur in farms, but also in petting zoos or country fairs.

E. coli infection risk factors

A risk factor is something which raises the chances of developing a condition or disease. For example,
obesity significantly raises the risk of developing type 2 diabetes. Therefore, obesity is a risk factor for
type 2 diabetes. The following risk factors are linked to a higher risk of problems with E. coli
infection:
 Certain foods - consuming soft cheeses, raw milk, apple juice, cider, and undercooked ground
beef are linked to a higher risk of becoming ill
Immunocompromised patients - those with weakened immune systems, such as patients with
AIDS, those taking immunosuppressive medications, and people receiving chemotherapy are
susceptible to complications.
Stomach surgery - patients who have had the size of their stomach surgically reduced have less
stomach acid that kills off bacteria.
The person's age - very young children and elderly individuals have a higher risk of developing
serious illness and complications

E. coli infection complications

The vast majority of infected individuals make a full recovery within a week. However, susceptible
individuals (mentioned above) may develop hemolytic uremic syndrome (HUS).

Hemolytic uremic syndrome (HUS) - this condition is characterized by hemolysis (breakup of red
blood cells) and kidney failure. Platelets, the red blood cells that are responsible for blood clotting,
clump together within the small blood vessels of the kidneys, resulting in reduced blood flow
(ischemia) and eventually leading to kidney failure. Decreased platelets also increase the risk of
bleeding problems.

The patient can develop CNS (central nervous system) problems, including seizures, and can also go
into a coma. Kidney failure among infants and young children is usually caused by HUS.
Patients start off with E. coli infection symptoms - severe abdominal cramps, diarrhea which
eventually becomes bloody, and nausea and vomiting (sometimes). While the majority of patients
make a full recovery within a week to 10 days, approximately 6% go on to develop HUS. The majority
are young children and elderly individuals. Between 3% to 5% of patients with HUS die, according to
the National Institutes of Health, USA.

Prevention
Cook meat well - especially ground meat.
Drinks - pasteurized milk, apple juice or cider are safer than unpasteurized.
Wash vegetables - especially leafy green ones. Washing thoroughly might not protect you completely, but
it helps.
Wash cutlery and crockery - make sure knives, forks, plates and serving dishes are thoroughly washed with
warm, soapy water.
Store foods separately - use separate cutting boards, do not store raw ground beef right next to other
foods.
Hand hygiene - wash your hands thoroughly with warm water and soap after going to the toilet, before
preparing foods, after preparing foods, and after touching animals. Wash your hands regularly.
Most doctors advise patients to get plenty of rest and drink lots of water to prevent dehydration.
Wash fresh fruits and vegetables thoroughly before eating raw
Prevent cross contamination in food preparation areas by washing hands, counters, cutting boards, and
utensils after they touch raw meat.
Do not allow children to share bath water with anyone who has any signs of diarrhea or stomach flu.
And keep any toddlers still in diapers out of all bodies of water (especially wading and swimming pools).
Do not let any family members touch or pet farm animals. Merely cleaning the hands with germ killing
wipes may not be adequate!
 Wear disposable gloves when changing the diapers of any child with any type of diarrhea. Remember that
E. coli O157:H7 diarrhea initially is non-bloody, but still very infectious.
Avoid drinking (and even playing in) any non-chlorinated water. There is an added risk if the water (well,
irrigation water or creek/river) is close to, or downstream from any livestock.

Proper food handling techniques can go a long way toward preventing exposure to E. coli. All ground
meats should be cooked thoroughly so the centre is no longer pink. You should also:

Refrigerate or freeze meat as soon as possible after buying it and then thaw frozen meat in the
refrigerator, not on the counter.
Place cooked meat on clean plates. Don't re-use dishes that have been in contact with raw meat.
Use a digital food thermometer when cooking ground beef, which should be cooked to an internal
temperature of at least 71 C (160 F).
Serve cooked meat immediately or keep it hot (60 C or 140 F).
Clean and sanitize countertops and utensils after contact with raw meat.
Not store raw and cooked food together.
When marinating meat, not use the liquid as a dip or to pour over cooked meat.
Drink only pasteurized milk or cider.
Drink water from a supply known to be safe. If you have a private well, it should be tested several times a
year.

Since most cases of E. coli contamination are passed from person to person, keep distance to talk with
people, good personal hygiene is critical to protecting yourself:

Wash your hands thoroughly and frequently.

Don't handle food if you have diarrhea.
Wash raw fruits and vegetables thoroughly before cooking or cutting them.
Sanitize food preparation surfaces and utensils.

Anyone known to be infected with E. coli, should not share dishes, cutlery or glasses with anyone.
Their towels, face cloths and bedding should be washed separately in hot water and bleach.

Signs and symptoms of E. coli O157:H7 infection

The patient will typically experience symptoms within three to four days after being exposed to the
bacteria, however, in some cases they may appear within a day or a week later.

The individual may experience:

Abdominal pain - typically, the first symptom is severe abdominal cramping that comes on
suddenly.
Diarrhea - a few hours after the sudden abdominal pain, the patient typically has watery diarrhea.
A day later there may be bright red bloody stools, caused by sores in the intestines.
Nausea
Vomiting - note that many patients who become ill may not vomit
Fever - note that many infected people may not have a fever
Fatigue - diarrhea causes loss of fluids and electrolytes (dehydration), making the patient feel sick
and tired

A considerable number of infected people have no noticeable symptoms. However, they are
capable of unwittingly spreading the infection to others.