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E. coli are bacteria that normally live in the intestines of humans and animals. Although, most strains of this bacteria are harmless, several are known to produce toxins that can cause diarrhea. Once particular E. coli strain called 0157:H7 can cause severe diarrhea and kidney damage.

Symptoms

People infected by E. coli 0157:H7 can develop a range of symptoms. Some infected people may have mild diarrhea or no symptoms at all. Most cases develop severe diarrhea and abdominal cramps. Blood is often seen in the stool. Usually little or no fever is present. The symptoms usually appear about 3 days after exposure, with a range of 1 to 9 days. Complications: In some people, particularly children under five years of age, the infection can cause a complication called hemolytic uremic syndrome (HUS). This is a serious disease in which red blood cells are destroyed and the kidneys fail. Transfusions of blood or blood clotting factors as well as kidney dialysis may be necessary. A prolonged hospital stay is often required. Fortunately, most people with HUS recover completely, but it can be fatal.

Transmission

Cattle are the primary reservoir for E. coli 0157:H7. Food-borne infections are most commonly associated with contaminated beef products that are not thoroughly cooked before eating. Other outbreaks have been traced to unpasteurized milk, or apple cider made from apples contaminated by cow manure. Direct person-to-person transmission can also occur.

Diagnosis

Infection with E. coli 015:H7 can only be diagnosed by a special stool culture that is not performed in many laboratories. Public health authorities have advised doctors and laboratories to consider performing a special stool culture test if they suspect E. coli 0157:H7, particularly in people with bloody diarrhea.

Treatment

Most people recover without antibiotics or other specific treatment in 5 to 10 days. Scientific studies have not yet been conducted to determine if antibiotics are useful or harmful in the treatment of E. coli 0157:H7 infection. Antidiarrheal agents, such as loperamide (Imodium), should also be avoided. Hemolytic uremic syndrome is a life-threatening condition usually treated in an intensive care unit. Blood transfusions and kidney dialysis are often required. With intensive care, the death rate for hemolytic uremic syndrome is 3%-5%.

Prevention

Do not eat undercooked hamburger or other ground beef products. Cook all ground beef and hamburger thoroughly. Make sure the cooked meat is brown throughout (not pink), and the juices run clear. Drink only pasteurized milk and milk products. Avoid unpasteurized apple cider. Make sure infected people, especially children, wash their hands carefully with soap after using the toilet to reduce the risk of spreading the disease.