E. Coli Infection

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KEY POINTS

• An E. coli infection is caused by E. coli bacteria. Only certain types of E. coli cause diarrhea and other infections. The infection is also called food poisoning.
• Usually you will get better in 5 to 10 days without medical treatment. If you have a serious infection, or if it affects your kidneys, you will need to stay in the hospital for treatment.
• Wash your hands and clean any dishes or utensils before you prepare, cook, serve, or eat food. Keep kitchen counters and other food preparation surfaces clean. Wash fruits and vegetables well, especially if you are eating them raw. Cook all meat thoroughly. Refrigerate any food you will not be eating right away.

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What is E. coli infection?

An E. coli infection is caused by E. coli bacteria. Most E. coli is harmless, some types of E. coli are normally found in your intestines, and only certain types of E. coli cause diarrhea and other infections. Because the bacteria usually enter the body through food, the infection is also called food poisoning.

Often the illness is brief and does not need any treatment. However, the infection sometimes causes severe, life-threatening illness.

What is the cause?

The bacteria can live in animal or human intestines. Bowel movements can spread the bacteria to soil or water. Contaminated food usually looks and smells normal.

You may get infected if:

• You eat or drink dairy products that have not been pasteurized (heated to kill certain bacteria) by the manufacturer.
• You eat food that has the bacteria in it, especially raw or undercooked meat.
• You eat raw foods, such as leafy vegetables or alfalfa sprouts, which have the bacteria on them.
• You eat food that has been handled by someone who is infected.
• You swallow water from a well, lake, stream, or city water that has not been treated to kill bacteria.
• You have contact with an infected animal.

The infection can spread easily from person to person in day care centers where children are infected and in diapers or not toilet-trained.

What are the symptoms?

Symptoms may include:

• Loose, watery, unformed bowel movements, which may be bloody
• Nausea and vomiting
• Severe belly pain
• Mild fever (99 to 100.5° F, or 37 to 38° C)

Symptoms usually start 2 to 8 days after eating or drinking contaminated food or water. The symptoms may last for several days.

Some types of E. coli infections can cause a type of kidney failure called hemolytic uremic syndrome (HUS). HUS is more common in children younger than 5 years old and older people. The symptoms start as the diarrhea is improving and include yellow skin (jaundice), or a skin rash that looks like tiny bruises, weakness, and not urinating very much or not urinating at all. If HUS is not treated quickly, it can cause death.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Test of a sample of your bowel movements
• Blood tests
• Urine tests

How is it treated?

Usually you will get better in 5 to 10 days without medical treatment. Antibiotics are usually not prescribed.

If you have a serious infection, or if it affects your kidneys, you will need to stay in the hospital for treatment.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Rest your belly, but make sure that you drink enough liquids to keep your urine light yellow in color. You can do this by eating small amounts and by drinking clear liquids. Clear liquids include water, weak tea, fruit juice mixed half and half with water, Jell-O, clear soft drinks without caffeine (like lemon-lime soda), and clear broth. Stir soda until the bubbles are gone.
• Avoid liquids that are acidic, like orange juice, or caffeinated, like coffee.
• If you have severe diarrhea, your body can lose too much fluid and you can get dehydrated. Dehydration can be very dangerous, especially for children and older adults. You may also be losing minerals that your body needs to keep working normally. Your healthcare provider may recommend an oral rehydration solution (ORS), which is a drink that replaces liquids and minerals.
• You may eat soft, plain foods. Good choices are soda crackers, toast, plain noodles, potatoes, rice, cooked cereal, applesauce, and bananas. Eat small amounts slowly and avoid foods that are hard to digest or may irritate your stomach, such as foods with acid (like tomatoes or oranges), spicy or fatty food, meats, and raw vegetables. You may be able to go back to your normal diet in a few days.
• Don’t take aspirin, ibuprofen, or other nonsteroidal anti-inflammatory drugs (NSAIDs) without checking first with your healthcare provider. NSAIDs, such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take this medicine for more than 10 days.
• Ask your doctor or nurse before you take any nonprescription medicines for diarrhea if you have an E. coli infection. If you have chronic health problems, always check with your provider before you use any medicine for diarrhea.

Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent E. coli infection?

These steps can help prevent food poisoning:

• Wash your hands with soap and running water, and clean any dishes or utensils before you prepare, cook, serve, or eat food. Keep kitchen counters and other food preparation surfaces clean. Replace used dishcloths and kitchen towels with clean ones often.
• Cover any sore or cut on your hands before preparing food. Use rubber gloves or cover the sore with a clean bandage.
• Make sure the milk, cheese, and juice products you eat and drink have been pasteurized (heated to kill certain bacteria) by the manufacturer.
• Wash fruits and vegetables well, especially if you are eating them raw. Children less than 5 years old, people with weakened immune systems, and older adults should avoid eating alfalfa sprouts. There is no way to remove the bacteria from the sprouts.
• Thaw frozen meats in the refrigerator or a microwave. Do not let meat stand at room temperature.
• Keep juices from raw meat, poultry, and seafood away from other foods.
• Cook all meat thoroughly. Use a meat thermometer to make sure meat is cooked enough to kill bacteria. Pork should be heated to an internal temperature of at least 160°F (71°C). Ground beef should be cooked until a thermometer inserted into several parts of the patty reads at least 160°F (71°C). Ground beef can turn brown during cooking before bacteria in the meat are killed. For whole chickens and turkeys a temperature of 180°F (82°C) is recommended for thigh meat and 170°F (77°C) for breast meat.
• Refrigerate any food you will not be eating right away.
• Cook eggs until the yolk is firm.
• If you are served undercooked meat or poultry at a restaurant, send it back for further cooking. Ask for a clean plate, and for sandwiches, ask for a new bun.
• When you are camping or hiking, drink water only after it has been purified with boiling, proper filtration, or disinfectant tablets (available at most sporting or camping stores).
• Wash your hands with soap and running water after you go to the bathroom. Teach children to wash their hands carefully with soap and water after using the toilet and before having a snack or meal.
• If you take care of young children, wash your hands often and dispose of diapers carefully so that bacteria can't spread to other surfaces or people.
• Stay home from work or school until you feel better. Keep children with diarrhea home from daycare and school until the diarrhea stops.
• Wash your hands after contact with animals or their cages at petting zoos, farms, fairs, and your own backyard.