E. coli are bacteria that normally live in the intestines of humans and animals. Although most strains are harmless, several are known to produce toxins that can cause diarrhea. These Shiga toxin-producing E. coli(STEC) can cause severe diarrhea and kidney damage. E. coli can also cause urinary tract infections, respiratory illness and pneumonia, and other illnesses.
Anyone can become infected with STEC, but the very young and the elderly are more likely to develop serious complications. Even healthy older children and young adults can become seriously ill.
Shiga toxin-producing E. coli can be acquired by eating contaminated food. These bacteria live in the intestines of some healthy cattle and contamination of their meat may occur during the slaughtering process. Sheep, deer, and other hoofed animals may also be infected with the organism. Improper handling of these meats or eating meat that is rare or inadequately cooked is a common way of becoming infected. Contaminated fresh vegetables, unpasteurized fruit juices, and raw milk have also caused STEC infections.
Person-to-person transmission, especially in childcare settings, can occur if infected people do not wash their hands thoroughly after using the toilet or after diapering children ill with diarrhea.
In addition, drinking contaminated water and swimming in contaminated lakes may cause infection. Infections have also resulted from direct contact with farm animals and/or their living areas.
Some infected people have mild diarrhea or no symptoms at all. Most identified cases develop severe diarrhea (which can be bloody), abdominal cramps and vomiting. Usually little or no fever is present. Persons who experience these symptoms should contact a healthcare provider.
The time between ingesting STEC bacteria and feeling sick is usually two to six days after an exposure but may be as short as one day or as long as eight days.
In some people, particularly children under five years of age, the infection can cause a complication called hemolytic uremic syndrome (HUS), which affects the kidneys. Transfusions of blood or blood clotting factors, as well as kidney dialysis, may be necessary to treat this syndrome. HUS, if it occurs, develops an average of seven days after the first symptoms, when the diarrhea is improving. A prolonged hospital stay is often required. Most people with HUS recover completely, but it can be fatal.
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