Escherichia coli (E. coli) bacteria normally live in the intestines of people and animals. Most E. coli are harmless and actually are an important part of a healthy human intestinal tract. However, some E. coli are pathogenic, meaning they can cause illness, either diarrhea or illness outside of the intestinal tract. The types of E. coli that can cause diarrhea can be transmitted through contaminated water or food, or through contact with animals or persons.

E. coli consists of a diverse group of bacteria. Pathogenic E. coli strains are categorized into pathotypes. Six pathotypes are associated with diarrhea and collectively are referred to as diarrheagenic E. coli.

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• Shiga toxin-producing E. coli (STEC)—STEC may also be referred to as Verocytotoxin-producing E. coli (VTEC) or enterohemorrhagic E. coli (EHEC). This pathotype is the one most commonly heard about in the news in association with foodborne outbreaks.

• Enterotoxigenic E. coli (ETEC)

• Enteropathogenic E. coli (EPEC)

• Enteroaggregative E. coli (EAEC)

• Enteroinvasive E. coli (EIEC)

• Diffusely adherent E. coli (DAEC)

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Symptoms

Symptoms of Shiga toxin-producing E. coli (STEC) infection vary for each person, but often include severe stomach cramps, diarrhea (often bloody), and vomiting. Some people may have a fever, which usually is not very high (less than 101˚F/38.5˚C). Most people get better within 5 to 7 days. Some infections are very mild, but others are severe or even life-threatening.

Most people with a STEC infection start feeling sick 3 to 4 days after eating or drinking something that contains the bacteria. However, illnesses can start anywhere from 1 to 10 days after exposure. Contact your healthcare provider if you have diarrhea that lasts for more than 3 days or diarrhea that is accompanied by a fever higher than 102˚F, bloody diarrhea, or so much vomiting that you cannot keep liquids down and you pass very little urine.

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Hemolytic Uremic Syndrome (HUS)

About 5 to 10% of people who are diagnosed with STEC infection develop a potentially life-threatening complication known as hemolytic uremic syndrome (HUS). HUS develops about 7 days after symptoms first appear, when diarrhea is improving. Clues that someone is developing HUS include decreased frequency of urination, feeling very tired, and losing pink color in cheeks and inside the lower eyelids. People with HUS should be hospitalized because their kidneys may stop working and they may develop other serious problems. Most people with HUS recover within a few weeks, but some suffer permanent damage or die.

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Prevention

Escherichia coli (abbreviated as E. coli) are bacteria found in the environment, foods, and intestines of people and animals.

Most E. coli are harmless and are actually an important part of a healthy human intestinal tract. However, some E. coli can cause diarrhea, urinary tract infections, respiratory illness, bloodstream infections, and other illnesses. The types of E. coli that can cause illness can be transmitted through contaminated water or food, or through contact with animals or people.

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What are Shiga toxin-producing E. coli?

Some kinds of E. coli bacteria cause disease when they make a toxin called Shiga toxin. The bacteria that make these toxins are called “Shiga toxin-producing E. coli,” or STEC for short.

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How can I prevent a STEC infection?

 

• Know your chances of getting food poisoning. People with higher chances for foodborne illness are pregnant women, newborns, children, older adults, and those with weak immune systems, such as people with cancer, diabetes, or HIV/AIDS.

• Practice proper hygiene, especially good handwashing.

  • Wash your hands thoroughly after using the bathroom and changing diapers.

  • Wash your hands thoroughly before and after preparing or eating food.

  • Wash your hands thoroughly after contact with animals or their environments (at farms, petting zoos, fairs, even your own backyard).

  • Wash your hands thoroughly before preparing and feeding bottles or foods to an infant or toddler, before touching an infant or toddler’s mouth, and before touching pacifiers or other things that go into an infant or toddler’s mouth.

  • Keep all objects that enter infants’ and toddlers’ mouths (such as pacifiers and teethers) clean.

  • If soap and water aren’t available, use an alcohol-based hand sanitizer with at least 60% alcohol (check the product label to be sure). These alcohol-based products can quickly reduce the number of germs on hands in some situations, but they are not a substitute for washing with soap and running water.

• Follow the four steps to food safety when preparing food: cleanexternal icon, separateexternal icon, cookexternal icon, and chillexternal icon.

• Wash fruits and vegetables well under running water, unless the package says the contents have already been washed.

• Cook meats thoroughly:

  • To kill harmful germs, cook beef steaks and roasts to an internal temperature of at least 145°F (62.6˚C) and allow to rest for 3 minutes after you remove meat from the grill or stove.

  • Cook ground beef and pork to a minimum internal temperature of 160°F (70˚C).

  • Always use a food thermometer to check that the meat has reached a safe internal temperatureexternal icon because you can’t tell whether meat is safely cooked by looking at its color.

• Don’t cause cross-contamination in food preparation areas. Thoroughly wash hands, counters, cutting boards, and utensils after they touch raw meat.

• Avoid raw milk, unpasteurized dairy products, and unpasteurized juices (such as fresh apple cider).

• Don’t swallow water when swimming and when playing in lakes, ponds, streams, swimming pools, and backyard “kiddie” pools.