What is E Coli (Escherichia coli)

E Coli or Escherichia Coli is a gram-negative, rod-shaped, facultatively anaerobic, Coliform bacterium of the genus Escherichia found in the environment, food, and intestines of humans and other warm-blooded animals. Most types of E Coli are either harmless or less harmful and cause relatively brief diarrhea. But there are a few strains like E Coli O157:H7 that can cause stomach cramps, severe bloody diarrhea, and vomiting.

E Coli symptoms

Generally, the initial signs and symptoms of E Coli (O157:H7) appear after 4-5 days of exposure to bacteria. But illness may start just after one day of exposure, and even the appearance of symptoms may also take more than a week. E Coli includes the following mild to severe conditions;

  • Mild watery to severe and bloody diarrhea.
  • Pain and cramping in the stomach.
  • Sensitivity and Tenderness of the stomach.
  • Nausea and vomiting in about 30% of cases.

When to See the Doctor

A virulent E Coli strain can cause either watery diarrhea (non-inflammatory) or dysentery (inflammatory diarrhea with stools usually containing blood, mucus, and leukocytes). Diarrhea stools contain a large amount of sodium, chloride, potassium, and bicarbonates. Therefore, persistent diarrhea may cause severe dehydration and loss of electrolytes. If diarrhea is severe and bloody, you must see a doctor on an emergency basis, or else the condition may aggravate and results in further complications. Vomiting is another condition of E Coli, which may lose the additional amount of water and electrolytes.

How do we get infected?

There are several strains of E Coli present in the human intestine, among which most of the strains are harmless and do not produce enterotoxins. Only E Coli O157:H7 produces a powerful toxin that hurts the lining of the small intestine. This can cause bloody diarrhea. You develop an E Coli infection when you ingest this strain of bacteria. Ingestion of a very small amount of contaminated food with E Coli can sicken you. For example, eating a slightly undercooked hamburger, and swallowing a mouthful of contaminated water will cause infection. Unlike other bacteria, E Coli is a more active infectious condition, and a very small quantity of slightly contaminated food can cause diarrhea. Apart from other causes, mostly ingestion of contaminated food/water, and person-to-person contact may make you fall prey to exposure. In the following paragraphs some potential sources of exposure are discussed:

Contaminated Food

Contaminated food is the most common medium for ingesting E Coli into the human intestine. A partially cooked contaminated food eaten by us can make us sick.

    • Ground beef. During cattle slaughter, their meat is exposed to intestinal fluid, which possesses E Coli. In a slaughterhouse, the bacteria can transmit from meat to meat of various animals. Contaminated meat of one animal can contaminate that of the other. Ground beef is taken from different animals, which increases the risk of contamination. In the case of partially cooked ground beef, E Coli will make its way into our intestines. If the meat is well heated up to 160°F/70°C, the bacteria will die.
    • Untreated milk. E Coli is also found on cow’s udder, and the milking equipment and utensils. E Coli can make its way into the milk. If the milk is not pasteurized and treated, the bacteria will enter our digestive tract without being killed. Therefore, unpasteurized milk must not be ingested, in order to prevent E Coli infection.
    • Fresh produce. Fresh produce is those fruits and vegetables, which are eaten directly without any processing. Animal manure as fertilizer and runoff from cattle farms can contaminate fields where fresh produce is grown. Fresh vegetables like spinach and lettuce, are particularly vulnerable to this type of contamination. Cleansing this fresh produce is essential before eating.

Contaminated water

As E Coli resides in human and animal intestines, therefore, it is found in large quantities in stool. Both human and animal stools can pollute the groundwater, lakes, ponds, springs, streams, rivers, and other water, which is either directly drunk or used to irrigate the fields. Although to some extent the public water systems use chlorine, ultraviolet light, or ozone to kill E Coli, however, municipal water supply lines can be contaminated with the sewerage line, and the risk of an E Coli outbreaks increases. Moreover, private water wells are a greater cause for concern because many don’t have a way to disinfect water. Rural water supplies are the most likely to be contaminated. Swimming in lakes and pools, streams, and ponds contaminated with animal/human stools, can also cause E Coli infection.

Contact with an infected person

The infected person can easily transmit the infection to other persons if they do not properly wash their hands, especially after using the toilet. Therefore young children can easily spread the infection among other members of the family due to a lack of hygienic precautions. People living in close contact with animals, and visiting petting zoos, and animal barns can increase the risk of an outbreak.


E Coli causes Urinary Tract Infection

When there is an infection in any part of the urinary system, it is known as Urinary Tract Infection (UTI). The urinary system includes the kidneys, ureters, bladder, and urethra. Most infections involve the lower urinary tract — the bladder and the urethra. E Coli is normally a non-harmful intestinal infection, but it becomes very serious when it reaches the urinary tract. The chances of the development of E Coli into a urinary tract infection in women are greater than in men, as the trip from the anus to the urethra is very short in the case of women. It is, therefore, wiping from “front to back” after using the toilet is helpful to prevent a UTI.

An untreated UTI can cause serious complications as it moves up to the kidneys. Treating infected kidneys becomes more difficult if the infection is not treated promptly. Moreover, the risk of UTI in sexually active, pregnant, and older women having E Coli is greater than in others. A UTI can simply be treated by using antibiotics.

Risk Factors of E Coli

Anyone who is exposed to E Coli bacteria can be affected. But infant children, older people, pregnant, and sexually active women are more vulnerable to the said infection. The most common risk factors are as follows:

  • Age Factor. E Coli targets young children and older adults. Apart from illness caused by E Coli, more serious complications are also expected.
  • Weakened Immune System. People with HIV AIDS infection, and taking drugs for cancer treatment, generally have a weak immune system. Such people remain at risk of having E Coli.
  • Risky Food Factor. Riskier foods include undercooked hamburgers; unpasteurized milk, apple juice, or cider; and soft cheeses made from raw milk.
  • Weather/ Seasonal Factor. Though it is not clear why most of the E Coli cases came around in summer weather. The season was found to significantly impact E. coli persistence in the past years. Hot sun radiations also increase the risk.
  • Decreased Stomach Acid Level. Stomach acidity helps fight the E Coli infection. Taking medicines like esomeprazole, pantoprazole, lansoprazole and omeprazole reduce stomach acidity.

Complications Associated with E Coli

Most E Coli infections get better on their own. But in pregnant, sexually active, and older women and younger children, E Coli can easily develop into a UTI. The condition may be life-threatening if not treated promptly, as it causes kidney failure. A UTI after reaching the kidneys is not simply treated by using antibiotics.

How to Prevent E Coli?

No vaccine or medication has, so far, been prepared to prevent E Coli infection, however, investigators are trying their best to find out some potential vaccine to reduce the risk of infection. Meanwhile to minimize your chance of being exposed to E Coli, avoid drinking water from lakes and pools, frequently wash your hands, avoid eating partially cooked food, and avoid cross-contamination.

Avoid Risky Food

    • Use Fully Cooked Meat: Make sure the meat is completely cooked with no pink showing. But still, the color is not an authentic guide to know if the meat is done cooking. The ground meat can brown even before it is completely cooked. It must be heated up to 70 degrees Celcius, even at its thickest point.
    • Use Pasteurized Cow Milk: E Coli bacteria also live on cow’s udder, and the milking equipment and utensils. E Coli can make its way into the milk. If the milk is not pasteurized and treated, the bacteria will enter our digestive tract without being killed. Therefore, unpasteurized milk must not be ingested, in order to prevent E Coli infection.
    • Wash Fresh Produce Before Eating: E Coli lives on fresh produce, especially green leafy vegetables and salads. Simply rinsing the produce is not enough to wash out the bacteria, because they have many places for bacteria to cling to them. Very careful rinsing is needed to remove dirt and reduce the bacteria from fresh produce.

Watch Out for Cross Contamination

    • Wash Utensils. Use hot soapy water on knives, countertops, and cutting boards before and after they come into contact with fresh produce or raw meat.
    • Keep raw foods separate. This includes using separate cutting boards for raw meat and foods, such as vegetables and fruits. Never put cooked hamburgers on the same plate you used for raw patties.
    • Wash your hands. Wash your hands after preparing or eating food, using the bathroom, or changing diapers. Make sure that children also wash their hands before eating, after using the bathroom, and after contact with animals.

Diagnosing E Coli

There are some signs and symptoms, that your doctor can observe. These symptoms include;

  • Mild watery to severe and bloody diarrhea.
  • Pain and cramping in the stomach.
  • Sensitivity and Tenderness of the stomach.
  • Nausea and vomiting in about 30% of cases.

For a precise and accurate diagnosis, your doctor may send a sample of your stool to a laboratory to test for the presence of E Coli bacteria. The bacteria may be cultured to confirm the diagnosis and identify specific toxins, such as those produced by E Coli O157:H7.

E Coli Treatment

The good news about E Coli infection is it heals on its own. Meanwhile, there is no specific treatment for the condition. The only treatment is to

  • Rest the patient
  • Fluids to reduce dehydration and fatigue

Although E Coli causes diarrhea, antidiarrheal medicines are not recommended, because antidiarrheal medicines can slow down the digestive system and peristalsis preventing your body from getting rid of toxins. Antibiotics are also not recommended as they increase the risk of serious complications and they don’t appear to help treat the infection. The treatment for E Coli infection is to drink plenty of mineralized water, and rest. In case of severe conditions, that may lead to further complications like UTI, and Kidney failure, you must be hospitalized. If there is a risk of kidney failure, treatment includes IV fluids, Kidney dialysis, and blood transfusion is the only solution.


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