Over 100 cases in 19 states, including New Mexico, of illness due to E. coli infection have been reported to the CDC since August 2, 2006. Half of these infections have resulted in hospitalization, 15% have resulted in a form of kidney failure known as heomolytic-uremic syndrome (HUS), and one person has died as a result of E. coli infection. E. coli is classified as an emerging cause of food-borne illness in the United States by the CDC. An estimated 73,000 E. coli infections and 61 deaths occur in the US each year. Most E. coli infections are associated with eating undercooked, contaminated ground beef. Person-to-person contact in the home and in daycare centers are also important means of disease transmission. There are hundreds of strains of E. coli bacteria. E. coli O157:H7 produces a powerful toxin and is the strain responsible for serious infectious illness in humans. This most recent outbreak of E. coli infections has been caused by contaminated raw spinach. The FDA has advised the public not to eat any fresh spinach or salad blends containing spinach. People that have eaten fresh spinach and do not feel well should see their health care provider. E. coli in spinach can be killed by cooking at 160°F for 15 seconds (water boils at 212°F).

Symptoms of E. coli illness start about 7 days after infection. The first sign is abdominal cramps that begin suddenly; a few hours later watery diarrhea begins. After a day or so, the diarrhea changes to bloody diarrhea. The diarrhea causes the loss of water and electrolytes which results in fatigue and weakness. Diarrhea can be accompanied with mild fever, nausea and vomiting. Anyone experiencing any of these symptoms that suspects E. coli infection should see their health care provider right away. Diagnosis of E. coli infection is made by a culture of a stool sample. The sample must be taken within 48 hours of the onset of diarrhea, so it is important to see a health care provider as soon as possible. The most common complication is hemolytic-uremic syndrome, which starts 5 to 10 days after the onset of diarrhea and results in low red blood cell count, low platelet count, and kidney failure. HUS is more common in children. HUS requires hospitalization for treatment.

Most people recover from E. coli infection without treatment in 5 to 10 days. Treatment consists of preventing dehydration and watching for complications. Antibiotics do not appear to have any effect on the illness and may precipitate kidney problems. Anti-diarrheal medications should also be avoided, as they may increase the amount of toxins present.

Prevention of E. coli infection consists of properly cooking food to at least 160°F and by washing or disinfecting hands regularly. Hand washing is especially important after bowel movements and after changing diapers.

Reference: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/escherichiacoli_g.htm.

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