E. COLI CONTAMINATION
The Centers for Disease Control and Prevention reports that food poisoning from romaine lettuce harboring the bacteria E. Coli spread recently to 29 states and sent at least 150 people to the hospital. The areas involved include all parts of the country from Florida to North Dakota to California, and new cases are making it the worst E. Coli outbreak nationally since 5 people died and 200 were hospitalized in 2006.
Although E. Coli is a common inhabitant of the intestinal tract, some strains, especially O157:H7, produce a toxin known as “Shiga” that causes bloody diarrhea, nausea and vomiting, dehydration, and other symptoms. Victims range from 1 to 88 years old, and a number are experiencing kidney failure, which has killed one person so far. Several E. Coli varieties are common causes of urinary tract infections.
Sources of Shiga-toxin producing E. Coli may include:
· Contaminated water (even swimming in it may cause infection)
· Undercooked ground beef
· Unpasteurized milk or juice
· Cheese made from raw milk
· Raw fruits, vegetables, and sprouts
· Contact with animals and their enclosures
· Feces of those infected
After the organism enters the system, it usually takes several days for symptoms to appear. Unlike many infections, E. Coli tends not to cause high fevers, but the abdominal pain, diarrhea, and vomiting can be severe. Dehydration can cause decreased urine production, dark urine, weakness, and fatigue.
Re-hydration support during the illness will help support the victim for the 6-8 days it takes most to get over the infection. Antibiotics are rarely indicated, as it usually goes away by itself; it is even thought that taking anti-diarrheal medicines may slow the recovery process by preventing the elimination of the organism through bowel movements. Dairy products or items with high fat content or fiber can make your symptoms worse.
If it occurs, kidney damage will begin to become apparent after the first week.
Simply avoiding bagged lettuce at the grocery store is not enough, as many of those made ill ate the lettuce in salads served in restaurants. It is not yet known where in the chain from farm to consumer that the contamination with the bacteria took place. A farm in Yuma, Arizona may be involved.
Prevention involves avoiding poorly prepared food and water. Use different cutting boards for raw fruits and vegetables than you would for raw meat.
The most important factor in preventing E. Coli outbreaks is strict diligence applied to washing hands before cooking, after caring for animals and their environments, and diapering infants or otherwise disposing of human waste.
Eating salads is a healthy option for most, but always be sure to make yours with freshly-washed hands and vegetables.
Joe Alton MD
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