What is E.coli?

Escherichia coli, also known as E.coli is a bacterium commonly found in the gut. Several types of E.coli exist as part of the normal flora of a human gut and have several beneficial functions.

Most types of E.coli pose no harm, except for serotype O157:H7. This can cause food poisoning in humans and can become life-threatening.

A healthy adult will normally make a full recovery from E.coli (O157:H7) within 5 to 7 days. However, young children, elderly adults and patients with weak immune systems can develop a potentially fatal type of kidney failure called Hemolytic Uremic Syndrome (HUS).

What are the symptoms of E.coli?

Symptoms of E.coli depend on the site of infection and which type of E.coli is causing the infection. Classic symptoms include severe abdominal pain, vomiting and diarrhoea that may be bloody. Abdominal pain is the first symptom and comes on suddenly. A few hours after the abdominal pain, the patient usually has watery diarrhoea, however not every patient that becomes ill suffers from this. Other symptoms that may be present include, fever, fatigue and dehydration from loss of fluids and electrolytes caused by the diarrhoea.

Symptoms usually become apparent between 1 & 7 days, typically between days 3 and 4 and can last up to 7 days if there are no complications. A large number of infected people have no obvious symptoms, however, they can unwittingly spread the infection to others.

HUS may develop in 5 -10% of people infected with a toxin producing form of E.coli. This results in a severe kidney-related complication, that could, in extreme cases, lead to renal failure.

How do you treat E.coli?

The specific treatment will depend on the type of infection. There are no current treatments that can cure E.coli O157:H7, it just has to run its course.

Cystitis infections usually go away by themselves after a few days, sometimes a short course of antibiotics may be prescribed. Intestinal infections are not usually treated with antibiotics either. Antibiotics aren’t recommended as they can make the risk of complications worse. Most doctors advise patients to drink plenty of water to avoid dehydration and get lots of rest.

A sample of faeces should be sent off to confirm that it is an E.coli infection. Any contacts should  be screened and the patient should be off work or school until the infection has cleared.

With regards to the treatment of HUS, it depends on the severity of the infection. Treatments may include:

  • General support such as intra-venous fluids
  • Medications such as corticosteroids
  • Plasma filtration of exchange
  • Dialysis

Again antibiotics aren’t usually used as the can increase the release of toxins whilst killing the bacteria, increasing the harm done to the patient’s kidneys.

How do you prevent E.coli?

 To help prevent the risks of E.coli outbreaks:

Keep good hand hygiene, particularly after using the toilet and before preparing food.

Wash fruit and vegetables (particularly leafy green ones) to remove excess dirt, reducing bacteria.

Cook meat well especially ground meat

Keep good hand hygiene, particularly after using the toilet and before preparing food.

Drink pasteurised milk as it is safer than unpasteurised.

Wash cutlery and crockery thoroughly in warm, soapy water.

Make sure you store foods separately, don’t store raw meats next to other foods, and use separate chopping boards.

Some people have been infected by swallowing the water from swimming pools or playing in lakes or ponds, so swallowing water during these activities should be avoided.

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