E. Coli 0157:H7 (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
In this Article
- E. coli definition and facts
- What are E. coli 0157:H7 bacteria?
- 25 early and late symptoms of E. coli 0157:H7 infection
- How do people get E. coli 0157:H7 infections?
- What causes E. coli infection?
- Is E. coli 0157:H7 contagious?
- Is there a test for E. coli?
- What is the treatment for E. coli 0157:H7?
- How can I prevent from getting E. coli?
- What are the complications of infection with E. coli 0157:H7?
- What kind of doctor(s) treat E. coli 0157:H7 infections?
- Other enterohemorrhagic E. coli strains (for example, 0145, 026:H11, 0104:H4 and 0121)
- Summer Food Safety FAQs
25 early and late symptoms of E. coli 0157:H7 infection
Early symptoms of E. coli O157:H7 infection
The early or initial symptoms of E. coli O157:H7 infections usually appear about three to five (though occasionally in as few as one day or as many as 10 days) after a person ingests the bacteria; the symptoms include:
- Stomach cramps
- Diarrhea that often is bloody
- Fever of about 100 F to 101 F (37.7 C to 38.3 C)
- Loss of appetite
- Mild dehydration
These symptoms can be seen in infected children and adults.
Later symptoms E. coli O157:H7 infections
The majority of people (especially normal adults) that are infected resolve the infection without antibiotics in about five to seven days. However, some people (about 10% of people infected and especially children under the age of 5 and the elderly) develop more severe signs and symptoms, and these people usually require hospitalization and aggressive treatment. These patients develop the usual early symptoms listed above, but do not resolve the infection. They develop symptoms that last longer (at least a week) and, if not treated promptly, the infection may lead to disability or death.
Later or late symptoms of E. coli infections may include some of the following symptoms:
- Hemorrhagic diarrhea (large amounts of blood in the stools)
- Pale skin color
- Severe dehydration
- Little or no urine output
- Severe abdominal pains
- Easy bruising
- Shortness of breath
- Generalized swelling
- Kidney failure
- Excessive bleeding
- Mental changes
These symptoms or complications fall into three main categories:
- Hemorrhagic (bloody) diarrhea: Hemorrhagic (bloody) diarrhea is defined as an increased amount of blood in the diarrheal stool that does not seem to decrease over time and usually is accompanied by severe abdominal pain. Although this may resolve within a week, some individuals can develop anemia and dehydration that can cause death.
- Hemolytic-uremic syndrome (HUS): Hemolytic-uremic syndrome symptoms of pallor (due to anemia), fever, bruising or nosebleeds (due to destruction of blood platelets that are needed for blood to clot), fatigue, shortness of breath, swelling of the body, especially hands and feet, jaundice, and reduced flow of urine may be seen. HUS symptoms usually develop about 7 to 10 days after the initial diarrhea begins. HUS is the most common cause of kidney failure in children; children under 10 years old are the most likely to develop HUS. E. coli 0157:H7 produces toxins that damage the kidneys and destroys platelets that can lead to kidney failure, excessive bleeding, seizures or death.
- Thrombotic thrombocytopenic purpura (TTP): Thrombotic thrombocytopenic purpura is caused by the loss of platelets; however, the symptoms that occur are somewhat different and occur mainly in the elderly. The symptoms are fever, weakness, easy, rapid or "spontaneous" bruising, kidney failure, and mental impairment that can rapidly progress to organ failures and death. Until the 1980's, TTP was considered a fatal disease, but since the 1980's, plasma exchange and infusion techniques have reduced the death rate in TTP patients to about 10%.
For most people (about 90%), the E. coli 0157:H7 infection clears and a good outcome or prognosis occurs. However, if any of the above mentioned complications occur, the prognosis may range from good to poor. The variable prognosis depends on the severity of the complication, the rapidity of diagnosis and treatment, the response of the individual to adequate treatment and the overall health of the individual. Children and the elderly are at higher risk for adverse outcomes.
Strains of E. coli 0157:H7 are mainly known to produce gastrointestinal symptoms; there are only a few reports of such strains causing urinary tract infections.
How do people get E. coli 0157:H7 infections?
Most commonly, E. coli 0157:H7 comes from eating raw or undercooked ground beef (for example, hamburger) or from drinking raw milk. The bacteria are found in animal feces, particularly cattle feces, and contact with the feces can lead to contamination of many types of food and fluids. In 2010, the FDA recalled several productions of beef, including beef placed in pet food. Less commonly, E. coli O157:H7 can be transmitted from one person to another, usually by direct physical contact.
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