What is E. coli?

Escherichia coli (E. coli) bacteria normally live in the intestines of people and animals. Most E. coli are harmless to humans. Some strains of E. coli produce a toxin called Shiga toxin that causes diarrhea and can lead to severe illness. These Shiga toxin-producing E. coli are sometimes called STEC (pronounced S-TECK).

How is STEC spread?

STEC is commonly spread by eating undercooked ground meat (such as hamburgers) and contaminated raw vegetables and fruit. You can also get E. coli from drinking raw (unpasteurized) milk, unpasteurized apple cider, soft cheeses made from raw milk, and swimming in or drinking contaminated water. People with STEC who do not wash hands well after a bowel movement can spread it to others. People of any age can become infected with STEC.

What are the symptoms of STEC?

Symptoms of STEC infections vary for each person, but often include:

• Severe stomach cramps
• Diarrhea that is often bloody
• Vomiting
• Low grade fever (less than 101°F/ 38.5°C)

Symptoms often begin slowly with mild belly pain or non-bloody diarrhea that worsens. Most people get better within 5-7 days. Some infections are very mild, but others are severe or even life-threatening.

How long after exposure do symptoms begin?

Symptoms usually occur in three to four days, sometimes as long as ten days.

Are there complications?

Hemolytic uremic syndrome (HUS) is a serious complication of STEC infections that can damage the kidneys and other organs. HUS signs may include decreased urination feeling very tired, and losing pink color inside the lower eyelids. HUS is more common in young children and the elderly with STEC infections. Most people with STEC infection do not develop HUS.

How is it treated?

STEC infection is diagnosed with a stool test. Stay hydrated. Antibiotics and anti-diarrhea medicines are typically not recommended because they may make the infection worse.

When should I contact my healthcare provider?

Contact your healthcare provider if you have diarrhea that lasts for more than three days or immediately if diarrhea is accompanied by fever, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine.

How can E. coli be prevented?

• Cook meats thoroughly. Cook ground meats to an internal temperature of at least 160°F/70°C. Use a thermometer, not color, to determine if ground meats are thoroughly cooked.
• If you are served a pink hamburger in a restaurant, send it back for further cooking.
• Separate uncooked meats from all other foods in the refrigerator and during food preparation.
• Prevent cross contamination in food preparation areas by thoroughly washing hands, counters, cutting boards, and utensils after they touch raw meat.
• Wash your hands thoroughly after using the bathroom or changing diapers and before preparing or eating food.
• Wash your hands after contact with animals or their environments (farms, petting zoos, fairs, even the backyard).
• Avoid raw milk, unpasteurized dairy products, and unpasteurized juices (like fresh apple cider).
• Wash all fruits and vegetables thoroughly with water before eating.
• People with diarrhea should not swim in public pools or lakes, share baths, or prepare food for others.
• Avoid swallowing water when swimming or playing in lakes, ponds, streams, swimming pools, and backyard kiddie pools.