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Our Expert on Infectious Diseases
Q: I always thought E. coli infections came from undercooked beef, but now I hear raw spinach and green onions can cause it. What’s going on?Ask Our Experts About E. coli Infections About Our ExpertsPuneet Gupta, M.D., is a pediatric gastroenterologist with Pediatric Specialists of the Lehigh Valley, and Marcelo G. Gareca, M.D., is an infectious disease specialist with Lehigh Valley Infectious Diseases. Both are Lehigh Valley Physician Group practices that are affiliated with Lehigh Valley Hospital. Practicing Medicine Since 1989 Education M.B.B.S., 1986, All India Institute of Medical Sciences, New Delhi Residencies in General Pediatrics All India Institute of Medical Sciences Fellowship in Pediatric Gastroenterology University of Chicago Board Certification Board certified in General Pediatrics and Pediatric Gastroenterology Awards and Distinctions Welsh Pediatric Society, Prize for Best Presentation, 1993
Q: I always thought E. coli infections came from undercooked beef, but now I hear raw spinach and green onions can cause it. What’s going on?A: E. coli is short for Escherichia coli, bacteria that live in the colon and stools of many mammals, including humans. These bacteria aid the digestion process. There are many strains, and the one that causes severe diarrhea in humans – E. coli O157:H7 – lives in the digestive tracts of cattle, deer, goats and sheep, but is most common in cattle. Beef becomes contaminated during the slaughtering process, when fecal matter comes in contact with the meat. Fruits and vegetables are contaminated when run-off water from pastures and feed lots gets into irrigation water. The Centers for Disease Control (CDC) estimates that 73,000 people get infected with E. coli O157:H7 annually, and about 61 people die from it. Q: What are the symptoms of an E. coli O157:H7 infection?A: In an average of three or four days after exposure, patients experience severe abdominal cramps and watery or bloody diarrhea, which can lead to dehydration. As soon as you detect blood in the stool, see your physician and ask for a stool culture. Do not take Imodium or other anti-diarrhea medicines because they keep the harmful bacteria inside the intestine, causing more damage. In most adults the infection runs its course in a few days. Once the harmful bacteria are eliminated, people start to feel better. Children, the elderly and immune-compromised people experience complications more often than healthy adults. Q: What are the complications?A: The most common one is hemolytic uremic syndrome (HUS), which kills red blood cells and can lead to kidney failure. HUS is most commonly seen in children and requires treatment in a hospital. Antibiotics are ineffective, and may even be harmful, so treatment is mostly supportive. Children who are very dehydrated also need to be hospitalized so they can have fluid through an IV drip. Most children who contract an E. coli O157:H7 infection will not need hospitalization. Q: How can I protect myself and my family?A: Pay careful attention to food preparation. In general cooking will kill the bacteria. Ground beef, which is comprised of many parts of the cow ground up together, has more potential for causing infection than a steak or a roast. Cook hamburgers to an internal temperature of at least 160˚. Use a meat thermometer, and make sure the center is not pink. Don’t put cooked hamburgers back onto the same plate you used to bring the raw patties to the grill. Use separate cutting boards for meat and vegetables and wash them thoroughly after each use. Wash all fruits and vegetables carefully before eating them, especially those you eat raw. In some cases even careful washing may not remove the bacteria. Don’t drink unpasteurized milk or fruit juices. E. coli O157:H7 outbreaks have been traced to petting zoos. So, if your children have touched animals at a petting zoo or a farm, have them wash their hands thoroughly immediately afterwards. Carry waterless soap with you. Q: If someone in my family gets an E coli O157:H7 infection, can it spread to other family members?A: Yes, if you are not extra careful about hygiene, especially with small children who have diarrhea. Wear gloves while changing the diapers of a child with the infection, or wash your hands very thoroughly afterwards. Dispose of the diapers immediately and safely. Encourage everyone in the family to wash their hands often, especially after going to the bathroom. The infection spreads rapidly in day care centers and nursery schools, so keep sick children home until a stool culture shows that they are no longer infected. Q: How can I make sure the food I buy is safe?A: Cattle that are fed grass instead of grain have less E. coli O157:H7 in their intestines, but most of the beef in supermarkets is from grain-fed cattle. Some ranchers are raising grass-fed cattle, but the beef is more expensive. You can purchase grass-fed beef online from specialty ranches. In general, it is better to buy locally grown produce. Crops grown on vast industrialized farms have a greater potential for contamination, especially if they are near large cattle feedlots. Packaged spinach and salads contain products from various farms; during sorting, shipping and packaging, the bacteria from one farm can taint the produce from other farms and regions. Produce sold at local Farmers’ Markets usually comes from small farms not located near cattle feedlots. Pay attention to news bulletins if there is an outbreak of E. coli O157:H7 in your area. Throw out any food they advise may be contaminated. Grass-fed beef sources:www.eatwild.comwww.americangrassfedbeef.com www.grasslandbeef.com This page last updated 4/1/08 10:51 AM
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