E. coli (Escherichia coli) is one of the most common causes of diarrhea. It is the name of a bacterium that is found in the digestive tract of humans as well as animals.
There are different types of E. coli bacteria and most are harmless and have lived in the digestive tract of mammals for millions of years but if they get in the wrong place like the lungs or bladder or are one of the dangerous strains that produce toxins, they can cause illness.
Sometimes E. coli bacteria may cause urinary tract infections. This is
more likely in females where the urethra (pipe to the bladder) is much
shorter than in males and where the urethra is much closer to the anus
(back passage opening). Always wipe front to back when visiting the
The more dangerous toxin-producing E. coli bacteria strains may cause bloody diarrhea and are called enterohemorrhagic E. coli (EHEC). In very severe cases, this EHEC may be the cause of kidney failure or severe anemia which can result in death. The most common of these dangerous strains is called E. coli 0157:H7.
The most common symptom is sudden onset severe diarrhea, sometimes bloody.
Other E. coli symptoms may include:
Rarer E. coli symptoms of a severe infection include:
You will only know for sure that you have an E. coli infection if you supply your doctor with a stool sample which is analyzed in the laboratory but sometimes you may suspect this infection from your symptoms and your movements in the days prior to the symptoms starting. The incubation period can be from 1-10 days but is usually 24-72 hours.
There are 8 main sources that can lead to an E.coli infection:
1) Contact with the feces of humans or animals can cause this infection. It can happen when you consume water or food that has been contaminated by stool. As the E. coli bacteria may be found on the surface of meat it can get into the middle of some products while it is being processed.
If this kind of processed meat is not cooked to 71°C 160°F (use a meat thermometer to be sure), the bacteria may survive and you might get infected when you consume the meat. This is one of the most common ways that people who eat meat can get infected with it. Any food that comes in contact with raw meat can get infected. Hamburgers that have not been cooked all the way through are a particular problem.
The grinding (mincing) of the meat will have transferred the bacteria from the surface of the meat to the inside of the burger and if it does not reach the required temperature illness can result. This does not happen if you eat a steak, as when it is seared in the pan the outside is sterilized and the inside is not contaminated
If you like your hamburgers cooked medium as I do you can get around this by searing the surface of the meat in a hot pan and then grinding it yourself and making it into burgers.
2) Raw shell fish and sea food
3) Dairy products and raw milk are other culprits. The bacteria can spread from the udders of a cow to its milk. Dairy product labels should be checked to ensure that it says pasteurized. This would mean that they have been treated and the bacteria destroyed. Unpasteurized soft cheeses can be a source of infection.
4) Raw vegetables and fruit such as alfalfa sprouts, lettuce or unpasteurized fruit juices that have been infected with animal feces are another cause. Organic food is very popular with some people but be aware that the method of fertilization is often with animal manure and this can cause contamination. Wash or peel all fruit and vegetables.
5) Contaminated water is a very common cause of an E.coli infection. Animal or human feces that have been infected with E.coli sometimes get into pools, lakes and other water supplies. If the water that is supplied to cities and towns has not been treated properly with chlorine, humans can get infected by it.
This can also occur when someone swallows water while swimming in an irrigation canal, lake, pool or even a swimming pool. This is a particular problem with flood water as often the flood water is contaminated with water from the sewer pipes where they have overflowed following a storm or heavy rain. Privately owned wells and water sources should be tested regularly to make sure that they are safe.
6) Person to person contact is another way in which this disease can spread. If a person who is infected does not wash his/her hands properly after a bowel movement, the E.coli can spread from objects they touch or food they prepare.
7) Petting zoos and farms have been known to cause outbreaks. There have been documented cases of children being contaminated after touching the animals. Make sure that they wash their hands thoroughly after touching any animals.
8) Low quality beaches. Check the quality of any beaches that you visit. Many beaches around the world have sewerage outfalls onto them which can leave the beach and sea contaminated with bacteria. Look out for beaches awarded the Blue Flag which is a quality mark which started in Europe (France) in 1985 but is now spreading around the world.
There is no treatment that can cure an E. coli infection, the aim is to support the body and prevent complications until the infection clears. It takes about two days to recover from a mild E. coli infection, but there are some basic treatments that can make you feel better. These will also help in avoiding dehydration.
It is important to get enough fluids and restrict your diet to feel better and recover faster. Clear fluids such as water, with sports drinks and bouillon (clear broth) are a good idea as salts and sugars often need to be replaced.
An oral rehydration fluid can be useful. If possible do not eat solid food for a few hours as this allows the body to concentrate on dealing with the infection.
If this is difficult for you, consider the BRAT diet. Try to avoid fats
and proteins as it is difficult for your body to digest these when it is
coping with diarrhea. Children should continue with an age appropriate
diet with additional fluids.
When you have diarrhea with this infection, nausea and vomiting can
accompany it. If you are unable to retain enough fluids in your body and
in severe cases, an intravenous drip may be required to give fluids. Talk to the staff before going to a hospital as you do not want to infect other people.
Anti-diarrheal medications should not be taken as these slow down the passage of waste products through the digestive system and may allow more time for toxins produced by the bacteria to be absorbed by the body and cause complications.
Always seek advice from your doctor if there is blood in your stool, also if you have a fever or your abdominal cramps are severe. Seek medical assistance more quickly if a baby, child or elderly person is ill as they are more likely to suffer from serious complications.
Recovery from a severe infection can take up to 10 days and antibiotics cannot be used as they can make it more likely that complications will occur.
Getting an E.coli infection can cause a major disruption to your carefully planned schedule and in some cases can lead to serious illness. To avoid this happening to you or one of your loved ones take precautions with raw meat and food. Be wary of bathing in water where you do not know the quality and follow simple hygiene tips such as the correct hand washing technique.
We were in a restaurant in Lyon, France and it was one of those places where you cook the food yourself on a hot stone. The problem was that the waiter brought the raw chicken on the same plate as the salad and potatoes. I complained and said that it was dangerous having raw meat next to salad. The waiter did the usual Gallic shrug and tried to persuade me that I was a crazy foreigner with overzealous ideas. At this point my husband who is a trained veterinarian stepped in and told him that he was going to report the restaurant to ANSES, the French food safety authorities. They quickly changed their mind but I would never go to that restaurant again.
Always stand your ground if you feel that the food being presented to you is not safe. Your health is worth having a row over.
It may seem like you cannot do anything about E. coli symptoms because prevention of infection requires control measures at every point in the food chain.
Fortunately, there are many preventative measures you can take to protect yourself by keeping your kitchen, bathroom and fridge clean and in order, washing your hands and checking the hygiene ratings of restaurants before you visit.
For other causes of diarrhea please see other pages on this site.