| E. Coli Infection From Food or Water
		
			| E. Coli Infection From Food or WaterSkip to the navigationTopic OverviewWhat is an E. coli infection?E. coli (Escherichia coli) is the name of a germ, or bacterium, that
			 lives in the
			 digestive tracts of humans and animals. There are many types of
			 E. coli, and most of them are harmless. But some can
			 cause bloody diarrhea. Some strains of E. coli bacteria may also
			 cause severe
			 anemia or kidney failure, which can lead to
			 death. Other strains of E. coli can cause
			 urinary tract infections or other infections. What causes an E. coli intestinal infection?You get an E. coli infection by coming into
			 contact with the feces, or stool, of humans or animals. This can happen when
			 you drink water or eat food that has been contaminated by feces. E. coli  in foodE. coli can get into meat during processing. If
			 the infected meat is not cooked to 160°F (71°C), the bacteria can survive and
			 infect you when you eat the meat. This is the most common way people in the
			 United States become infected with  E. coli. Any food
			 that has been in contact with raw meat can also become infected. Other foods that can be infected with
			 E. coli include: Raw milk or dairy products. Bacteria can
				spread from a cow's udders to its milk. Check the labels on dairy products to
				make sure they contain the word "pasteurized." This means the food has
				been heated to destroy bacteria.Raw fruits and vegetables, such as
				lettuce, alfalfa sprouts, or unpasteurized apple cider or other unpasteurized
				juices that have come in contact with infected animal feces. 
 E. coli  in waterHuman or animal feces infected with E. coli sometimes get into lakes, pools, and water supplies.
			 People can become infected when a contaminated city or town water supply has
			 not been properly treated with chlorine or when people accidentally swallow
			 contaminated water while swimming in a lake, pool, or irrigation canal. E. coli  from person-to-person contactThe bacteria can also spread from one person to
			 another, usually when an infected person does not wash his or her hands well
			 after a bowel movement. E. coli can spread from an
			 infected person's hands to other people or to objects. What are the symptoms?The main
			 symptoms of an E. coli intestinal infection are:  Bloody diarrhea.Stomach cramps.Nausea and vomiting.
 Some people do not notice any symptoms.
			 Children are more likely than adults to have symptoms. Symptoms usually start 3
			 or 4 days after you come in contact with the E. coli. Most people get better in about a week. They often
			 don't see a doctor and don't know that E. coli caused
			 their problems.  When E. coli causes
			 serious problems with the blood or kidneys, symptoms include: Pale skin.A
				fever.Weakness.Bruising.Passing only
				small amounts of urine.
 How is an E. coli intestinal infection
			 diagnosed?Your doctor may suspect that you have an
			 E. coli infection after he or she asks you questions and
			 does an exam. Your stool will probably be tested for E. coli. How is it treated?E. coli
			 infection usually goes away on its own. Your main treatment is to make yourself
			 comfortable and drink sips of water. Diarrhea causes the body to lose more
			 water than usual. This can lead to
			 dehydration, which is especially dangerous for babies
			 and older adults. Taking frequent, small sips of water will help prevent
			 dehydration. If you have bloody diarrhea that may be from an
			 E. coli infection, do not take diarrhea medicine or
			 antibiotics. These medicines can slow down the digestion process, allowing more
			 time for your body to absorb the poisons made by the E. coli. Call your doctor instead. In some people,
			 E. coli infection causes serious problems with the blood
			 and kidneys. These people may need
			 blood transfusions or
			 dialysis. Dialysis is a treatment that helps filter
			 waste products from the blood when the kidneys aren't working right.  How do you prevent an E. coli
			 intestinal infection?Food and water that are infected with E. coli germs look and smell normal. But there are some things
			 you can do to prevent infection: Cook ground
				beef to at least  160°F (71°C).  In the kitchen, wash your hands
				with hot, soapy water often, especially after you touch raw meat.
				Wash any tools or kitchen surfaces that have touched raw meat. Use
				only pasteurized milk, dairy, and juice products. Use only
				treated, or chlorinated, drinking water. When you travel to
				countries that may have unsafe drinking water, don't use ice or drink tap
				water. Avoid raw fruits and vegetables, except those with skin that you peel
				yourself. Wash your hands often, and always wash them after you
				use the bathroom or change diapers.
 Frequently Asked Questions| Learning about E. coli infection: |  |  | Being diagnosed: |  |  | Getting treatment: |  |  | Ongoing concerns: |  | 
SymptomsChildren are more likely than adults to
		  develop symptoms of
		  an E. coli  infection. Most people with the
		  infection will have: Severe stomach cramps and stomach
			 tenderness.Diarrhea, watery at first, but often becoming very
			 bloody.Nausea and vomiting.
 Some people who are infected with the bacteria do not
		  notice any symptoms. They may spread the bacteria to others without knowing
		  it. There are many
		  conditions with symptoms similar to those of E. coli intestinal infection. Diagnosis of E. coli infection can be
		  complicated by the fact that most bacterial infections that cause diarrhea are
		  accompanied by a high fever. If you have no fever or only a mild fever, your
		  doctor may suspect that something other than bacteria is causing your
		  symptoms. Bloody diarrhea is common in confirmed cases of
		  E. coli intestinal infection, but the bacteria also should be
		  considered a possible cause of non-bloody diarrhea.  For more information on
		  when to call a doctor about non-bloody diarrhea, see: Symptoms of
		  E. coli infection usually end in about a week with no
		  further problems. But
		  severe blood and kidney problems may occur within 2 weeks after the onset of diarrhea. These problems can
		  cause kidney failure and sometimes long-term disability or death in some
		  children and older adults.Exams and TestsThe medical evaluation for diarrhea
		  that may be caused by
		  disease-causing E. coli  bacteria usually starts with a
		  physical examination and a medical history.  During the medical
		  history, your doctor will ask questions about your symptoms, such as: When did diarrhea begin, how long has it
			 lasted, and how frequent are bowel movements?Is there blood in the
			 diarrhea? If so, how much?Have you had chills or a
			 fever?Have you had any abdominal cramps, nausea, or
			 vomiting?Do you feel tired or irritable?Have you
			 fainted or felt lightheaded?
 Infection with E. coli is easily
		  mistaken for
		  other conditions with similar symptoms, such as other infectious
		  diseases. A doctor may suspect you have E. coli infection if you have been exposed to the bacteria. During the
		  medical history, your doctor may ask if you have: Been in a day care center, school, nursing
			 home, or other adult care institution.Eaten recently at a
			 restaurant.Consumed any undercooked meat or unpasteurized milk, dairy products, or
			 juice.Had contact with
			 anyone with recent or ongoing diarrhea.Traveled
			 recently.Used antibiotics recently.
 During the physical examination, a doctor will
		  usually: Take your temperature.Take your
			 blood pressure and determine your pulse rate.Look at your skin
			 color to see whether you are unusually pale.Check your stomach for
			 tenderness.Perform a rectal exam to find out whether you have
			 blood in your stool.
 Doctors who suspect E. coli
		  infection will order a type of
		  stool culture that detects strains of E. coli. Because the bacteria can leave the body in only a few
		  days, the sample should be obtained as soon as possible after symptoms
		  appear. Other tests are sometimes used when the diagnosis is
		  unclear, but these are not yet widely available. If a child or
		  older adult is diagnosed with E. coli infection, he or
		  she may be watched for development of
		  severe blood or kidney problems. Monitoring requires
		  blood and urine tests to measure essential elements of blood and body
		  fluids.Treatment OverviewTreatment of infection with
		  disease-causing E. coli  bacteria involves managing
		  complications-mainly
		  dehydration caused by diarrhea.  If you
		  develop symptoms of
		  severe blood or kidney problems, such as
		  anemia or kidney failure, your treatment may
		  include: Careful regulation of fluids and essential
			 minerals.Dialysis, to filter waste products from
			 your blood. Some people with kidney failure caused by E. coli infection require dialysis.Blood transfusion, to treat anemia by giving you additional oxygen-rich red
			 blood cells.
 Medicines to avoidMost people recover from
			 E. coli infections in 5 to 10 days without the need for
			 medicine.
			 Antibiotics are not recommended. Tell your doctor if
			 you think you may have E. coli infection and are taking
			 antibiotics. Nonprescription or prescription diarrhea medicines
			 usually are not used to treat E. coli infection. Many
			 antidiarrheal products slow the rate at which food and waste products move
			 through the intestines. This may allow more time for the body to absorb the
			 poisons produced by the bacteria, increasing the risk of complications such as
			 severe blood and kidney problems. Avoid these nonprescription
			 products if you have or suspect you have an E. coli
			 infection: Loperamide products. These include Imodium, Maalox, and other antidiarrheal products. Note: Only those products that list
				loperamide in their ingredients should be avoided.Products
				containing salicylates. These include Pepto-Bismol and similar bismuth-based
				antidiarrheal products, aspirin, and ibuprofen (such as Advil). Salicylates can
				increase bleeding from the intestines. Also, salicylates are associated with
				Reye syndrome, a rare but serious illness in
				children.
 Prescription diarrhea medicines may be harmful when given
			 to a person with E. coli infection. A doctor may
			 prescribe one of these medicines if he or she does not know that  E. coli caused the diarrhea. Be sure to discuss your symptoms with your
			 doctor. Sharing information is important to get the proper diagnosis of your
			 condition. Avoid these prescription medicines if you have or think
			 you may have an E. coli infection: Difenoxin with
				atropine (Motofen)Diphenoxylate with
				atropine (Lomotil)Loperamide (prescription-strength Imodium)
Home TreatmentHome treatment of infection with
		  disease-causing E. coli  bacteria consists of keeping yourself
		  comfortable and preventing the spread of the bacteria. If you aren't infected,
		  take steps to prevent infection. If you think that you or someone
		  in your care may be infected with E. coli, contact a
		  doctor immediately. Do not treat diarrhea symptoms with any nonprescription or
		  prescription medicines. Home treatment for diarrhea or bloody diarrhea caused by
			 E. coli infectionDo not use nonprescription antidiarrheal
				products if you have bloody or non-bloody diarrhea that you suspect may be
				caused by E. coli infection. These products include
				Imodium and Maalox Anti-Diarrheal. Do not take other medicines that you have
				left over from a previous illness.  Take frequent, small sips of
				water or a
				rehydration drink to replace lost fluids and help
				prevent
				dehydration. Because dehydration can be more dangerous
				in babies, call your doctor if you think your baby may be dehydrated. Your
				stomach cannot handle too much fluid at one time. Seek medical care if you
				develop signs of
				moderate dehydration, which include: 
				Dry appearance inside the
					 mouth.Eyes that don't tear.Low output of
					 urine.Lightheadedness.
 Especially in children and adults age 65 and older, watch
			 for symptoms of
			 severe blood and kidney problems, such as fever,
			 weakness, pale skin, or passing small amounts of urine. If any of these
			 symptoms develop, see a doctor immediately. Tips for protecting yourself against E. coli infection from contaminated food and waterCook ground beef to a temperature of at least
				160°F (71°C).
				Ground beef should be cooked until all pink color is
				gone, but don't rely only on color. Check the temperature with a meat
				thermometer. Cut open restaurant and home-cooked hamburgers to ensure that they
				have been completely cooked. The juices should be clear or yellowish, with no
				trace of pink. Never eat raw or undercooked ground beef.When
				preparing food: 
				Wash your hands often with hot, soapy
					 water, especially after handling raw meat. Always wash cooking
					 tools, cutting boards, dishes, counter tops, and utensils with hot, soapy water
					 immediately after they have come into contact with raw meat. Do not put cooked
					 meat back onto a plate that has held raw meat unless the plate has been
					 thoroughly washed with soap and water and dried.Use separate
					 cutting boards for raw meat and for other food items.Keep raw
					 meat, poultry, and seafood separate from vegetables, fruits, breads, and other
					 foods that have already been prepared for eating.
Use only
				pasteurized milk, dairy, and juice products. Check
				product labels for the word "pasteurized." Juice made from concentrate is the
				same as pasteurized.Use only treated (chlorinated) drinking
				water.Travelers to countries where the water supply may not be safe
				should be especially careful not to put ice in their drinks or drink tap water.
				All water consumed should be boiled or bottled. Eat meals when they are hot.
				Avoid raw fruits and vegetables, except those with skin that you peel
				yourself.
 Tips for preventing person-to-person spread of E. coli bacteriaWash your hands often, and always wash
				them after bowel movements or changing diapers. If your home has more than one
				bathroom, restrict the infected person to the use of one bathroom
				only.Dispose of soiled diapers and stools carefully. If the
				infection is suspected in a young child, use disposable diapers instead of
				cloth diapers until the illness has passed.Adults should make sure that
				children who have diarrhea wash their hands thoroughly after using the
				bathroom. Children infected with E. coli should avoid
				contact with other children, particularly during swimming.Wash
				handles on toilets and sinks with an antibacterial cleaner.People
				who have been diagnosed with E. coli infection should
				not handle food or work in a day care center or other institution until they
				have tested negative for the bacteria in two stool samples. If you have taken any antibiotic, the stool sample
				should be taken at least 48 hours after you took the last dose.Chlorinate water in swimming pools and hot tubs.
Other Places To Get HelpOrganizationsPartnership for Food Safety Education: Fight Bac! (U.S.) www.fightbac.orgU.S. Department of Health and Human Services: FoodSafety.govwww.foodsafety.govReferencesOther Works ConsultedAmerican Academy of Pediatrics (2015). Escherichia coli diarrhea (including hemolytic-uremic syndrome). In DW  Kimberlin et al., eds., Red Book: 2015 Report of the Committee on Infectious Diseases, 30th ed., pp. 343-347. Elk Grove Village, IL: American Academy of Pediatrics.Donnenberg MS (2015). Enterobacteriaceae. In JE Bennett et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 8th ed., vol. 2, pp. 2503-2517. Philadelphia: Saunders.Mah A, et al. (2016). Infections due to Escherichia coli and other enteric gram-negative bacilli. In EG Nabel et al., eds., Scientific American Medicine, chap. 234. Hamilton, ON: BC Decker. https://www.deckerip.com/decker/scientific-american-medicine/chapter/234/pdf. Accessed December 15, 2016.
Procop GW, Cockerill F III (2001). Enteritis caused by Escherichia coli and Shigella and Salmonella species. In WR Wilson et al., eds., Current Diagnosis and Treatment in Infectious Diseases, pp. 548-556. New York: McGraw-Hill.
CreditsByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
 Kathleen Romito, MD - Family Medicine
 Adam Husney, MD - Family Medicine
 Elizabeth T. Russo, MD - Internal Medicine
 Specialist Medical ReviewerW. David Colby IV, MSc, MD, FRCPC - Infectious Disease
Current as ofMarch 29, 2017Current as of:
                March 29, 2017 Last modified on: 8 September 2017  |  |