Escherichia coli

Commonly referred to as E. coli, Escherichia coli is a  bacterium that is typically found in a number of environments including various foods, soil and animal intestines. E. coli is very diverse and belongs to the genus Escherichia.

Most types of E. coli are harmless and even help keep your digestive tract healthy. But some strains can cause diarrhoea if ingested.

E. coli not only causes food poisoning, you can also get pneumonia and urinary tract infections from the different types of the bacteria. In fact, 75% to 95% of urinary tract infections are caused by E. coli. Some versions of E. coli make you sick by making a toxin called Shiga. This toxin damages the lining of your intestine. The strains of E. coli that make the toxin are sometimes called STEC, which is short for “Shiga toxin-producing E. coli.”

O157:H7 is an especially bad strain of E.coli and can make you very sick. It causes abdominal cramps, vomiting and bloody diarrhoea. It is the leading cause of acute kidney failure in children. It can also cause life-threatening symptoms such as:

  • Adult kidney failure
  • Fever 
  • Bleeding
  • Confusion
  • Seizures

These symptoms are life-threatening and if displayed immediate emergency medical help must be sought. 

Transmission (Infection)

You can become infected through the ingestion of E. coli bacteria. Among the ways this can happen:

Minced-meat: You eat ground meat that carries E. coli, and the meat wasn’t cooked enough to kill the bacteria. When meat is processed, sometimes bacteria from the animals’ intestines  make their way into the meat. This happens more with ground meat because it comes from more than one animal.

Untreated milk: You drink unpasteurised milk, which hasn’t been heated to a temperature that kill bacteria. E. coli can get into the milk from the cow’s udder or from milking equipment.

Vegetables and fruit: You might eat fresh vegetables or fruit that’s been contaminated by water that has the bacteria. This happens most often when manure from nearby animals mixes with the water supply.

Other foods and beverages: You might also get E. coli from unpasteurised fruit juices, yogurt and cheese made from raw milk.

Water: You swallow water that contains E. coli, perhaps while swimming in a pool, lake, or pond.

Other people: You might get E. coli from another person who has it, such as a child. The bacteria can be passed to you if you clean up after an infected person and then don’t wash your hands really well before you touch your mouth.

Animals: It can be found at petting zoos or animal exhibits at fairs.

At home: You can also contaminate food in your own kitchen  if you allow a knife or cutting board that has touched uncooked meat (like chicken) to come into contact with food that will be eaten raw (like a salad).

Symptoms

Symptoms usually appear 2 to 5 days after you’ve ingested the E. coli bacteria. The most common symptoms are:

  • Abdominal cramps 
  • Diarrhoea, which may be bloody
  • Nausea
  • Constant fatigue

You may have a slight fever. Healthy people infected with E. coli usually feel better within a week, while others can develop a serious complication called haemolytic uraemic syndrome, which affects the kidneys. This is more likely to happen to older people and children.

Treatment 

Before treatment can commence, the E.coli bacterium must first be confirmed as the causative agent of the illness. Confirmation is done by a laboratory analyses of the patient’s stool sample. The infection usually goes away on its own.

For some types of E.coli associated with diarrhoea, such as the watery travellers’ diarrhoea, antibiotics can shorten the length of time you have symptoms and might be used in moderately severe cases.

But if you have fever, bloody diarrhoea or if your doctor suspects Shiga toxin-producing E. coli, antibiotics should not be taken. They can actually increase the production of Shiga toxin and worsen your symptoms.

It’s important to rest and get plenty of fluids to replace what your body is losing through vomiting or diarrhoea.

Don’t take over-the-counter medications that fight diarrhoea. You don’t want to slow down your digestive system, because that will delay your body’s shedding of the infection.

When you start to feel better, stick to low-fibre foods at first such as toast, eggs and rice. 

Dairy products and foods that are high in fat or fibre can make your symptoms worse.

Prevention

One of the most important things you can do to protect yourself and your family against E. coli is wash your hands, particularly in these situations:

  • Before you prepare food
  • Before preparing bottles or food for infants or toddlers.
  • Before touching anything, such as a dummy, that goes into a small child’s mouth.
  • After you’ve used the bathroom or changed a nappy.
  • After you’ve had contact with animals, even your own pets.
  • After handling raw meat.

You can also prevent E. coli infections by being careful about  the foods that carry the greatest chance of contamination:

  • Cook burger patties until they’re 71 degrees Celsius inside.
  • Drink only pasteurised milk, juice, and cider.
  • Wash all of your produce before you eat it. Be especially careful to get dirt off leafy greens such as lettuce and spinach.

In your kitchen, a couple of simple rules will help keep you safe:

  • Wash: Clean knives, counters, and cutting boards with hot, soapy water after raw meat has touched them.
  • Keep raw and cooked separate: Use different cutting boards for food that you eat raw, such as vegetables and fruit. Don’t put cooked meat back on the same plate you used for raw meat without washing the plate first.
  • Swimming: When you’re swimming, try not to swallow the water, whether it’s a pool, a lake, or the ocean. It may be contaminated.

PREVENTING FOOD POISONING:

Wash your hands, utensils and food surfaces.

Separate raw and ready-to-eat foods.

Cook foods at safe temperatures.
Keep cold foods cold and hot foods hot.

Refrigerate or freeze perishable foods promptly.

Defrost foods safely.

SOURCES:
CDC: “E. coli.”
Johns Hopkins Health Library: “Escherichia coli O157:H7,” “Escherichia coli.”
National Institute of Allergy and Infectious Disease: “E. coli.”
Mayo Clinic: “Diseases and Conditions — E. coli.”
KidsHealth.org (Nemours Foundation): “E. coli.”
World Health Organization: “E. coli Fact Sheet.”
Chris Hayhurst (2004) E. Coli.

Food Pathogens: Salmonella

SALMONELLA

What is Salmonella?
Salmonella is a type of bacteria that causes food-related illness. The illness caused by these bacteria is called salmonellosis. It can cause a stomach cramps, diarrhoea, fever and stomach pain. Most healthy people recover on their own at home within 4 to 7 days.

How common Is Salmonella?
Salmonella infections are very common. Many are reported around the world every year. Most cases are mild and recover at home, more severe cases require hospitalisation and rarely it can be life-threatening.
Infections are more common in the summer than the winter. This is because salmonella grows quickly in higher temperatures, when food isn’t refrigerated.

Salmonella Causes
People and animals can carry salmonella in their intestines and faeces. The bacteria often spread through contaminated foods. Common food sources of salmonella infection include:

Raw and undercooked meat, including chicken, turkey, duck, beef, veal, and pork.
Raw fruits or vegetables.
Unpasteurised milk and other dairy products, including soft cheese, ice cream and yogurt.
Raw or undercooked eggs.
Processed foods like chicken nuggets.

You can also get salmonella directly through:
Poor hand washing. You might pass along the bacteria by not washing your hands well after using the bathroom or changing a nappy.
Pets (dogs, cats, birds, and reptiles can carry the bacteria).

Salmonella Risk Factors
Children, especially those under 5, are more likely than adults to get sick from salmonella. Older adults and people with weak immune systems are also more likely to be infected. Other risk factors include:
*Salmonella is more common in places with poor sanitation.
*Taking certain medicines. Cancer medicines or steroids can weaken your immune system. Antacids lower how much acid is in your stomach, which makes it easier for salmonella to survive there. Antibiotics can kill “good” bacteria in your body and make an infection harder to fight.
*Inflammatory Bowel Disease. This can damage the lining of your intestines, making it easier for salmonella to take hold.

Salmonella Poisoning Symptoms
Most of the signs and symptoms of a salmonella infection are stomach related. They include:
Stomach cramps
Bloody stools
Diarrhoea
Cold and chills
Fever
Headache
Vomiting

Symptoms tend to start 8 to 72 hours after infection. Most symptoms usually don’t last more than a week, but it can take several months for your bowel movements to get back to normal.

When to seek medical help
Persistent general symptoms (more than a week after first getting the infection).
A young child, an older adult, or someone who has a weakened immune system should see a doctor if they have any of these symptoms for more than a couple of days:
Bloody stools
Ongoing high fever
Dehydration

Salmonella Complications
Dehydration
If the salmonella infection gets into your blood, it can infect other parts of your body, including:
The tissues around your brain and spinal cord
The lining of your heart or heart valves
Your bones or bone marrow
The lining of your blood vessels

Salmonella Diagnosis
Your doctor may have you take blood tests, or they might ask for a stool sample.
Sometimes, they may want to do testing to figure out the exact kind of bacteria you have. This can help health officials trace the source if there’s an outbreak in your area.

Salmonella Treatment
For healthy adults: If you have diarrhoea, drink a lot of water and other fluids. Your doctor might suggest that you drink a rehydration liquid. If your doctor confirms that you have a salmonella infection, they might prescribe antibiotics.

For children: If your child has a healthy immune system, the doctor might just let the infection run its course. Fever and dehydration will be monitored and treated, if required.

In special cases: Infants, the elderly, and people who have weakened immune systems may need antibiotics.

Salmonella Prevention
Salmonella can hide in a variety of foods, but you can do a lot of things to help ensure the bacteria stay away:

*Don’t eat raw or barely cooked eggs or meat.
*Don’t eat or drink anything with unpasteurised milk or juice.
*Don’t wash raw poultry, meat, or eggs before cooking.

*Wash raw fruits and vegetables well.
*Don’t prepare food for other people if you’re vomiting or have diarrhoea.
*Refrigerate food properly, both before cooking it and after serving it.
*Wash your hands well with soap and warm water before and after handling food.
*Keep kitchen surfaces clean before preparing food on them.
*Don’t mix cooked food with raw food or use the same utensils to prepare them. For example, don’t use the same knife to cut raw chicken and then to slice mushrooms, and use different plates or cutting boards to slice them on.
*Cook meat to its correct minimum temperature. Use a food thermometer to be sure.
*Wash your hands with soap and water after touching animals, their toys, and their bedding.

SOURCES:
CDC: “Salmonella,” “Foods That Can Cause Food Poisoning,” “Salmonella and Food,” “Salmonella Questions and Answers.”
World Health Organization: “Salmonella (non-typhoidal).”
Foodsafety.org: “Sneaky Salmonella: It’s Common, Costly, and Preventable.”
Mayo Clinic: “Diseases and Conditions – Salmonella Infection.”
National Health Service (U.K.): “Salmonella infection.”
Kids Health from Nemours: “Salmonella Infections.”
Foodsafety.gov: “Salmonella.”
U.S. Department of Agriculture Food Safety and Inspection Service: “Salmonella Questions and Answers.”
FDA: “Think Food Safety and Be Salmonella Safe!