E Coli

Information relating to the Escherichia coli 0157 bacteria.

What is it?

Verocytotoxin-producing Escherichia Coli (VTEC) are bacteria responsible for a range of illnesses in humans from mild diarrhoea to severe colitis, renal failure and septic shock. There are a number of different types of VTEC bacteria, the most common responsible for human diseases in the United Kingdom being Escherichia colic 0157. Numbers of cases have arisen steadily from less than 10 each year in the early 1980s to 1039 in 1995. At present most of these infections are diagnosed in children under 5 years of age and the majority of cases occur in the Autumn.

How do you catch it?

Usually by eating food or drink contaminated with Escherichia coli 0157. Cattle are thought to be the main reservoir of infection and several large outbreaks have occurred in the United States that have been associated with eating undercooked beef burgers. Other suggested sources include contaminated milk and yoghurt, faecally contaminated raw vegetables and water and cooked meats. Spread of the infection from person to person has occurred within households, nurseries and infant schools, nursing and residential homes.

Direct contact with animals, particularly on farms or in animal sanctuaries, has also been reported as a source.

Only small numbers of bacteria, e.g. less than 10 organisms, are necessary to cause illness.

How can you avoid it?

Cooking beef burgers, and other meats, thoroughly until the juices run clear and there are no pink areas inside can significantly reduce exposure to VTEC bacteria. Vulnerable groups such as children, the elderly and immunocompromised patients should also avoid the consumption of unpasteurised milk. If visiting farms, animal sanctuaries etc. hands should be thoroughly washed after touching/feeding any of the animals and especially before eating any food.

What symptoms does it cause?

Diarrhoea is the commonest symptom and it may be a self-limiting mild diarrhoea that settles within two weeks but it can progress to a more serious colitis with severe abdominal pain and bloody diarrhoea. A very small proportion of cases go on to develop the hemolytic-uremic syndrome, which is a type of renal failure associated with anaemia and other blood disorders. This syndrome, which can on very rare occasions leads to death, is a more likely complication of VTEC infections in children and, to a lesser extent, the elderly.

What is the treatment?

As these infections are usually self-limiting, only simple measures such as plenty of fluids, a light diet and rest are needed. If more serious complications develop, then these are treated in hospital.

Is there anything else you should do while you are ill?

Avoid contact with other people until your diarrhoea has stopped, especially children and vulnerable people.
Avoid preparing food for other people.
Make sure everyone at home has his or her own towel.
Clean toilet seats, flush handles, door handles and taps frequently with hot soapy water. You do not need to use disinfectants, but if you want to then follow the manufacturer instructions carefully, and keep them away from children.
Soiled clothes should be laundered on as hot a wash as possible.

When can you go back to work/school?

An Environmental Health Officer will contact you from your Local Authority to see if they can identify where you may have contracted the disease. The Environmental Health Officer will tell you how long to stay off. In general you will be told to remain off work/school until you have been free from diarrhoea and vomiting for at least 48 hours. If there might be special risks of the infection spreading further, you will be given additional advice.

Those that do pose a special risk of spreading infection, i.e. children under 5 years of age, food handlers or health care worker, will be told to remain off work/school until two consecutive faecal specimens, taken at 48 hour intervals, have been found to be clear of the organism.

From an information leaflet published by Nottingham and North Nottinghamshire Health Authorities.