Medically Reviewed By Michaela Murphy, PA-C
— Written By Sarah Lewis, PharmD
Updated on June 14, 2022
E. coli-relateddiarrhea has no specific treatment. Instead, doctors manage it with supportive treatment, which involves administering extra fluids to avoid dehydration.
This article provides an overview ofE. colidiarrheal infection, including its symptoms, causes, diagnosis, and treatment.
What isE. coli?
There are
When you hear that people are getting sick fromE. coli, there are only
- Shiga toxin-producingE. coli(STEC),which is responsible for most outbreaks in the United States
- Other names for it include Verocytotoxin-producingE. coli and enterohemorrhagicE. coli. You may also hear people call it by the name of the most common strain of this subtype,E. coliO157:H7.
- enterotoxigenicE. coli, which is themost commoncause of traveler’s diarrhea
- enteropathogenicE. coli, which was once a cause of outbreaks among infants and children but is now rare
- enteroinvasiveE. coli, which is relatively rare
- enteroaggregativeE. coli, which can also cause traveler’s diarrhea
- diffusely adherentE. coli
What are the signs and symptoms ofan E. coliinfection?
AnE. colidiarrheal infection can show up anywhere from1–10 daysafter exposure. Most people start having symptoms within 3–4 days of ingesting contaminated food or water.
Symptoms may include:
- mild fever or no fever at all
- nausea and vomiting
- stomach cramps, which are often thefirst symptomand can be severe
- watery diarrhea that may become bloody after 24 hours
Most people get better within 5–7 days. However, if you have diarrhea that lasts for longer than 3 days or diarrhea with a high fever, blood, or vomiting that prevents you from keeping down liquids, seek prompt medical care.
Prompt medical care is also necessary for the following symptoms of dehydration:
- dizziness or confusion
- fatigue
- increased thirst
- skin that remains tented after you pinch it
- very little urine or very dark urine
People can still spread bacteria for several weeks or possibly months after they feel better. Young children tend to carry them longer than adults.
How do you know you have anE. coliinfection?
Visiting your doctor is the only way to know for sure if you have anE. coliinfection. In
Taking a stool sample isnot usually necessary. Diarrhea typically resolves on its own, whether it is due to a virus orE. coli. However, there are times when a stool sample is necessary, including in people with:
- an age of 70 years or above
- bloody diarrhea
- diarrhea lasting for longer than 7 days
- fever
- inflammatory bowel disease or a weakened immune system
- moderate to severe diarrhea
How do you treat anE. coliinfection?
E. coliinfections usually go away by themselves. These diarrheal infections are unpleasant butrarely dangerous. Treatment relies on preventing dehydration. It is important to drink lots of liquids. Oral rehydration solutions, broths, and bouillon are good choices to replace fluids and electrolytes.
You
What causes a person to getE. coli?
AnE. coliinfection starts when you swallow something that contains a disease-causing strain. This contamination has minuscule amounts of feces in it. These microscopic quantities can go undetected during food processing and preparation.
Undercooked ground meats, unpasteurized milk, and contaminated vegetables are somecommon sources of infection. With meat, the bacteria taint the meat during slaughter.
E. colican alsobe presenton people’s hands and in the following:
- animals — including cows, goats, and sheep — and their living areas
- feces of people with the infection
- raw fruits and vegetables, especially leafy greens and sprouts
- soft cheeses from raw milk
- soil
- unpasteurized milk and juice
- bodies of water, including lakes, ponds, streams, and swimming pools
Who is most at risk of an E. coliinfection?
In the U.S., the average person’s risk of getting anE. coliinfection is very low. About
Those at highest risk of anE. coliinfection include:
- adults older than 65 years of age
- children younger than 5 years of age
- people with weakened immune systems, such as those taking immunosuppressant drugs and those with cancer, HIV, or diabetes
What are the complications ofan E. coliinfection?
Serious complications fromE. coliare very rare. About
Symptoms of HUS tend to develop when diarrhea is improving, about 7 days after the illness begins. Symptoms include:
- feeling very tired
- losing the pink color in your cheeks and inside the lower eyelids
- urinating less frequently
People with HUS need hospitalization. Although most recover within a few weeks, permanent kidney damage and death are possible.
Doctors often recommend that people with high risk STEC are hospitalized for fluids and monitoring, especially if they are an older adult, a younger person, or someone who is immunocompromised.
In the U.S., about 30 people die each year fromE. coliinfections.
How can you protect yourself froman E. coliinfection?
You can reduce your chance of getting sick fromE. coli. Although your risk of an infection is already extremely low, you can take steps to
- Avoid eating high risk foods. Contaminated food causes more than half the cases of E. coli illness.
- Avoid untreated water.
- Stay away from people who are ill with anE. coliinfection.
- Wash your hands before preparing food, after diapering infants, and after touching grazing animals — such as cows, sheep, or goats — or their surroundings.
- Use a food thermometer when you cook ground beef to make sure that it reaches an internal temperature of 160°F (71ºC).
High risk foods to avoid include:
- undercooked ground beef
- unpasteurized milk or juice
- soft cheeses made from unpasteurized milk
- unpasteurized apple cider
- alfalfa and raw bean sprouts
Frequently asked questions
Here are some more questions that people commonly ask about E. coli.
When should you see a doctor concerningE. coli?
Although most cases ofE. coliare not dangerous, contact your doctor if your symptoms do not go away within a few days. Also, contact your doctor if you have bloody diarrhea, abdominal pain, high fever, or vomiting that prevents you from keeping down liquids.
How long does it take forE. colito go away?
E. coliinfections usually last about a week or less.
IsE. colicontagious?
People with anE. coliinfection arevery contagious. The infection can easily spread from person to person. Practice good hand hygiene and stay home to prevent transmission.
Summary
Although rare in the U.S.,E. coliinfections can cause significant diarrheal disease. They are a common cause of traveler’s diarrhea outside this country.
When outbreaks occur in the U.S., they are almost always due to the STEC subtype. Although most people recover within a few days, this subtype carries the risk of HUS. Contact your doctor if you develop bloody diarrhea or have diarrhea that lasts for longer than a few days.