Escherichia coli is a type of bacteria that cause foodborne illness. E. coli lives naturally in the intestines of both humans and animals. Most strains of E. coli are harmless and help to keep the digestive system functioning but other strains are potentially harmful and may be life-threatening.
E. coli strains that cause food-borne illness may produce a toxin known as Shiga, which damages the intestinal lining. Strains which make the Shiga toxin are known as Shiga toxin-producing E. coli or STEC strains. The most notable of the STEC strains is the O157: H7 strain, which has been responsible for a number of deaths and is the leading cause of acute kidney failure in children.
E. coli food poisoning generally causes illness within 2 to 5 days after eating contaminated food but it can occur more quickly or take much longer for symptoms to develop. E. coli contamination may occur in foods that have been exposed to fecal matter or contaminated water.
What Types of Food Causes E. coli Illness?
Any food that is contaminated with E. coli can cause food poisoning but some are more common than others. Most cases of food poisoning occur in foods which have not been adequately cooked or pasteurized or in foods that have been exposed to contaminated water. Foods which have caused most E. coli outbreaks include
- Ground beef – contaminated during the slaughter process when E. coli from cattle intestines is allowed to contaminate the meat. Ground beef processing often mixes meat from many different animals, multiplying the risk of contamination. When contaminated ground beef is not thoroughly cooked, E. coli food poisoning is possible.
- Unpasteurized milk – E. coli bacteria may be present on cow’s udders or on milking equipment which has not been thoroughly sterilized may contaminate milk. Pasteurization with heat or radiation will eliminate the bacteria and make the milk safe to drink.
- Fresh produce – can become contaminated when fresh manure is used as fertilizer or when water runoff from cattle farms is used to irrigate fields. The main foods that are at risk for E. coli infection include spinach, lettuce, and onions.
Contaminated water may also pose a risk for E. coli gastrointestinal illness as human and animal feces enter a water supply. Public water processing systems use sterilization processes including ultraviolet light, ozone, or chlorine but contamination events have occurred due to municipal water systems. Private wells may pose a greater risk as they do not use sterilization and rural water systems may also be at risk.
Personal contact exposure may occur when handwashing is inadequate. People whose hands have come into contact with E. coli infection may spread it to food or to another person. This may occur due to contact with another infected person or after contact with an animal or animal feces.
Notable E. coli Food Poisoning Outbreaks
Over the past several decades, E. coli outbreaks have been responsible for a number of deaths, some of which have been highly publicized. Most of the outbreaks which caused serious illness was of the O157: H7 strains.
- In 1993, over 700 people were sickened and 4 people, mainly children, died due to undercooked hamburgers served at Jack in the Box restaurants.
- In 1996, an outbreak of E. coli was caused by unpasteurized Odwalla apple juice which resulted in 66 illnesses and 1 death of a child.
- In 2006, more than 205 people were sickened and 3 people died after eating Dole Foods packaged, prewashed spinach.
- In 2017, 25 people were sickened an one person died after eating Leafy Greens, prepackaged salad.
As of September, only one major outbreak of E. coli has occurred. Contaminated Romaine lettuce shipped to 36 states resulted in 210 people sickened, 96 people hospitalized and 5 deaths. The event was traced to a farming area in Yuma, Arizona which used contaminated canal water to irrigate crops.
Other incidents over the past decade which did not include fatalities included:
- 2017 – SoyNut Butter
- 2016 – Beef products
- Alfalfa Sprouts
- 2015 – Rotisserie Chicken Salad
- Chipotle Mexican Restaurant
- 2014 – Raw Clover Sprouts
- Ground Beef
- 2013 – Ready-to-Eat Salads
- Frozen Food Products
- 2012 – Organic Salad Mix
- Raw Clover Sprouts
- 2011 – Romaine Lettuce
- Unshelled Hazelnuts
- 2010 – Cheese
- Shredded Romaine Lettuce
- 2009 – Beef
- Prepackaged Cookie Dough
Symptoms of E. coli
The signs of E. coli food poisoning usually begin several days after consuming a contaminated food. The most common symptoms include:
- Abdominal cramps
Most people who are healthy when infected with E. coli will recover within a week but some may develop serious complications. A hemolytic uremic syndrome is an acute kidney disorder which more commonly affects children and older people.
Hemolytic uremic syndrome (HUS) causes the destruction of red blood cells which may then clog the small blood vessels in the kidney and lead to acute kidney failure which may be life-threatening. HUS is most common in children and even though it is rare, is the number one cause of acute kidney failure in children. Most E. coli deaths are a result of HUS in children.
E. coli food poisoning may be treated with antibiotics and supportive measures such as hydration. Children who develop kidney failure may require blood or platelet infusion and/or dialysis. When treated early, the prognosis is good though some people with HUS may require long-term dialysis.
Symptoms of HUS include:
- Low urine production
- Bloody diarrhea lasting for several days
- Unexplained bruising
- Confusion or seizures
- Swelling of the face, extremities or body
- Extreme fatigue
Symptoms of HUS should be reported to a doctor immediately.
Who is most likely to get seriously ill from E. coli bacteria?
Healthy adults may become sickened by E. coli food poisoning but children and the elderly are at much greater risk. People with certain genetic traits or people with compromised immune systems may also be at increased risk.
Most deaths occur in children under the age of 5 who develop hemolytic uremic syndrome and is likely the reason why E. coli outbreaks are so widely publicized even though they may be less common than other types of food poisoning.
Preventing Listeria Food Borne Illness
Food infected with E. coli may not smell or look differently than other foods. Tips for preventing E. coli exposure include:
- Wash raw vegetables before eating, even when purchased as “prewashed”
- Wash fruits before eating them, include fruits with an inedible rind or peel like cantaloupe
- Keep uncooked foods separate from ready-to-eat and cooked foods
- Defrost meats in microwave or refrigerator
- Store raw meats below produce a level in the refrigerator so that juices do not drop onto produce
- Thoroughly cook a hamburger or other ground meats to a minimum 160 F
- Avoid products made with unpasteurized milk
- Avoid unpasteurized juices
- Avoid swimming in unclean areas. Do not swim if you have diarrhea, exit the water if you see that someone has defecated in the water.
- Wash hands and utensils for at least 20 seconds in warm soapy water after handling foods or after using the restroom
E. Coli Lawsuits
Unlike some other forms of food poisoning, most E. coli outbreaks originate in commercial food facilities or restaurants. As treatment of E. coli illnesses can be costly and may have debilitating effects, businesses whose procedures are inadequate to prevent contamination may be held liable. People who have become ill after exposure to E. coli from a food grower, processing or packaging facility or from a restaurant may be eligible for compensation.
Seek legal assistance if you have become ill due to an E. coli outbreak or if you are the loved one of a person who died due to E. coli outbreak which resulted in food poisoning.