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Let's Talk About ... E.Coli

Cartoon of Man with stomache acheAn estimated 73,000 cases of infection and 61 deaths occur in the United States each year. Infection often leads to bloody diarrhea, and occasionally to kidney failure. Most illness has been associated with eating undercooked, contaminated ground beef. Person-to-person contact in families and child care centers is also an important mode of transmission. Infection can also occur after drinking raw milk and after swimming in or drinking sewage-contaminated water.


What is E.coli?
Escherichia coli, or E.coli, is a kind of bacteria that lives in the guts of healthy humans and animals. Most types of E.coli are harmless, but E.coli 0157:H7 produces a powerful toxin and can cause severe illness.

How do people become infected with E.coli?
The most common ways people become infected with E.coli are:  

  • From animal to person or from person to person: This can happen when people are not washing their hands frequently and thoroughly, especially before eating, after using the toilet or changing diapers, and after petting or handling animals, especially farm animals.  
  • Eating raw or rare meat, especially hamburger or ground beef. 
  • Eating raw foods that have been contaminated with E.coli.  
  • Drinking unpasteurized milk or juice.  
  • Swimming in or drinking water contaminated with E.coli. 

What are the symptoms of E.coli?
Symptoms usually begin 3 to 4 days, or from 2 to 8 days, after becoming infected. Some people show no sign of illness. However, they can still pass the infection to others. The signs and symptoms can include:  

  • Diarrhea (loose or watery stools); bloody diarrhea is common
  • Severe abdominal cramping
  • Nausea
  • Dehydration  
  • No fever, or a low-grade fever
  • Hemolytic uremic syndrome (HUS), a serious complication that occurs in high-risk people (most often in children), which can cause kidney failure, seizures and even death

How is E.coli diagnosed?
Diarrhea is a common illness and can have many different causes; therefore a laboratory test is needed to diagnose E.coli, usually from a stool (feces) specimen. Your doctor can request a special test for E.coli O157:H7 from a laboratory.

What should I do if I think I have an E.coli infection?  

  • See your doctor right away. Most people get better without specific treatment in 5 to 10 days. Others become seriously ill. It is difficult to tell how a person will do, so seeing your doctor is very important.  
  • Drink plenty of fluids, such as water or soft drinks. Anti-diarrheal drugs such as Imodium®, Pepto-Bismol® and similar medicines should not be taken unless your doctor recommends it.  
  • People who prepare and serve food or work with ill people (hospital or hospice workers) or children (child care providers), should contact their local health department for specific recommendations.  
  • If someone in your family has this infection, ask your doctor what precautions to take, or contact your local health department to get specific recommendations.  

How can E.coli infection be avoided?  

Wash your hands thoroughly with soap before and after handling foods, before eating, after using the toilet or changing diapers, and after contact with animals, especially farm animals.  

Wash your hands thoroughly with soap before and after handling foods, before eating, after using the toilet or changing diapers, and after contact with animals, especially farm animals.  
  • Eat only thoroughly cooked meats and poultry (using a meat thermometer is the only way to ensure that food is thoroughly cooked).  
  • Do not place cooked food on a plate or other surface that previously contained raw meat or poultry without first washing the plate or surface thoroughly.  
  • Use only pasteurized milk and dairy products.  
  • Drink only pasteurized juices.  
  • Wash cutting boards and utensils thoroughly with soap and water between uses.  If possible, use separate cutting boards for preparing raw meats and poultry, and for preparing vegetables or other uncooked or lightly cooked foods.  
  • Avoid sewage-contaminated water.  
  • Wash all fruits and vegetables before eating.

Protect the health of those you love. If you or someone in your family has diarrhea, follow these simple rules:  

  • Do wash your hands often and thoroughly with soap and water.  
  • Do not swim in public pools or lakes.  
  • Do not share baths with others.  
  • Do not allow children with diarrhea to share baths, or to go to school or day care.  
  • Do not prepare food for others.  

Who can I call if I still have questions?
You can talk to a nurse in Communicable Disease Control by calling 704.336.5490 or 704.353.1202.  For the latest E.coli outbreak information, please visit

Sources: Centers for Disease Control, N.C. DHHS - Division of Public Health – General Communicable Disease Control Branch Nov. 2, 2004

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