E. coli Infection (Escherichia coli Infection)

E. coli is a type of bacteria that naturally lives in the stomachs of most animals, including people. Sometimes, a specific kind of E. coli called STEC can make humans sick. STEC is often found in the feces of animals like cows, deer, elk, goats, and sheep. Other animals like dogs, cats, pigs, horses, rabbits, chickens, and turkeys can also carry STEC and pass it on to humans. You can get sick from STEC by eating or drinking something contaminated with the bacteria or by touching an object or person that has the bacteria. Most people get sick from eating contaminated food, which can happen at any point during the process of making it.

The incubation period for a STEC infection can range from less than a day to 10 days (average 3-4 days). Symptoms of a STEC infection vary from person to person and may include one or more of the following: 

• Diarrhea and/or bloody diarrhea 

• Vomiting 

• Stomach cramps and pain 

• If fever is present, it can be very mild 

• Chills 

• Nausea 

• Irritability 

• Headache 

• Poor feeding 

General recommendations for avoiding STEC infection include: 

Food handling and preparation: 

• Cook all meat products to at least 160°C/70°C  

• Always use a thermometer to determine proper cooking temperatures for foods 

• Avoid cross-contamination of any raw meat products with other food items, such as fresh produce, during food preparation. Do not use the same cutting boards, knives, kitchen utensils, etc. 

• Keep raw meat products separate from other foods and cooked meat products. Do not place cooked hamburgers on the same plate used for raw patties.

• Wash all fruits and vegetables before eating, especially if eating them raw. If possible, peel or cook fruits and vegetables. 

Kitchen safety: 

• Wash hands, knives, utensils, cutting boards, kitchen surfaces, etc. when preparing raw food products. This includes meat, dairy, vegetables, and fruit.

• Make sure that your refrigerator is at 40°F or lower and freezer 0°F or lower to avoid bacterial growth. 

• Routinely clean the inside walls and shelves of the refrigerator and immediately clean any spills involving high-risk foods. Use hot soapy water and then rinse. 

• Clean up the juices of any raw meat products immediately with hot soapy water and avoid cross-contamination.

Vulnerable populations (young children and the elderly) and high-risk foods: 

• Avoid eating raw or undercooked meat products, especially ground meat (hamburgers).

• Avoid eating any raw dairy products, such as raw or unpasteurized milk and cheese or yogurt made with raw milk (Queso fresco, Queso Blanco, Brie, Camembert, Feta).

• Avoid pre-made unpasteurized fruit juices such as ciders and fresh-squeezed juices. Keep them refrigerated at all times if store-bought and consume them as soon as possible if juicing.

• Avoid eating store-bought pre-mixed ready-to-bake products before cooking (e.g., cookie dough).

• Make sure that you thoroughly cook or reheat any premade frozen, refrigerated, or ready-to-eat meals (e.g., frozen microwave meals) to at least 160°C/70°C, before eating.

Thorough hand washing: 

• Before you prepare food for yourself or others or eat a meal.

• After handling any raw, ready-to-eat, or processed meat products and any pet foods.

• After contact with any animal, including domestic pets, or after visiting or touching an animal enclosure (e.g., petting zoo or animal cage), even if you didn’t touch an animal directly.

• After using the bathroom, changing diapers, or assisting someone with diarrhea.

• Make sure children always wash their hands before eating, after using the bathroom, or after touching an animal or its enclosure.

Cases caused by Shiga-toxin-producing E. coli reported in Texas have increased slowly over the past 10 years. Cases increased from 351 cases in 2010 to 1,324 cases in 2019. In the past, big outbreaks in Texas were linked to frozen foods that are ready to eat, as well as prepackaged cookie dough that is kept in the fridge.

If you have bloody diarrhea or diarrhea lasting three days or more, you might have an infection from a bacterium called E. coli O157:H7. This strain of E. coli can cause your kidneys to fail or be permanently damaged. Although this does not happen to most people, children under five and people over 65 are more at risk for kidney problems than other people. Since other bacterial infections can also cause bloody diarrhea, your doctor will need to order a special test to diagnose E. coli O157:H7. 

Protecting yourself and your family from E. coli O157:H7 

• Since meat with E. coli O157:H7 still looks and smells good, make sure ground beef is cooked until the meat is no longer pink and the juices run clear. E. coli O157:H7 can survive in undercooked hamburger meat. 

• After preparing meat dishes in the kitchen, use a bleach solution to sanitize your counters, utensils, cutting boards, and other surfaces used or touched in preparing the raw meats. You can make this solution by mixing one teaspoon of bleach with a quart of water. 

• Use a different cutting board and utensils for fruits, vegetables, and bread from the ones you use for meats. If you don't have extra boards and utensils, make sure you sanitize your one board and utensils well between uses. Following these steps will keep you from spreading E. coli O157:H7 from one food to another. Also, be certain to wash organically grown vegetables and fruits well. 

• Buy only pasteurized milk, dairy products, and juices. E. coli O157:H7 can live in raw milk and other liquids. 

• Use safe water. Drink water from an approved public drinking water system, bottled water, or water that has been treated with chlorine or another disinfectant. Don't swim in water that has sewage in it as E. coli O157:H7 can live in untreated water. 

• If anyone in your family or someone you know is already sick with E. coli O157:H7, make sure everyone washes his or her hands often with soap and warm water. People, especially children in diapers, can give E. coli O157:H7 to others. 

Most people who get sick from E. coli O157:H7 are completely well within five to ten days. If you think you or one of your family members has an E. coli O157:H7 infection, call your doctor or clinic now. Ask your doctor to call your local health department at 1-800-705-8868 if he/she finds out the illness is from E. coli O157:H7. 

Report Escherichia coli, enterohemorrhagic within one week. Initial report form 

There are several laws in Texas (Tex. Health & Safety Code, Chapters 81, 84, and 87) that require doctors, hospitals, schools, and labs to inform the Texas Department of State Health Services (DSHS) if they think someone has a notifiable condition (25 Tex. Admin. Code §97.2).

There is no vaccine for E-coli.