The Diagnosis!

Want to know what steps doctors will take to diagnose you of E. Coli?  It's actually rather simple, just a physical check up and a stool culture!(1) You can collect the sample at home or in the medical clinic, but be sure not to mix in any urine, soap, or blood with the stool test. It is advised for women to wait 3 days after their menstrual period to do stool cultures to avoid blood contamination. This test will determine the presence of bacteria, fungi, or parasites in your intestine that could be causing your symptoms.  If Escherichia Coli is present, you will be notified and given more information.


References:

1. "E. Coli: Tests and Diagnosis - MayoClinic.com." Mayo Clinic. Web. 19 Apr. 2011. http://www.mayoclinic.com/health/e-coli/DS01007/DSECTION=tests-and-diagnosis.

OUTBREAKS

Authors: Naseer, Umaer1 Umaer.Naseer@fagmed.uit.no

Natås, Olav B.2,3

Haldorsen, Bjørg C.1

Bue, Berit3

Grundt, Heidi4

Walsh, Timothy R.5

Sundsfjord, Arnfinn1 arnfinns@fagmed.uit.no.

Source: APMIS; Feb2007, Vol. 115 Issue 2, p120-126, 7p, 2 Diagrams, 2 Charts.

Document Type: Article.

Seven patients with samples from the kidney, lungs, and urinary showed that they were having 3rd generation cephalosporin’s (antibiotic) resistance. The seven patients that were in the hospital were let go from the Divisions of Geriatrics and Pulmonary Medicine, Central Hospital of Rogaland, sometime between July and September 2004.A genotype found in six strains that were showed resistance to the following medication; gentamicin, nitrofurantoin, trimethoprim-sulfamethoxazole and ciprofloxacin. More research also showed that two people tested positive for E. coli urinary infections, which was the same the strain from two other different patients in the same area in both January and February 2004. The following patients that were dealing with that outbreak were later taken back into medical care. Test's that were ran showed that one of the E.Coli strains that a patient had was something that helped kill three of the patients. These three deaths occurred because of the deficiency of antimicrobial therapy. Antimicrobial therapy is an antimicrobial substance that kills or stunts the growth of microorganisms like bacteria, fungi, or protozoans.

Authors: Guh, Alice1, 2 ggt4@cdc.gov

Quyen Phan2

Nelson, Randall2

Purviance, Katherine2

Milardo, Elaine3

Kinney, Stacey2

Mshar, Patricia2

Kasacek, Wayne4

Cartter, Matthew2.

Author Affiliations: 1Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia 2Connecticut Department of Public Health, 3Farmington Valley Health District, Avon, Connecticut, 4Connecticut Department of Agriculture, Hartford.

Source: Clinical Infectious Diseases; 12/15/2010, Vol. 51 Issue 12, p1411-1417, 7p, four Charts, one Graph.

Document Type: Article.

Got Milk!? Well in Connecticut, they had milk but the milk was the wrong kind of milk. The milk you did not want to purchase for any reason ever. It would be in July 2008 that two children caught E.Coli 0157 after they drinking milk that was purchased at a retail market. This milk was raw milk, raw milk itself has its own worries itself, one being, E.Coli. The outbreak caused things like diarrheal illness for the people that were customers here at this retail market. Stool specimens of both humans and animals were taken and tested for E.Coli 0157. Out of the 14 cases that were identified only half of them were confirmed. Out of the seven cases, five of them were such a danger that they required the patients to seek medical attention and stay in the hospital. Luckily, no deaths were reported from this outbreak that happened. One milking cow also had E.Coli, the issue here was there was no rule against raw milk's distribution allowing animals to spread E.Coli easy and people catch and spread the E.Coli well after drinking and being around the animals. The increase of raw milk testing for pathogens is something that is was a result from this incident, also to prohibit nonfarm retail sales as well.

Authors: McCartney G; Cowden J; Murray S; Ahmed S.

Author Address: Public Health, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK. Gerry@sphsu.mrc.ac.uk.

Source: Epidemiology and Infection [Epidemiology Infect] 2010 Oct; Vol. 138 (10), pp. 1439-42. Date of Electronic Publication:

2010 Feb 10

Publication Type: Journal Article.

Journal Information: Country of Publication: England NLM ID: 8703737 Publication Model: Print-Electronic Cited Medium:

Numerous foodborne outbreaks in retail stores! In 2007, there was an outbreak of E.Coli 0157, which is the strain that is found in foods! The outbreak was in Paisley, Scotland and was connected to meat that was not prepared from a supermarket as best as it should have. The item that wasn't handled correctly was beef this time rather than other foods that can carry E.Coli such as lettuce, spinach or other various types of meats. When things like this occur before a store says there's E.Coli in our store! They go about using a precaution method basically stating be careful because there's a chance E.Coli can be here in this item or items. So before the store said that the beef is the issue that you should watch out for they just used a precaution method.

Preventing Escherichia Coli, How to survive! Or at least stand a good chance..

Preventing the potentially deadly E. Coli disease is not as difficult as one may think.  Just like many other diseases, it can be prevented with good hygiene, proper cooking knowledge, and caution of certain types of meats. Today we will be talking specifically about what steps to take while cooking food to prevent the contamination of E. Coli.
The first thing you will want to make sure you do is wash your hands! Escherichia Coli can live on surfaces for weeks, and the last think you want to do is cross-contaminate food by touching other foods after dealing with meat!
(image from  http://www.ehow.com/how_5259215_cook-meal-minutes-chicken-rice.html)

Be sure to rinse the meat off throughly, however this will not get rid of all the bacteria. To do this, you must heat the meat up to 160 degrees Fahrenheit, to make sure all bacteria has been killed.  Make sure the meat is cooked thoroughly before eating.  Be especially careful with ground meat, as you are more succeptile to get E. Coli from it.
Clean all dishes used to cook the meat with soap and hot water to kill of any remaining bacteria.  By following these steps you will drastically cut back chances of not only getting E. Coli, but any disease that could be contracted from eating raw meats.

Although these will cut back your chances of contracting the disease, there are also other ways that E. Coli may get into your body besides just meat. To counter this, you should:

• Not drink any milk, apple juice, apple cider, or other fluids that are unpasteurized or untreated. 
• Do not allow children to share bath water with those who have symptoms of diarrhea or stomach flu
• Wear disposable gloves while changing the diapers of babies who have diarrhea 

These are just a few tips and steps that can help save your life, and the lives or your loved ones from this disease.  Put these tips to practice, and stay healthy for life!

Reference:
1. "Preventing E. Coli Infection | E. Coli Food Poisoning." E. Coli Food Poisoning | E. Coli Food Poisoning. Web. 17 Apr. 2011. http://www.about-ecoli.com/ecoli_prevention.

So YOU HAVE IT?! The treatments and what to expect in the hospital

(image from  http://dialysispostings.com/laboratory-tests-blood-levels-dialysis-patients%20)

Today we will go over what treatments will be necessary if it turns out that you do have E. Coli, and what you should expect on your stay in the hospital if it is necessary.
The Treatment: Amazingly, for E. Coli itself there is no specific treatment. Your best bet is to drink a lot of fluids to maintain your hydration, as the diarrhea and vomiting may cause dehydration from the rapid release of fluids.  Although Escherichia Coli is a bacteria, DO NOT take any antibiotics.  Do not take any anti-diarrheals as well, as this will slow the process of the bacteria leaving your body. It is believed that antibiotics increase the chances of developing Hemolytic Uremic Syndrome (HUS), which increases the likelihood of death.  Most people will recover within 5-10 days if properly hydrating themselves and if they do not develop HUS or other E. Coli related diseases.
So let's Review the Treatments for E. Coli:

• Drink plenty of fluids to properly maintain hydration 
• Stay Away from Antibiotics and Anti-Diarrheals!

However, if you do so happen to develop HUS or D+HUS (post-diarrheal hemolytic uremic syndrome), the treatments may range from moderate to intensive, and may require that you stay in a hospital from 2 weeks to 3 months.  During your hospital stay, you will be administered Nutrition via a peripherally inserted central catheter, as your colon may be inflamed from the diseases. If even after intestinal function has been regained, some patients may continue to have reduced appetite for up to 2 weeks.  In this case nutrients would then be administered via a nasogastric tube.(1)

Dialysis may also be required as treatment to cleanse the body of toxins and maintain a balance of fluids and electrolytes.  This will be necessary if reduced urine output occurs.  Younger children will undergo Peritoneal Dialysis, which involves inserting a catheter through the abdominal wall, and into the peritoneal cavity.  Adults and older children will be treated via Hemodialysis.  This circulates the blood through a hemodialysis machine to remove the uremic toxins and normalize blood chemistries. This would require a catheter being inserted into a major vein to gain access to blood.  

HUS may also cause severe anemia, and blood transfusions will be necessary to correct this. Platelet Transfusions will be required in those with thrombocytopenia to reduce the risk of bleeding.

In patients who develop High Blood Pressure, anti-hypertensive drugs will be used to equalize blood pressure levels. These treatments will be necessary to rid your body of the diseases caused by E. Coli.

Now, lets have one last re-cap of the treatments of the E. Coli-caused diseases, HUS:

• Nutrition administered via peripherally inserted central catheter, and if necessary a nasogastric tube.
• Dialysis to cleanse the body of uremic toxins. Peritoneal Dialysis in young children, and Hemodialysis in older children and adults.
• Blood Transfusions to correct sever anemia, and Platelet Transfusions to reduce risks of bleeding for those with thrombocytopenia. 
• Anti-hypertensive drug use for those who develop high-blood-pressure. 

As you can see, treatments for diseases caused by E. Coli are much more intense then treating E. Coli itself.  For a better understanding on the diseases HUS and Thrombocytopenia and not just their treatments, view the post "E. Coli, it can only be the beginning... of the end!".

References:

1. "Treatment of Hemolytic Uremic Syndrome- Diagnosis - Uremic Poisoning." Personal Injury Lawyer MN in Best Lawyers Minnesota Wrongful Death Attorneys Minneapolis - PritzkerOlsen, P.A. Web. 16 Apr. 2011. http://www.pritzkerlaw.com/hemolytic-uremic-syndrome-treatment/.

Natural Occurrence of E. Coli

Although many believe E. Coli to be this foreign, harmful invader, E. Coli is actually a naturally occurrence that we become aware about only when a true infection breaks out. As a matter of fact, we come in contact with E. coli bacteria on a nearly daily basis when cooking meat, but it is not everyday that we become infected.
E. Coli lives in the intestines of nearly all mammals. It is a naturally occurring bacteria that aids with their digestion. Yes, this means that animals can, and do, have E. Coli bacteria in their bodies without becoming infected. And guess what, It lives in our intestines too! Many strains of E. Coli will be ingested but cause no harm, they will be killed of by our stomach acid. However, when other E. Coli strains come in contact with other parts of our body, infection occurs.
Hopefully this will shed some light on what many of you thought you knew about E. Coli. For those of you who were aware of this, good job! Inform all of your friends that there is no need to worry that this disease was manufactured by the government to be biological weapons (and there are people out there that believe this.) Remember that E. Coli is a naturally occurring bacteria, one that we have to watch out for, and can be taken care of with careful hygiene and understanding of how it works.

source: <http://www.professorshouse.com/Food-Beverage/Topics/General/Articles/E--Coli---Just-the-Facts/> accessed 15 April 2011

E. Coli: It can only be the beginning...of the end!

Many people do not know the hidden diseases that come along with E. Coli. There are many more health risks than the common symptoms of diarrhea and vomiting. The leading cause of death pertaining to E. Coli is actually a disease many people developing after getting E. Coli called Hemolytic Uremic Syndrome (HUS). Besides this disease, other health risks include abnormal kidney function, blindness, paralysis, hemorrhagic colitis, high blood pressure, seizures, and Thrombotic Thrombocytopenic purpura (TTP). The most obvious of all, would be death.  Two of theses health risks are major, and lead to the most complications and will be described below. These diseases are known as HUS, and TTP.

Hemolytic Uremic Syndrome (1)
This usually affects children under the age of 10 years old, but it is also known to develop in older people.This disease causes damage and reduction of red blood cells, which in turns lead to sever anemia. The blood clots caused by this also inflict damage on blood vessel walls. In turn, this disease itself can lead to many others with many worse side effects. The signs preceding a development of HUS would be bloody diarrhea, and gastrointestinal illness.  HUS, as stated in our previous blog "OK so you have it....", requires much aggressive treatment and health care. When watched and treated carefully, HUS has only a 4% death rate, but as many as 15% of those who get E. Coli develop the syndrome. It is the leading cause of E. Coli related deaths.


Thrombotic Thrombocytopenic purpura (2)
This is when tiny blood vessels called thrombi form blood clots in the body, mainly in the central nervous system and kidneys.  These thrombi use a high number of platelets, decreasing the number of platelets in the blood to extremely low levels. This is often times called "adult HUS", as it mainly effects the older population of E. Coli patients.


It is not uncommon to get both of these diseases when one gets E. Coli.  As you can see, many serious health risks involves abnormalities in the blood (such as high-blood pressure and the forming of blood clots) which in turn lead to even bigger problems, greatly increasing the chance of death.  E. Coli can be the start of a much bigger problem for those who develop these diseases, and for that reason alone it should not be taken lightly. E. Coli itself goes away within 5-10, however these diseases can leave scars that last a lifetime.


References
1. "Hemolytic Uremic Syndrome - E. Coli and HUS - Lawyer and Lawsuit." Personal Injury Lawyer MN in Best Lawyers Minnesota Wrongful Death Attorneys Minneapolis - PritzkerOlsen, P.A. Web. 15 Apr. 2011. http://www.pritzkerlaw.com/hemolytic-uremic-syndrome/.

2. "Thrombotic Thrombocytopenic Purpura - PubMed Health." A.D.A.M Inc. Web. 15 Apr. 2011. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001579/.

E. Coli Myths and Misunderstandings

So we went around asking people what the knew and understood about E. Coli, and educating them on any information they did not know.  We were surprised to find that many people misunderstood E. Coli and did not even know the name of the bacteria that causes it! Today we will go over some comments people had, and correct the myths and misunderstanding it seems the public seems to be unaware of. Be sure to have a piece of pen and paper to write down any new information you find from this post and correct any misunderstandings!
(image from http://www.onlinehomesurveys.com/)

"Isn't E. Coli only found in certain animals like cows and only when they themselves are sick with an infection?"
          Actually, no. This myth is wrong in more ways then one. Escherichia Coli is found in many mammals, not just cows and other produce.  This bacteria is a normal occurrence in the intestines of their stomachs, and aid in the digestion of foods. E. Coli poising happens when we eat food that still has E. Coli on it, and it comes in contact with our digestive tract. The animal does not need to be sick to get us sick from eating it.


"Aren't there Vaccines for the E. Coli virus?"
          No, this is a major misunderstanding.  E.coli does not have any vaccines, because the bacteria itself is naturally occurring. Also, Escherichia Coli is not a virus, it is a bacteria, another reason there can be no vaccine for the sickness.


"I can't get E. Coli if i go vegetarian though right?"
          Unfortunately, this is not true. It is still possible to get E. Coli if you decide to go vegetarian. This is because other foods can be cross-contaminated and contain E. Coli, and you can also get the disease from drinking unpasteurized drinks. Staying away from meat will definitely decrease your chances of getting the disease, but it does not completely eliminate your chances.


"But it's contagious!"
          Not exactly. While it is true you can spread E. Coli to another person. this is done by fecal matter. As long as you stay away from an infected persons fecal matter, or anything contaminated by it, you can not get E. Coli from the infected person. Yes, that means you and your significant other can walk hand in hand!
          

"I never eat medium rare steaks, that's begging for E. Coli."
          Actually, medium rare steak is safe,as long as it is cooked at high enough temperatures (160degrees Fahrenheit). It is the ground meat you want to watch out for.  E. coli occurs on the surface of the meats and should be killed when the meat is seared during cooking.  The problem with ground meat, is that tissue containing the bacteria could be ground in with the meat during the grounding process.  This is what makes it potentially dangerous.


These are a few of the misunderstandings people that we questioned had about E. Coli. Don't be embarrassed if you were under the same impression they were, now that you have the correct information be sure to let everyone know and encourage health and hygeine!