New research suggests that E. coli may have a new weapon to combat antibiotics. Although debate has surfaced over the use of antibiotics and the ability for bacteria to become resistant to the drugs, researchers from Harvard have discovered that some bacteria are not only resistant to antibiotics, but actually consume the drugs.

According to Discover, the researchers took 11 soil samples from various environments with different levels of antibiotics. Bacteria were discovered in all the samples that were able to survive by consuming antibiotics. These bacteria included types of E. coli as well as Shigella. The bacteria even existed in conditions that contained more that 100 times the amount of drugs given as a normal dose to patients and more than 50 times the amount needed to qualify bacteria as resistant.

The research provides a new angle on the use of antibiotics to combat bacteria like E. coli, both in patients and in livestock. There is also a possibility that the genes that allow the consumption of antibiotics could be spread to pathogenic bacteria and make infections from bacteria such as E. coli 0157:H7 even more dangerous.

Continue reading "E. coli Eating Antibiotics for Lunch" »

Among the many strains of E. coli bacteria, E. coli O157:H7 is the one that is responsible for the majority of foodborne illnesses in the United States (1). E. coli O157:H7 was first identified in 1982 when it was traced to illnesses that were caused by undercooked hamburgers from a fast-food restaurant chain (2).

The Origin of E. coli O157:H7

E. coli O157:H7 originates from the intestines of cattle and other animals (3). The animals that harbor E. coli O157:H7 often shed the bacteria in their manure, which can spread the organism to the environment where it can survive for prolonged periods. Manure used as fertilizer can contaminate produce and water with E. coli O157:H7 (4). The US Food and Drug Administration (FDA) and the state of California recently reported that animal encroachment onto growing fields can spread the E. coli O157:H7 to produce (5). E. coli O157:H7 can also contaminate meat during the slaughtering process, and grinding contaminated meat for ground beef can result in thousands or even millions of pounds of ground beef being contaminated with E. coli O157:H7.

The Incidence of E. coli O157:H7

Though most cases of E. coli O157:H7 food poisoning result from contaminated ground beef, other outbreaks have been linked to spinach, lettuce, pepperoni pizza, unpasteurized apple and orange juice and milk, alfalfa sprouts, and even water.

The US Centers for Disease Control and Prevention (CDC) estimates that 73,000 E. coli O157:H7 infections occur in the United States each year. On average, 2,100 people with E. coli O157:H7 infections are hospitalized each year (6).

E. coli O157:H7, Hemorrhagic Colitis, and Hemolytic Uremic Syndrome

E. coli O157:H7 produces a Shiga toxin that produces ulcers in the colon. When these ulcers bleed, the medical condition is called hemorrhagic colitis, a sign of which is bloody diarrhea. When Shiga toxin spreads throughout the body it can lead to hemolytic uremic syndrome, a life-threatening condition that is one of the leading causes of kidney failure in the United States (7).

Pritzker | Ruohonen, a leading food safety law firm, has gained a national reputation in the area of E. coli litigation. To contact the firm, please call toll-free at 1-888-377-8900 or submit the firm's online free case consultation.

1. Frenzen PD, Drake A, Angulo FJ, et al. Economic cost of illness due to Escherichia coli O157 infections in the United States. J Food Prot 2005;68(12):2623-30 [Abstract]
2. Riley LW, Remis RS, Helgerson SD, et al. Hemorrhagic colitis associated with a rare Escherichia coli serotype. N Engl J Med 1983;308(12):681-5 [Abstract]
3. Cole D, Drum DJ, Stallknecht DE, et al. Free-living Canada geese and antimicrobial resistance. Emerg Infect Dis 2005;11(6):935-8 [Full text]
4. AAP. Escherichia coli diarrhea. In: Pickering LK, ed. Red Book: 2003 Report of the Committee on Infectious Diseases. Ed 26. Elk Grove Village, IL: American Academy of Pediatrics, 200
5. FDA. Investigation of an Escherichia coli O157:H7 outbreak associated with Dole pre-packaged spinach. Mar 21, 2007 [Full text]
6. CDC. Technical fact sheet on E. coli O157:H7 [Full text]
7. Robinson CM, Sinclair JF, Smith MJ, et al. Shiga toxin of enterohemorrhagic Escherichia coli type O157:H7 promotes intestinal colonization. Proc Natl Acad Sci 2006 Jun 20;103(25):9667-72 [Full text]

Why did Kayla Boner, an athletic 14-year-old girl, die after contracting an E. coli infection in October? It is generally very young children, the elderly, and those with compromised immune systems that develop E. coli-related hemolytic uremic syndrome (HUS), which is what led to Kayla's death. Healthy teenagers generally don’t develop HUS. An equally puzzling case is that of Stephanie Smith, a 20-year-old dancer. She has been hospitalized since Sept. 28 and is still in a coma. Although the source of Stephanie’s E. coli infection is known (frozen hamburger patties made by Cargill and sold at Sam’s Club), it is not clear why Stephanie developed HUS and became critically ill.

Most people who get HUS don’t die or end up in a coma, yet these two healthy, athletic young women did. One possible explanation for this is that the strains of E. coli O157:H7 that sickened these two young women are the result of mutations that made the E. coli super-virulent. This possibility leads to other questions:

• What is the beef industry (from the rancher to the processor) doing that may be promoting the mutation of E. coli O157:H7 into super-virulent strains?


• What is the beef industry doing differently that has led to over 28 million pounds of recalled ground beef products? Has this contributed to the mutation of E. coli O157:H7 into super-virulent strains?

We just contacted the Effingham County Health Department regarding the E. coli cases associated with the El Rancherito restaurant in Effingham, Illinois. There are 6 confirmed cases of E. coli O157, all of them were hospitalized. One is still in the hospital.

According to the county, all of the people with confirmed cases of E. coli ate at the El Rancherito between September 11th and 13th. They became ill between September 14th and 17th. The county is still awaiting test results that would confirm an E. coli “outbreak,” but epidemiological investigations have determined that all of the victims ate at the El Rancherito.

To confirm that the 6 cases are part of the same E. coli outbreak, genetic fingerprinting is done on E. coli isolates from the people’s stool samples. Pulse-field gel electrophoresis (PFGE) is the DNA "fingerprinting" method that health officials use to determine the source of E. coli outbreaks. Like human fingerprints, each bacteria and its offspring have a unique PFGE pattern. If all 6 cases of E. coli associated with the El Rancherito have matching PFGE patterns, that will be evidence that all 6 cases were sickened by the same source of E. coli. Any food and water samples taken from the El Rancherito will also be tested for E. coli, and the PFGE patterns of any E. coli isolates will be determined.

We are Pritzker | Ruohonen & Assciates, a leading E. coli litigation law firm. We are currently representing Illinois residents who were sickened in the outbreak associated with Taste of Chicago. We are also representing victims of outbreaks associated with restaurants and the family of a woman who died in an E. coli outbreak associated with a restaurant. To contact an E. coli lawyer at the firm, please call toll-free at 1-888-377-8900 or submit the firm's online consultation form.

We just spoke with the Glynn County health department in Georgia regarding the 3 cases of E. coli the county is investigating. All of the cases are E. coli O157:H7, the strain of E. coli most often responsible for E. coli outbreaks. E. coli O157:H7 causes hemorrhagic colitis, severe dehydration, and, in about 2%-7% of the cases, hemolytic uremic syndrome (HUS), which destroys red blood cells and causes kidney failure. The people most at risk for becoming seriously ill or dying from an E. coli O157:H7 infection are young children, the elderly, and people with weakened immune systems.

In Georgia, one of the E. coli victims is, according to news reports, fighting for his life:

A 68 year old Glynn County man, diagnosed with the bacteria, is fighting for his life. The family has asked us not to identify him.

His daughter tells First Coast News her father is doing better. Doctors told her last week he most likely would not survive. He was on life support and his kidneys had shut down.

Delaney La Rosa now says her father is surprising everyone. He came off life support Sunday night and his kidneys are now functioning.

La Rosa says her dad is in a semi-coma because of brain swelling. (First Coast News)

Health officials are waiting for test results from Atlanta to determine if the 3 cases of E. coli O157:H7 are linked to the same source, which would make these three cases an outbreak. An outbreak is defined by the CDC as an incident in which two or more cases of an illness result from the same source.

Pritzker | Ruohonen is monitoring this situation. To contact the firm, please call toll-free at 1-888-377-8900 or submit the firm's contact form.

When most people plan a fun day at the beach, they rarely consider that they could walk away with an infection of E. coli O157:H7; in fact, it has happened numerous times in the past few years. One of the first documented cases of an E. coli outbreak linked to a beach, according to the Morbidity and Mortality Weekly Report, occurred in 1995 at state park beach near Rockford, Illinois that left 5 children sick. All of the children that became ill swam at the park between June 24 and 25.

Since 1995, there have been several other documented outbreaks of E. coli O157:H7 originating from contaminated lake water around the world from Finland to the UK to numerous beaches in the US.

A study by the Natural Resources Defense Council, a group that tests water quality, found lakes contaminated with potentially harmful microbes in every one of the 50 states and estimate that one in ten beachgoers may get sick from drinking or swimming in contaminated water; this would be approximately 7 million people. The numbers may be somewhat exaggerated, but the risk is still present. To see if a beach near you is safe, see the EPA beach monitoring website.

Recent beach closings in Duluth, Minnesota over an E. coli scare has led to some interesting research by Satoshi Ishii et. al. from the University of Minnesota pointing to the origin of the contamination at the closed beaches. They explain that the original source of E. coli in freshwater is due to fecal contamination from waterfowl; mammals, including humans (think of the little kids at the beach who don't know any better); and from natural sources such as soil and algae. Of all the strains they found, only 0.85% were potentially pathogenic, including some strains specifically identified as originating from Canada geese and humans. Click here to view the study.

There is really no way to prevent an E. coli infection after swimming at a beach if the beach is contaminated except by not swallowing any water and not swimming with open wounds.

So next time you are at the beach, try to keep your children from drinking the water, keep them out of the water if they have an open cut or scratch and keep in mind that if they get sick soon afterwards, they may have developed an E. coli (or similar pathogen such as Campylobacter or Salmonella) infection.

Hemorrhagic colitis is an illness associated with an E. coli O157:H7 infection. Hemorrhagic means bleeding and colitis refers to the fact that it is a digestive disease characterized by the inflammation of the colon (large intestine). Inflammation of the colon can lead to abdominal pain and other problems. The name quite accurately describes the most common symptom of an E. coli infection, bloody diarrhea.

The most serious complication of hemorrhagic colitis is hemolytic uremic syndrome (HUS), the leading cause of kidney failure in children in the United States. About 5% of the people who get hemorrhagic colitis develop hemolytic uremic syndrome. Most of the people who develop HUS are children under the age of 8, but adults can also develop HUS. Hemorrhagic colitis (bloody diarrhea brought on by an E. coli infection) can result in death to an elderly person even without the additional complication of HUS.

For more information please see see our pages on the symptoms of E. coli O157:H7 and E. coli treatment.

There are numerous strains of E. coli, most of which do not cause disease in humans. Of the few antigenic types of E. coli that do cause disease, each uses different mechanisms to cause illness and thus cause different diseases or symptoms.

The three main categories of infection caused by E. coli are urinary tract infections, neonatal meningitis, and gastroenteritis (intestinal disease). Of these types, gastroenteritis is the only one that is caused by foodborne bacteria.

The antigenic types of E. coli that can cause gastroenteritis, again, are varied. There are four types of enterovirulent gastroenteritis-causing E. coli according to the FDA's Bad Bug Book: enterotoxigenic, enteroinvasive, enteropathogenic, and enterohemorrhagic. Each of these types are related to different strains of E. coli and have different mechanisms and symptoms. For example, enteroinvasive E. coli does not produce any toxin. While E. coli O157:H7, a strain of enterohemorrhagic E. coli, produces a shiga-like toxin that destroys red blood cells and platelets which in turn can cause damage to the liver.

E. coli O157:H7 is the primary strain of E. coli that causes foodborne illness. While other antigenic types of E. coli may infect some, O157:H7 is the most common and one of the most dangerous because it can develop into hemolytic uremic syndrome (HUS), a leading cause of kidney failure.

Here are some basic precautions that should prevent most E. coli infections:

• Cook all meat thoroughly
• Return undercooked meat at restaurants
• Keep your kitchen clean of harmful bacteria
• Drink only pasteurized milk, juice, or cider
• Wash fruits and vegetables thoroughly
• Be aware of the water you drink
• Wash hands with soap for a minimum of 15 seconds

Food companies are supposed to implement protective measures to limit consumer exposure to E. coli;however, as we have seen with the several recent, well publicized, and sometimes fatal E. coli outbreaks, these protections are not enough. It is important that you understand how to protect yourself and your family from becoming a news story.

Cook Meat Thoroughly

One of the most common causes of E. coli O157:H7 infections is through consumption of poorly cooked ground beef. It is important to cook your meat, and especially ground beef, well to prevent E. coli infection. When cooking meat, use a digital instant-read meat thermometer, making sure that the inside is at least 160º Fahrenheit. If you do not have a thermometer, it is best if you cook hamburgers and other ground beef products until there is no pink showing on the inside.

If you are served an undercooked hamburger or ground beef product at a restaurant, send it back for a thorough cooking. Don't hesitate to ask for a clean plate and new bun.

Prevent E. coli Infection in Your Kitchen

There are several simple things that can be done in the kitchen to prevent the spread of E. coli. You should always keep raw meats separate from ready-to-eat foods, fruits and vegetables, and other foods that will not be cooked before consumption. Cooked food should never be placed on an unwashed plate that held raw meat. Wash your hands, counters, and utensils with hot, soapy water after touching raw meat. After measuring the temperature of your meat to make sure it is thoroughly cooked, wash your meat thermometer before testing any other food products.

Drink Pasteurized Milk, Juice, or Cider

Commercial juice boxes and vacuum-sealed juice in glass containers have been pasteurized even though it may not say it on the label. Juice concentrates are heated enough to kill pathogens without further pasteurization. Y

Wash Fruits and Vegetables Before Eating

You should wash your fruits and vegetables thoroughly, especially if they will not be cooked before consumption. Children under the age of five, the elderly, and those with weakened immune systems should not eat alfalfa sprouts because they have an especially high rate of food poisoning. Research is underway to develop methods to decontaminate alfalfa seeds and sprouts.

Since most cases of hemolytic uremic syndrome (HUS) develop due to E. coli food poisoning, preventing E. coli infection is the best way to prevent HUS.

Cook Meat Thoroughly

One of the most common causes of E. coli O157:H7 infections is by eating undercooked ground beef. Because of this, it is important to cook your meat, and especially ground beef well. When cooking, use a digital instant-read meat thermometer, making sure that the inside is at least 160º Fahrenheit. It is possible for ground beef to be cooked until brown and not be cooked well enough to kill E. coli bacteria that may be present.

If you are served and undercooked hamburger or ground beef product at a restaurant, send it back for a thorough cooking. Don't hesitate to ask for a clean plate and new bun. The restaurant wants you to get ill as much as you do, so don't feel bad sending food back.

Prevent Hemolytic Uremic Syndrome and E. coli Infection in Your Kitchen

There are several simple things that can be done in the kitchen to prevent the spread of E. coli. You should always keep raw meats separate from ready-to-eat foods. Also, cooked food should never be placed on an unwashed plate that held raw meat. Wash your hands, counters, and utensils with hot, soapy water after touching raw meat. After measuring the temperature of your meat to make sure it is thoroughly cooked, wash your meat thermometer before testing any other food products.

Drink Only Pasteurized Milk, Juice, or Cider

Commercial juice in boxes and vacuum-sealed juice in glass containers has been pasteurized even though it may not say it on the label. Juice concentrates are heated sufficiently enough to kill pathogens.

Wash Fruits and Vegetables

You should wash your fruits and vegetables thoroughly, especially if they are not cooked before eating. Recent research has found that E. coli bacteria can migrate into the leaves of spinach and lettuce. When that happens, washing the leaves will not wash away the E. coli.

Contact with Sick Family Members

The risk of spreading E. coli infection can be reduced by ensuring that people with diarrhea (especially children) wash their hands carefully with soap after bowel movements. Hands should always be washed after changing diapers. Anyone with diarrhea should not swim in public pools or lakes, share baths with others, or prepare foods for others.

Hemolytic Uremic Syndrome Prevention if Already Infected with E. coli

There is no known method of reducing the possibility of an E. coli infection developing into HUS. It does appear that aggressive and early treatment of severe E. coli infections may reduce the amount of toxin-producing bacteria in the body, thus lowering the risk or HUS.

This information about hemolytic uremic syndrome and E. coli was provided by Pritzker | Ruohonen, a nationally-recogninzed law firm in the area of food borne illness lawsuits. If you or someone you love has become seriously ill from an E. coli infection or any other food borne illness, please contact an E. coli attorney for a free consultation regarding your legal rights and remedies. Please call toll-free at 1-888-377-8900 or submit the online consultation form for review by an E. coli lawyer at the firm.

Symptoms of E. coli O157:H7 usually begin to show 2 to 8 days after exposure to the bacteria. Symptoms often include severe bloody diarrhea or abdominal cramps without a fever. Sometimes non-bloody diarrhea or even no symptoms occur. The illness typically subsides after 5 to 10 days.

In high risk patients such as the elderly and children under 5 years, infection with E. coli O157:H7 can cause a very severe complication known as hemolytic uremic syndrome (HUS). HUS is caused by a toxin produced by the E. coli known as shiga-like toxins. These toxins destroy red blood cells and can cause kidney failure.

Symptoms of HUS may not occur until a week after typical E. coli symptoms occur. Signs can include small bruises or bleeding from the nose that are unexplained. Another common symptom is a reduction in urine output, which is a result of kidney malfunction. Urine may also appear red. The lack of urine can in turn cause high blood pressure or swelling of the face, hands, feet or entire body.

If you would like more information on E. coli O157:H7 and its symptoms, see the CDC website. Another good website is the National Institute of Health website.

Pritzker | Ruohonen has a national practice and represents E. coli victims throughout the United States. To contact the firm, please call toll-free at 1-888-377-8900 or submit the online contact form.