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.
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