Last week’s news: Health officials in Alberta say they are investigating five cases of E. coli infections in people, but they are not linking them to an extensive recall of ground beef from major Canadian grocery stores.
It seems the problem is sporadic rather than widespread. However, the person infected with E.coli can suffer from mild to severe and sometimes life threatening symptoms. It has been reported four of the infections are in Edmonton and one in Calgary. Apparently, one such case involves a four-year-old Calgary girl whose kidneys have failed and she has had two blood transfusions.
The Canadian Food Inspection Agency first warned last week that ground beef from Edmonton-based XL Foods may contain E. coli. Investigations are going on but it is not always easy to pin down the source of infection since there are many potential sources of exposure.
E. coli is one of the many organisms which colonise intestinal tract of humans and animals. E. coli and related bacteria constitute about 0.1 per cent of gut flora. E. coli colonizes an infant’s gut within 40 hours of birth with food or water or with the individuals handling the child. They remain harmless in the gut until they become virulent and cause all kinds of troubles.
Virulent strains of E. coli can cause gastroenteritis, urinary tract infections, and neonatal meningitis. In rarer cases, they can cause hemolytic-uremic syndrome (toxic substances destroy red blood cells causing kidney injury), peritonitis, mastitis, septicemia (bacteria in the blood cause chills, high fever, rapid breathing and rapid heart rate), and pneumonia.
Food, water and dirty hands are contaminated with animal or human faecal matter containing E. coli and then we ingest it. Other sources of E. coli are undercooked ground beef, unpasteurized milk or cider, salami, alfalfa sprouts and lettuce. Person-to-person transmission is common.
Clinical presentation is from mild nonbloody diarrhea to serious bloody diarrhea with severe abdominal cramping, septicemia and kidney failure. The incubation period averages about four days, but ranges from one to 10 days. Adults typically shed the bacteria for about a week after infection, young children, for up to three weeks. Diagnosis is made by stool cultures.
Treatment is, for the most part, supportive with maintenance of fluid and electrolyte balance and blood transfusion if necessary. Preventing this infection is difficult because E. coli is present almost everywhere. Attention should be paid to food safety, personal hygiene and the rapid identification of active cases. Always remember to wash your hands as often as possible. Servers and kitchen staff at restaurants and fast food joints, staff at nursing homes and hospitals and industries where food is extensively handled by different individuals have to pay extra attention to personal and environmental hygiene.
It is important to report to the local medical officer of health all suspected and confirmed cases of E. coli infection. These infected individuals should refrain from interacting with the vulnerable populations – elderly, children and the sick. If they handle food then they should refrain from these occupational activities until two stool samples have tested negative for E. coli.
Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!
