E. coli Infection from Contaminated Food can be Very Serious

Your hamburger may be a bio-hazard! (iStockphoto/Thinkstock)
Your hamburger may be a bio-hazard! (iStockphoto/Thinkstock)

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.

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Kidney Failure

Dr. B, why do kidneys fail?

Kidneys fail because their functioning capacity to get rid of body’s toxic substances is compromised by different kinds of diseases and injuries. Some of these are: diabetes, high blood pressure, polycystic kidneys, blockage of the urinary tract and certain type of medications.

Kidney failure, also called renal failure, can be partial or complete; acute or chronic. In acute renal failure, kidneys do recover function in six weeks or so. In chronic renal failure the damage is permanent. Chronically diseased kidneys can sustain life until about 90 percent of their functioning capacity has been lost.

What do kidneys do?

Kidneys remove wastes and toxic substances. They regulate water and electrolyte balance, and produce hormones that regulate blood pressure, the making of red blood cells, and uptake of calcium from the intestine.

Kidneys are essential to life. We are lucky that we have two kidneys compared to other essential organs like the brain, heart, and liver.

What happens if kidneys fail?

The body is unable to get rid of toxic substances from the blood. It has difficulty maintaining fluid and electrolyte balance and acid base balance. The blood pressure goes up. Certain parts of the body become puffy from fluid retention. There is change in the urinary output and in its content.

What is the long-term prognosis of chronic renal failure?

Without kidney dialysis and kidney transplant the prognosis is bad. Dialysis is life-prolonging process for patients with end stage kidney disease. Dialysis removes toxic materials from a patient’s blood. It also helps in maintaining body’s fluid, electrolyte and acid-base balance. But kidney transplantation is the most effective treatment.

Statistics show that as of 1998, there were 3434 patients waiting for an organ transplant in Canada. This is 88 percent increase since 1991! Eighty-one percent of patients listed for an organ transplant in 1998 were waiting for a kidney.

John Boksteyn, President of the Southern Alberta Branch and member of the National Board of Directors of The Kidney Foundation of Canada says that the Foundation is a national volunteer organization dedicated to improving the health and quality of life of people living with kidney disease.

Boksteyn adds, “March is Kidney Month and the volunteers have been working hard to collect funds for research and education. They also actively promote awareness of, and commitment to organ donation”.

How can we take care of our kidneys?

Maintain adequate hydration by drinking enough water. Have your blood pressure checked and treated if it is high. If you suffer from diabetes then follow your doctor’s advice and keep your blood sugar level under control. Have your urine checked for sugar, blood and protein as part of your physical examination. When you take any medications on regular basis, especially off the counter, then check for its effect on kidneys. Chronic urinary infection and kidney stone problems should be treated.

We are blessed with two kidneys to keep us healthy. Let us take care of them for our family and ourselves – you never know when a family member may need to borrow one!

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