Aging Begins at 30

Contaminated Hamburgers

What is Escherichia coli or E. Coli and why is it 0157 and H7. How can you protect your family when they eat that hamburger you just bought?

Dr. Escherich discovered a gut bacillus named after him, with coli added to indicate origin in animal and human colons. Antigens (to which the body makes defensive antibody proteins) were found on the hairs surrounding the bacterium and were called H1, H2, and so on. Other antigens found in the bacteria with hairs removed were labeled 0:, 01:, 02:, 03, etc. Ohne is without in German. So, we came to E. Coli 0157H7. E. Coli are a major cause of diarrhea throughout the world. They adhere to small bowel cells and produce diarrhea poisons. The E. Coli strain 0157H7 is also a rare cause of anemia by dissolving red blood cells and releasing hemoglobin which plugs the kidney urine producing filters. This unusual complication is hemolytic uremic (kidney failure) syndrome.

In 1982 E. Coli 0157:H7 was identified as an epidemic producer. In 1994 and 95 there were about 1,000 epidemic cases in Minnesota amongst a total of 20,000 E. Coli 0157H7 cases. Gel electrophoresis (electric field mobility) subdivided them further (P.F.G.E.). Over 150 subtypes of E. Coli 0157H7 can be identified. Seventy per cent of cases are found in single patients.

About 1 to 3 days after eating a contaminated undercooked hamburger one develops a mild "Turista" diarrhea or a fulminant cholera-like illness with bloody diarrhea. A quarter of cases end with only mild stomach cramps and diarrhea. A very few develop severe anemia. Twenty-five hemolytic-uremic patients were identified in Minnesota recently all under age 10. In 1982 to 1992 there were 15 American E. Coli food poisoning deaths. Now 200 deaths a year are estimated.

An epidemic is two or more cases in separate households with a common food exposure. Minnesota had ten epidemics in 1994 and 95. There were 35 "clusters" of the same PFGE type occurring within 2 weeks of each other but, with no known common source. This new subtype identification allows public health workers to identify outbreaks and look for a common food exposure.

Outbreaks have occurred due to hamburgers, salami, unpasteurized milk, cider, alfalfa or radish sprouts, raw milk, unwashed fruits or contaminated lake water (but not usually swimming pools as the water is chlorinated). Communal meal outbreaks have been studied.

At higher risk are infants, children, pregnant women, elderly or immunocompromised persons (AIDS or cancer). They should avoid raw vegetables. Most bacteria come from cow colons. The E. Coli don't harm the animals but contaminate food as cow manure, or in an unwashed food delivery truck, at the food processing plant or a child poops in a swimming area or diaper refuse contaminates a day care center. Food safety from the farm to the table is a national necessity.

Treatment involves oral glucose, salt enriched fluid replacement and antibiotics or sulfonamides. Bismuth Lomotil or Imodium give less stools and less cramps but they don't alter the volume of intestinal fluid loss or cure the disease. They may make the patient sicker.

Cook the hamburger to 1600 by using a meat thermometer, wash the vegetables, and keep your kitchen counter top clean. Bon Appetit.

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See related Patient Topics E. Coli Infections, Food Safety, Food, Nutrition and Metabolism, Infections or Poisoning, Toxicology, Environmental Health.

See related Provider Topics Food, Nutrition and Metabolism, Infections or Poisoning, Toxicology, Environmental Health.

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