Signs & Symptoms of Coliform Bacteria

Tens of thousands of people will contract a coliform infection this year. In the past, the focus has been on contaminated meat products, but recent outbreaks have frequently centered around fresh vegetables like lettuce and spinach. With the advent of "salad in a bag," fewer people are washing produce and, therefore, increasing their risk. The key to limiting exposure is to practice common sense. Wash your hands and wash your food. If you have diarrhea lasting three or more days, seek medical attention.

Identification

• Coliform bacteria are a group of gram negative microorganisms. The presence of these germs in large numbers is indicative of poor water potability. Coliforms are found in the feces of warm-blooded animals. Generally harmless, high numbers of total coliforms are used as indicators of pathogenic contamination, as it would not be cost effective to test for all the various disease causing microbes. E. coli is notorious in the coliform family. Notably, most of its strains are innocuous, but the species of E. coli known as O157:H7 produces a dangerous, even deadly poison that kills around 60 people annually. Exposure and infection affect more than 70,000 people per year who contract disease through ingestion of contaminated food and water.

Misconceptions

• Many people still believe that E. coli is only contracted through undercooked meat. You need not look further than the 2008 Michigan iceberg lettuce case to know that that isn't true. Vegetables can harbor the deadly microbe by being grown in soil laced with contaminated manure, run-off or even the hands of the person picking it. Today, you are more likely to contract E. coli O157:H7 through a vegetable source rather than a meat source due to that primary misconception. Salad just seems "safe."

Symptoms

• The most common symptoms of E. coli poisoning are bloody diarrhea (hemorrhagic colitis), nausea, vomiting and abdominal pain. A person may or may not have a fever. In more serious cases involving children, the elderly or immunosuppressed patients, kidney failure and anemia (post-diarrheal hemolytic uremic syndrome) may occur. Unfortunately, those who progress to kidney failure often have permanent kidney damage if they survive the initial illness.

Treatment

• There is no magic pill to treat E. coli poisoning. Treatment consists of supportive care, including hydration and good nutrition. If the patient develops hemolytic syndrome, he faces a long hospitalization along with frequent labs to monitor electrolytes and fluid balance. In some cases, TPN (total parenteral nutrition) is ordered along with dialysis. Those are the extreme cases. Many people can recover at home with plenty of oral fluids and rest.

Prevention/Solution

• Practicing thorough personal hygiene is the first step in preventing E. coli contamination. Keep in mind that the spread of this disease is fecal/oral. Meticulous hand washing before ingestion of any food will lower the chance of infection. Washing raw vegetables and fruits before eating is also highly recommended. If possible, they should be soaked in highly diluted (1 teaspoon per 1 quart) chlorinated water for 15 minutes. Further rinsing will remove the chlorine taste from the food. Meats and vegetables should be cooked until the core temperature reaches 160 degrees F. Cross-contamination with cooking utensils and cutting boards is another area of concern. Other precautions include not sharing bathwater with someone who has active diarrhea, wearing disposable gloves when changing an infant's diaper if it contains diarrhea, and drinking bottled water if you don't know your water's source.