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How to Avoid Dangerous E. Coli Infections 

For weeks, in adjacent rooms in the Pediatric Intensive Care Unit at SSM Cardinal Glennon Children’s Medical Center, Claire and Christopher Lustig fought for their lives. 

The young siblings from Effingham, IL, had been diagnosed with a condition called hemolytic uremic syndrome (HUS), in which red blood cells are destroyed and the kidneys often fail. The syndrome is most often caused by infection with Escherichia coli O157:H7 (the most dangerous of hundreds of strains of E. coli), a condition that affects 200 people every day and kills one person every week in the United States, according to the U.S. Centers for Disease Control. 

Two-year-old Christopher was the first Lustig child to shown signs of the illness.  On Dec. 2, he became sluggish and had blood in his bowel movements.  His 4-year-old sister, Claire, began showing the same initial symptoms as her brother on Dec. 12 and was also admitted to Cardinal Glennon.

Christopher was confirmed to have E. coli contamination; his sister’s tests came back negative for E. coli, although the bacteria can work its way through the body before tests are able to detect it.

Now that the children are recovering, parents Dave and Tina Lustig hope that by sharing their story, other parents will become more aware of food borne illnesses, and the symptoms and dangerous effects of E. coli contamination. The Lustigs are understandably shaken by the infection that has affected the two youngest of their four children.  Brothers Charlie, 10, and Michael, 7, have shown no signs of the illness. The Lustigs are unsure how or why Claire and Christopher became ill.

“It’s hard to believe that this could happen to two children in the same family,” Dave Lustig said from his daughter’s bedside. “Tina and I are hoping to see the kids get a little better every day, and they’ve been doing that.”  

 Medical intervention has turned fate a bit in the children’s favor. The children spent the holidays in intensive care, but each was upgraded and moved to a regular nursing floor just after New Year’s Day.  Still, their long-term health prospects hang in an air of doubt.  Christopher, for instance, suffered at least one stroke and may have some permanent neurological damage. He will need months of physical therapy to regain some of the physical ability he has lost.

Each year in this country, 73,000 people become sick and 61 die from E. coli infection.  The condition often causes severe bloody diarrhea and abdominal cramps; sometimes the infection causes watery diarrhea or no symptoms. Usually little or no fever is present, and the illness resolves in 5 to 10 days. In some severe cases, such as those experienced by the Lustig children, complications can be serious.
           
Most E. coli illness is associated with eating undercooked, contaminated ground beef. Person-to-person contact in families and child care centers is also known to spread the illness. Infection can also occur after drinking unpasteurized milk and after swimming in or drinking sewage-contaminated water.

E. coli can be found on a small number of cattle farms and can live in the intestines of healthy cattle. Meat can become contaminated during slaughter, and organisms can be thoroughly mixed into beef when it is ground. Also, bacteria present on a cow's udders or on milking equipment may get into raw milk. 

Eating meat, especially ground beef that has not been cooked sufficiently to kill E. coli O157:H7, can cause infection. Contaminated meat looks and smells normal. Although the number of organisms required to cause disease is not known, it is suspected to be very small.  Among other known sources of infection are seed sprouts, lettuce, salami, unpasteurized milk or juice, and swimming in or drinking sewage-contaminated water.

Bacteria in diarrheal stools of infected persons can be passed from one person to another if hygiene or handwashing habits are inadequate. This is particularly likely among toddlers who are not toilet trained. Family members and playmates of these children are at high risk of becoming infected. 

You can protect your family by thoroughly cooking ground beef and washing your hands carefully and frequently.
           

The CDC also advises the following:

  • Avoid spreading harmful bacteria in your kitchen. Keep raw meat separate from ready-to-eat foods. Wash hands, counters, and utensils with hot soapy water after they touch raw meat. Never place cooked hamburgers or ground beef on the unwashed plate that held raw patties. Wash meat thermometers in between tests of patties that require further cooking.

  • Drink only pasteurized milk, juice, or cider. Commercial juice with an extended shelf-life that is sold at room temperature (e.g. juice in cardboard boxes, vacuum sealed juice in glass containers) has been pasteurized, although this is generally not indicated on the label. Juice concentrates are also heated sufficiently to kill pathogens.

  • Wash fruits and vegetables thoroughly, especially those that will not be cooked. Children under 5 years of age, immunocompromised persons, and the elderly should avoid eating alfalfa sprouts until their safety can be assured. Methods to decontaminate alfalfa seeds and sprouts are being investigated.

  • Drink municipal water that has been treated with chlorine or other effective disinfectants.

  • Avoid swallowing lake or pool water while swimming.

  • Make sure that persons with diarrhea, especially children, wash their hands carefully with soap after bowel movements to reduce the risk of spreading infection, and that persons wash hands after changing soiled diapers. Anyone with a diarrheal illness should avoid swimming in public pools or lakes, sharing baths with others, and preparing food for others.

  • For more information about reducing your risk of food borne illness, visit the US Department of Agriculture’s Food Safety and Inspection Service or the Partnership for Food Safety EducationFor more advice on cooking ground beef, visit the U.S. Department of Agriculture.

        

Dr. Bob Wilmott is Chief of Pediatrics at SSM Cardinal Glennon Children’s Medical Center  and is a Professor of Pediatric Medicine at St. Louis University School of Medicine. If you have a child health question for Dr. Wilmott, go to the “Ask Dr. Bob” section of the Cardinal Glennon Web site at www.cardinalglennon.com.

 

 

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