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Introduction
Escherichia Coli O157-H7 Montiel 2
In 1982, Escherichia Coli O157-H7 was first recognized as human pathogen due to some
bloody diarrhea outbreaks in Oregon and Michigan, (Lim). It was also linked to some
Hemolytic-Uremic Syndrome outbreaks in 1983, (Lim). However, it was until 1994 that it
became a nationally notifiable infection and in 2000, reporting cases was mandatory for 48
states, (Rangel). Furthermore, it has been named one of the most important foodborne pathogens
since cases continue to be reported ever since the outbreaks. It is estimated that every year about
73,480 illnesses, 2,168 hospitalizations, and 61 deaths are caused by E. Coli 0157-H7, (Rangel).
Escherichia Coli O157-H7 is known as the worst type of E.Coli and it creates a Shiga toxin. Due
to this Escherichia Coli O157-H7 is also known as a Shiga-producing E.Coli (STEC), (Food
Safety). In addition, this Shiga toxin produces virulence factors that harm human beings by
causing severe damage to the lining of the intestine and is known to be one of the most powerful
toxins, (CDC). The most recent outbreaks of E.Coli 0157-H7 have occurred in 2016 with beef
products produced by Adams Farm and alfalfa sprouts produced by Jack and The Green Sprouts,
(CDC Outbreak).
The major known reservoir for E. Coli 0157-H7 is cattle; however, pigs, turkeys, sheep,
and goats have also been found to carry it, (Lim). It has also been discovered that usually the
reservoir host is asymptomatic, meaning that they shown no symptoms of the disease, (Lim).
According to WHO, these reservoir hosts tend to carry E. Coli 0157-H7 in their lower intestines.
Other sources are contaminated food, contaminated water, the animals environment, and the
Transmission
Escherichia Coli O157-H7 Montiel 3
Food becomes a source of E.Coli 0157-H7 when it is contaminated by the feces of infected
animals. This is mostly commonly found in undercooked beef, unpasteurized milk and juices,
cheeses made from unpasteurized milk, and raw fruits and vegetables, (Food Safety). Cross-
contamination of food during food preparation can also lead to transmission. Likewise, water
becomes contaminated when it carries E. Coli 0157-H7 and is untreated. The transmission of the
disease occurs when people either drink untreated water or swim in contaminated water, (Food
Safety).
Raw fruits and vegetables can also become a source of transmission if they come into
contact with an infected animal during handling or cultivation, (WHO). In addition, if a person
touches an animal that is infected or touches its environment, then he or she will become prone
to infection. An individual can also become infected if they come into contact with the feces of
an infected person. Child care facilities and contact with family members are common ways of
transmission, (WHO).
The incubation period between exposure to E. Coli 0157-H7 and the onset of symptoms
is usually between one to ten days. (Food Safety). However, this varies in every infected
individual. The symptoms that begin to develop are fever, nausea, vomiting, stomach cramps,
bloody diarrhea, malaise, little to no food intake, and mild dehydration, (Food Safety). The most
commonly known symptom is bloody diarrhea. Often these symptoms are referred to as
hemorrhagic colitis, (CDC). The duration of the illness usually lasts between five to ten days,
(MDH).
Complications tend to develop in young children and the elderly because they progress
to more serious symptoms more frequently than other populations, (FDA). Hemolytic Uremic
Syndrome is a potentially life-threatening complication derived from E.Coli 0157-H7 and only
about 5-10% of infected individuals develop it, (CDC). This syndrome is characterized by
hemolytic anemia, abnormal destruction of red blood cells. and acute renal failure. People who
develop this show symptoms of decreased frequent urination, feeling very tired, paleness, edema
fainting, and weakness along with hemorrhagic colitis, (NIDDK). These individuals must be
immediately hospitalized because they can develop serious renal failure. According to the CDC,
most individuals tend to recover after a few weeks; however, some people can suffer permanent
damage or die.
In order for a proper diagnosis to take place, a fecal sample must be analyzed along with
an accurate history and physical exam, (CDC). A tentative diagnosis is set only after a
people is made. It is recommended to contact a doctor after three days of diarrhea accompanied
by excess vomiting, blood in stool, and high fever, (CDC). The CDC recommends that
Escherichia Coli O157-H7 Montiel 5
community-acquired diarrhea should be tested using immunologic test systems since these tests
are able to identify all types of Shiga toxins and can recognize E.Coli 0157-H7 more effectively
unlike the bacterial culture techniques, (CDC). However, it is recommended that both bacterial
complications. However, the treatment for most people includes rest and fluids to prevent
medications because they will prevent the body from getting rid of the toxins and to avoid
antibiotics because they can increase the risk of complications, (Mayo Clinic). However, if
individuals have developed Hemolytic Uremic Syndrome, then they should hospitalized to
receive proper treatment, which would consist of IV fluids, blood transfusions, and kidney
dialysis, (Mayo Clinic). There is currently no vaccine for E.Coli 0157-H7, (CDC).
Prevention
control measures at all stages in the food chain must be taken such as the agricultural production,
processing, handling, manufacturing, and food prepping. At the industrial level, methods such as
pre-screening the animals before slaughter, hygienic measures, and education in hygienic
handling of foods for workers are good methods to reduce the risk of transmission, (WHO).
However, the only proper method to make sure that no transmission or contamination for foods
takes place is to have a bactericidal treatment take place, such as heating, pasteurization, or
irradiation, (WHO).
Preventive methods can take place at the household by following basic good food
hygienic practices. According to WHO, the following five keys can help prevent overall food-
Escherichia Coli O157-H7 Montiel 6
borne illnesses: keep clean, separate raw and uncooked, cooked thoroughly, keep food at safe
temperatures, use safe water and raw materials. Other methods such as heating food at a proper
temperature and washing fruits and vegetables before consumption can also help prevent the
illness. The elderly and young children should take more precaution and avoid eating raw food or
liquids since they are the most targeted populations, (WHO). It is also important for producers of
fruits and vegetables to take preventative methods such as: practicing good overall hygiene,
protect fields from animal faecal contamination, use treated faecal waste, evaluate and manage
risks from irrigation water, and keep harvest and storage equipment clean and dry, (WHO). This
will help prevent contamination at any stage of the food process such planting, growing,
Summary
Escherichia Coli O157-H7 was first discovered due to outbreaks that occurred in the
1980s, but it was until a decade later that it would be nationally known as an infection. It is
considered the worst type of E.Coli because it can lead to serious complications such as death.
E.Coli 0157-H7 produces a Shiga toxin which helps the growth of E.Coli inside the body and
Escherichia Coli O157-H7 Montiel 7
attacks the lining of the intestine. This in turn leads to many symptoms, such as bloody diarrhea
and high fever. The spread of this illness is through contaminated foods, water, and infected
animals and people. Most people are able to treat this illness through rest and drinking lots of
fluids to help prevent dehydration and fatigue. Young children and the elderly are the most
targeted populations and must take more precautionary methods. In order to prevent the
transmission of E.Coli 0157-H7 to foods and help prevent illness, overall proper hygienic
measures need to take place at the industrial, farming, and household level. Proper food
sanitation needs to take place in order to prevent contamination. However, people should still be
aware of heating food properly and making sure they wash their hands before handling food. If
these measures are taken, then any risk of infection will be reduced.
Works Cited
Bad Bug Book - BBB - Escherichia coli O157:H7 (EHEC). (n.d.). Retrieved February 17, 2017,
from http://www.fda.gov/Food/FoodborneIllnessContaminants/
CausesOfIllnessBadBugBook/ucm071284.htm
https://www.foodsafety.gov/poisoning/causes/bacteriaviruses/ecoli/
Escherichia Coli O157-H7 Montiel 8
http://www.health.state.mn.us/divs/idepc/diseases/ecoli/basics.html
http://www.who.int/mediacentre/factsheets/fs125/en/
E. coli Treatments and drugs. (n.d.). Retrieved February 17, 2017, from
http://www.mayoclinic.org/diseases-conditions/e-coli/basics/treatment/con-20032105
General Information. (2015, November 06). Retrieved February 17, 2017, from
https://www.cdc.gov/ecoli/general/index.html
Hemolytic Uremic Syndrome in Children | NIDDK. (n.d.). Retrieved February 17, 2017, from
https://www.niddk.nih.gov/health-information/kidney-disease/children/hemolytic-uremic-
syndrome
Lim, J. Y., Yoon, J. W., & Hovde, C. J. (2010). A Brief Overview of Escherichia coli O157:H7
and Its Plasmid O157. Journal of Microbiology and Biotechnology, 20(1), 514.
Rangel, J. M., Sparling, P. H., Crowe, C., Griffin, P. M., & Swerdlow, D. L. (2005).
https://dx.doi.org/10.3201/eid1104.040739.
Reports of Selected E. coli Outbreak Investigations. (2017, January 10). Retrieved February 19,