Escherichia coli outbreaks
Harley, John P. Department of Environmental Medicine, New York University, New York, New York.
Last reviewed:March 2019
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Occurrences of disease cases in excess of normal expectancy caused by the bacterium Escherichia coli. Outbreaks of disease resulting from Escherichia coli (E. coli) contamination have serious consequences. However, most strains of E. coli bacteria are commensals, that is, they are harmless to the humans and other animals that they colonize. Some E. coli strains, though, especially the serotype known as E. coli O157:H7 (Fig. 1), are common causes of foodborne disease outbreaks, leading to severe intestinal infections. (Note that a foodborne disease outbreak occurs when two or more cases of a similar illness result from the consumption of a common food.) Transmitted by ingestion of fecally contaminated food or water, pathogenic E. coli bacteria are responsible for large numbers of cases of diarrheal disease and other gastrointestinal ailments. For example, in the United States alone, E. coli O157:H7 causes tens of thousands of cases of disease per year, including thousands of hospitalizations and dozens of deaths annually. The bacterium also can cause hemorrhagic lesions in the intestines that lead to hemorrhagic colitis with severe abdominal pain and cramps followed by bloody diarrhea. In addition, the bacterium is a frequent cause of hemolytic uremic syndrome (HUS), consisting of renal insufficiency, anemia, and thrombocytopenia (a low blood-platelet count) that can lead to the permanent need for kidney dialysis or even death. In particular, children younger than 5 years of age are most likely to contract HUS, which typically occurs around 2 weeks after infection. See also: Bacteria; Bacterial growth; Bacterial physiology and metabolism; Bacteriology; Diarrhea; Escherichia; Food microbiology; Food poisoning; Foodborne disease; Gastrointestinal tract disorders; Pathogen; Water-borne disease
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