Food Poisoning: Understanding Escherichia Coli Infections

Disclaimer.  I am not a licensed health practitioner.  This is just another post on knowledge and understanding you might wish to acquire in advance of a disaster in case no higher care is available.  As long as our society is functioning, you should leave anything more substantial than applying a Band-Aid to the professionals.  No medication, including those available over the counter, should be taken without consulting a physician.  Information shared here is for educational and entertainment purposes only.  It is not medical advice nor a substitute for licensed medical care. 

Escherichia coli was first isolated and identified over 130 years ago.  There are the good E. coli bacteria that we are supposed to have in our intestines, and there are the bad actors that make us sick. They've been implicated in a myriad of illnesses, including urinary tract infections, meningitis, pneumonia, and cholecystitis.  And some strains can cause food poisoning as well.

The Centers for Disease Control and Prevention provides information on the four most common types of E. coli food-borne infections.  Symptoms take from one to ten days to develop after exposure, but most commonly appear within three to four days.  All types of E. coli food poisoning have the following symptoms in common:

• Severe abdominal cramping
• Profuse, watery, usually bloody diarrhea

Other symptoms that may occur include:

• Low-grade fever (below 101 degrees)
• Nausea
• Vomiting
• Chills
• Headache
• Muscle aches

While most cases of this type of infection are contracted through feces-contaminated food and water, cows, petting zoos, contaminated food handlers, and failing to wash thoroughly after helping a small child with the toilet or changing a diaper have also been implicated.  The illness usually concludes within five to seven days, but in some cases may last up to three weeks. Treatment is largely supportive care with fluids.  Most strains have developed antibiotic resistance, and the CDC suggests that antibiotic use, especially in the case of E.coli O157:H7, may increase the risk of hemolytic uremic syndrome.  One physician recommends treatment with azithromycin or ciprofloxacin (but provides no dosing regimen for these) or doxycycline, 100 mg twice a day for the first day, and then 50-100 mg once or twice per day for 10 days.[1]

In no case should Imodium or any other anti-diarrheal medications be administered.  Imodium works to keep bodily fluids in, but in the case of a bacterial infection, the patient needs to get the bacteria out.


Diarrheagenic E. coli is often referred to as traveler's diarrhea.  It makes its victims very uncomfortable but doesn't do any lasting damage.[2] 

Enterotoxigenic E. coli (ETEC) is very similar to diarrheagenic E. coli and is another form of traveler's diarrhea not common in the US.  While physicians used to prescribe antibiotics for travelers going abroad, this practice is being increasingly curtailed.  In general, TMP-SMZ and ampicillin are usually not effective.  Ciprofloxacin often works, but it's not without side effects and risks.  It's probably best to let the illness run its course.[3]


Enterohemorrhagic E. coli (EHEC) O104:H4 caused a large outbreak in Europe in 2011.

Shiga-toxin producing E. coli (STEC) O157:H7 is the most common of all the STEC strains and the one that gets all the press.  The others sometimes making headlines include O26, O103, O111, and O145.  The O157:H7 strain sometimes causes hemolytic uremic syndrome, which begins about seven days after the onset of the first symptoms in five to ten percent of cases.  The very young and very old are at the greatest risk of complications.[4]

The berberine family of herbs have been demonstrated to be effective against these E. coli infections.[5]

References:
[1]  Joseph Alton, et al., Alton's Antibiotics,  51, 160.
[2]  "Diarrheagenic E. coli," Centers for Disease Control and Prevention, https://www.cdc.gov/ecoli/diarrheagenic-ecoli.html (accessed 3 March 2020).
[3]  "Enterotoxigenic E. coli," Centers for Disease Control and Prevention, https://www.cdc.gov/ecoli/etec.html (accessed 3 March 2020).
[4]   "Questions and Answers," Centers for Disease Control and Prevention, https://www.cdc.gov/ecoli/general/index.html#what_shiga (accessed 3 March 2020).
[5]  Stephen Buhner, Herbal Antibiotics, 177-78.