Raw meat, vegetables and fruits, milk and fresh unpasteurized dairy products are the foods at greatest risk of transmitting microorganisms, such as E. Coli.
Bacteria of the Escherichia coli family (E. coli), also called “coliforms”, are widespread in water, the environment and the intestines of animals. Several slightly pathogenic strains are housed without problems in low concentrations even in the human intestine, in balance with the healthy endogenous flora.
In some cases, however, the ingestion through contaminated drinks or foods of particular strains of E. coli that are toxin-producing and able to temporarily take over the other components of the intestinal microbiome can create more or less serious problems.
In most cases, the discomfort caused by an intestinal infection by E. coli is limited to a modest diarrhea that resolves on its own within a few days, without the need for pharmacological therapies.
Some subgroups of bacteria belonging to the genus E. coli can, however, cause much more severe health problems, to the point of requiring hospitalization, especially when children or the elderly are affected, characterized by less diligent immune defenses, greater sensitivity to the effects of dehydration and a more fragile hydroelectrolyte balance.
The most feared strains of E. coli belong to the serotype “O” and among these we must mention above all E. coli O157: H7, also known as hemolytic or entero-hemorrhagic E. coli, as it can cause violent diarrhea mixed with blood, as well as particularly challenging symptoms in terms of nausea, abdominal cramps and vomiting.
The intensity of the manifestations determined by E. coli of serotype “O” is linked to their ability to produce so-called “Shiga” toxins (named after the doctor who highlighted them for the first time, Kiyoshi Shiga), particularly harmful to the intestinal mucosa.
Especially in children and the elderly, foodborne infection by E. coli O157:H7 can become complicated by causing the so-called uremic syndrome, a very critical and life-threatening condition if not managed promptly and appropriately, characterized by acute renal failure, hemolytic anemia (ie caused by excessive degradation of red blood cells) and thrombocytopenia (drastic decrease in the number of platelets resulting in deficiency of blood clotting).
Symptoms and diagnosis of Escherichia coli infection
Recognizing the symptoms of an intestinal E. coli infection is quite simple when the most aggressive “hemolytic” strains are involved, while if the form of diarrhea and associated disorders are mild to moderate it may be almost impossible to distinguish them from those caused by gastroenteritis due to other causes. , as viruses of the rotavirus family (very common among children aged 6 months to 5 years) or other bacteria causing food-borne infections (salmonellosis, listeriosis, cholera, Anisakis gastroenteritis, etc.).
To understand which pathogenic microorganisms may depend on the development of more or less profuse watery diarrhea, abdominal discomfort and bloating, nausea and vomiting, it is also important to observe any extra-intestinal symptoms (fever, apathy, drowsiness, mental confusion, motor disorders, etc.) and analyze what foods and drinks were taken in the days before the onset of the manifestations.
Unfortunately, this second operation can prove to be quite laborious, since between the ingestion of the contaminated food that triggered the infection and the first intestinal discomforts can pass from a day to a week.
Typically, if it is an E. coli infection, the incubation period is, on average, 3-4 days and all those who have eaten the same foods will have similar gastrointestinal symptoms, although probably of different intensity depending on age and degree of individual sensitivity.
In addition, it will be more easily referred to E. coli a diarrheal syndrome contracted in summer, after a meal in a bar, restaurant or canteen of dubious quality, during a trip or stay in non-optimal hygienic-sanitary settings (for example, camping).
On the contrary, if the gastrointestinal malaise occurs in the months from November to March and is accompanied or preceded by flu-like symptoms (fever, cough, sore throat, bone pain), in all probability it will be a viral form, transmitted from person to person either by fecal-oral route or by contact or respiratory route. In this case, the interval between the entry of the virus into the intestine and the onset of symptoms is shorter (on average 1-2 days) and it will mainly be children in the first years of life and people with reduced immune defenses.
In the most acute and severe forms of gastroenteritis, it may be necessary to carry out some laboratory tests in order to accurately identify the microorganism responsible and undertake targeted therapies and / or monitoring of cases on the territory.
The first and most useful among these is the stool culture examination which involves taking a stool sample and being cultured on an artificial “soil” specially designed to promote a rapid multiplication of bacteria that may be present, so as to make them easily recognizable.
The bacterial colonies themselves can be further investigated to verify the presence of distinctive toxins of the most harmful strains. In addition, specific proteins can be searched, such as viral antigens useful for confirming or ruling out rotavirus infections.
Carrying out these investigations is especially important if diarrhea has arisen during or after a trip to an exotic country or in areas where cases of severe toxoinfections have already occurred, subject to epidemiological monitoring by the Istituto Superiore di Sanità (ISS) (in Italy) and / or by supranational surveillance centers such as the European Center for Disease Control and Prevention (eCDC) or the Center for Disease Control and Prevention (CDC) in the United States.
Mild diarrhea generally tends to resolve on its own without causing major discomfort. In case of moderate-to-severe diarrhoea, if adults in good general health are affected, the doctor should be contacted if symptoms do not improve within 48 hours; If it is children, the elderly or frail people (for example, patients with diabetes or kidney disease) it is necessary to contact the doctor already after 12-24 hours.
How to eliminate Escherichia coli from the intestine
Regardless of the viral, bacterial or other cause, the first and most important intervention for the treatment of gastroenteritis consists in replenishing the liquids and mineral salts lost with diarrheal discharges to prevent forms of severe dehydration and very critical and potentially lethal electrolyte imbalances, especially in children and the elderly.
To rehydrate the body it is sufficient to drink plenty of liquids such as common non-carbonated water, vegetable broths, chicken or meat (slightly salty), soups and cereal soups not too thick, light tea and natural fruit juices without added sugar, yogurt to drink. In cases of greater saline depletion, specific rehydrating solutions can also be taken, enriched with mineral salts (in particular, potassium, magnesium, sodium and chlorine).
It is important to point out, however, that there are also liquids that should not be takenduring gastroenteritis. These are mainly water or carbonated soft drinks, sugary drinks (which can worsen watery diarrhea by retaining liquids in the intestinal canal), alcohol (which promote dehydration of the body and have a toxic action), coffee and drinks containing caffeine (stimulating intestinal transit), herbal teas with properties that are not well defined and can trigger unpredictable intestinal or renal reactions.
Regarding the amount of liquids to drink, however, there are no upper limits: a minimum volume of liquids must be taken sufficient to compensate for losses and satisfy thirst. It is, therefore, absolutely to avoid the mistake, not uncommon and very dangerous, to drink little for fear of increasing the discharges.
The second recommendation in case of diarrhea of a certain importance is to rest in a cool environment so as not to consume energy that cannot be adequately compensated by food intake (being the intestinal absorption of nutrients temporarily compromised) and to avoid further dispersion of liquids and mineral salts with sweat.
When the nausea and vomiting that may be present have subsided, you can eat nutritious and easily digestible foods that do not stress too much intestinal transit, such as crispy or toasted bread, rice, boiled potatoes, crackers, rusks, cereal bars, eggs, parmesan cheese, etc.
On the contrary, it is better to avoid (at least in the phase of acute diarrhea) fresh milk and dairy products (except natural plain yogurt or probiotic preparations that can help normalize the intestinal microflora), fatty foods or very rich in fiber and over-seasoned, spicy or spicy foods that can irritate the intestinal mucosa, worsening the symptoms.
On the medication front, unless otherwise indicated by a doctor, the best advice is not to take any in order to reduce diarrhea or to counteract E. coli. Antidiarrheals are in fact more harmful than useful, since discharges are the most effective means of eliminating pathogenic bacteria and their toxins from the intestine. Antibiotics, on the other hand, in addition to not always being effective against E. coli, expose to a greater probability of developing uremic syndrome, with all that this entails in terms of complications and health risks.
After a diarrhoeal episode of a certain importance and lasting more than 3-4 days, it may be useful to take concentrated probiotic preparations (available in pharmacies) and vitamin supplements to promote the most rapid restoration of perfect intestinal function and full well-being.
Practical measures for prevention
Given that E. coli follows a fecal-oral transmission route, through the ingestion of foods contaminated by the bacterium or its toxins, the indications useful for prevention in daily life mainly concern measures aimed at reducing the probability that potentially contaminated foods arrive on the table and are consumed without first having been subjected to appropriate “neutralizing” measures.
The foods that can carry E. coli and its toxins are mainly raw or undercooked meats (contaminated during slaughter of animals or subsequent processing), vegetables and fruits consumed raw and not washed sufficiently, milk and dairy products not subjected to pasteurization or high temperature treatment (UHT), fruit juices, vegetable centrifuges and fresh unpasteurized juices.
To avoid annoying intestinal problems due to E. coli it is important:
– buy fresh food products only from trusted retailers (in particular, meat and dairy products) and prefer products with traceable supply chain
– always cook the meat well, even in the internal parts
– wash very well the fruits and vegetables that are consumed in full (ie without removing the peel), passing them several times under running water
– wash the fruit well before cutting it or removing the peel to prepare juices or fruit salads
– Place food in the refrigerator in such a way as to avoid contamination (i.e. keeping meat and dairy products wrapped in film and placing them in separate compartments from vegetables and fruit).
Other classic prevention rules, at home and outside the home, are summarized in the following table.
| At home | Away from home |
|---|---|
| Always wash your hands thoroughly before cooking, after being in the bathroom, after carrying out work in the garden or garden or touching animals | Avoid eating “street food” uncooked at the time of purchase or distributed by retailers of dubious hygiene |
| In the kitchen, use different utensils to process raw vegetables and fruits and for meat, dairy products and eggs | Pay attention to the degree of hygiene of the bar / restaurant and evaluate the position of the bathrooms in relation to the kitchen, how they are managed food and dishes and the level of cleanliness of the staff |
| Do not use the same dish/container used for raw meat to place, serve or preserve the same meat after cooking | Do not eat fruit or vegetables bought in the markets without having first washed them thoroughly, even if offered for tasting |
| After use, always wash with warm water and detergent for crockery all kitchen utensils that have come into contact with meat, raw fruits and vegetables | Do not drink juices or fruit salads prepared by hand in kiosks on the street |
Respecting these basic principles of food hygiene will allow us to prevent not only intestinal infections caused by E. coli, but more generally to protect ourselves from most foodborne diseases due to microorganisms such as viruses and bacteria or other biological agents and protect our health and well-being, both and those close to us.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.