1. By: Katie Johnson & Dana McPeak

2.  Large and diverse group of bacteria  E. coli bacteria normally live in the intestines of people and animals  Some E. coli are pathogenic, meaning they can cause illness

3.  E. coli infections typically begin three or four days after exposure to the bacteria (Incubation period)  Symptoms gradually progress over several days  Diarrhea, which may range from mild and watery to severe and bloody  Abdominal cramping, pain or tenderness  Nausea and vomiting  Fever, usually not very high (less than 101 degrees)  Infections can range from mild to life threatening  Some types of STEC can cause Hemolytic Uremic Syndrome (HUS- type of kidney failure)  5 to 10 percent of people infected develop HUS

4.  Contaminated food - infections start when you swallow STEC (Shiga Toxin-Producing E. coli) - the most common foods that are contaminated include: 1. Ground Beef- E. coli bacteria in their intestines can get on the meat 2. Unpasteurized Milk- E. coli bacteria on a cow's udder or on milking equipment can get into raw milk 3. Fresh Produce- runoff from cattle farms can contaminate fields where fresh produce is grown 4. Restaurant meals- cooks or servers who don't wash their hands after using the bathroom can transmit E. coli bacteria to food  Contaminated Water - human and animal feces may pollute ground and surface water, including streams, rivers, lakes and water used to irrigate crops

5. - people have also been infected from swimming in lake water and pools that have been infected  Personal Contact - travels from person to person, especially when infected adults and children don't wash their hands properly - outbreaks have also occurred among children visiting petting zoos and animal barns, and even simply from changing diapers

6.  Bacteria that lives in the guts of ruminant animals including cattle, goats, sheep, deer and elk  Major source of this illness is cattle  STEC that cause human illness generally do not make the animals sick  Animals that are infected with this from the environment spread this illness to humans  Shiga toxin belongs to a group of protein toxins - has a moiety (part) that binds to the cell surface - has a another part that enters the cytosol - inhibits protein synthesis enzymatically - can cause apoptosis (programmed cell death)  Some strains of E. coli can secrete such toxins  The bacteria that produce these toxins are the cause of this illness

7.  Anti-diarrheal medication slows your digestive system down, preventing your body from getting rid of the toxins  E. Coli colonizes the intestinal mucosa where it multiplies and causes damage to the target cells and interferes with the homeostasis that prevails in the GI tract  E. Coli attaches to the microvilli of the intestines via an adhesion molecule known as intimin  If contaminated in the lungs, the patient can experience bacterial pneumonia

8.  Age - young children and older adults are at higher risk of experiencing illness - have more serious complications from the infection  Weak immune systems - usually weakened from AIDS or drugs to treat cancer or to prevent the rejection of organ transplants - more likely to become ill from ingesting E. coli  Eating certain types of foods - these foods include undercooked hamburger, unpasteurized milk, apple juice or cider, and soft cheeses made from raw milk

9.  Your doctor will send a sample of your stool to a laboratory to test for E. coli  If this test is positive, it must be sent to a public health laboratory for further testing  This testing helps to identify the specific strain because it helps locate the outbreak  Not all STEC infections are diagnosed: - many infected people do not seek medical care - they don’t provide a stool specimen for testing  265,000 STEC infections occur each year in the United States

10.  Most people get better between 5 to 7 days  Non-specific supportive therapy (hydration)  Antibiotics should not be used because they may increase the risk of HUS  Antidiarrheal agents may also increase the risk of HUS and slow your digestive system down

11.  Avoid risky foods -avoid pink hamburger -cook meats at a temperature of at least 160 degrees (use a thermometer) - drink pasteurized milk, juice and cider - wash raw produce thoroughly  Avoid cross-contamination - wash utensils - keep raw foods separate - wash your hands - avoid swallowing water when swimming or playing in lakes, ponds, streams and swimming pools

12.  Multistate Outbreak of Shiga toxin-producing Escherichia coli O121 Infections Linked to Farm Rich Brand Frozen Food Products: May 10 th 2013 -35 persons infected with the outbreak strain - reported from 19 states - 82% of ill persons are 21 years of age or younger - 31% of ill persons have been hospitalized - two ill people developed hemolytic uremic syndrome (HUS) - information available to date indicates that consumption of Farm Rich brand frozen food products is one likely source of infection

13.  Multistate Outbreak of Shiga Toxin-producing Escherichia coli O157:H7 Infections Linked to Organic Spinach and Spring Mix Blend: December 10 th 2012 - 33 persons infected with the outbreak strain - reported from 5 states - 46% of ill persons were hospitalized - two ill persons developed hemolytic uremic syndrome (HUS) - outbreak was linked to pre- packaged leafy greens produced by State Garden of Chelsea, Massachusetts

14. http://www.mayoclinic.com/health/e-coli/DS01007/DSECTION=risk-factors http://www.cdc.gov/ecoli/