- The Washington Times - Tuesday, September 19, 2006

Outbreaks of E. coli 0157:H7 — the germ that has recently infected 131 persons in 21 states who ate tainted fresh spinach — typically afflict 73,000 Americans yearly, killing about 61 of them, according to federal health officials.

Food-borne infection with this particular strain of the common and usually harmless bacterium, Escherichiathis coli, often causes severe bloody diarrhea and stomach cramps usually within two to three days of exposure. Healthy adults can completely recover in a week.

But the picture is far bleaker for some patients, particularly children under age 5 and the elderly. The very young and the elderly who become infected with E. coli 0157:H7 are at increased risk for a complication called hemolytic uremic syndrome (HUS), in which red blood cells are destroyed and the kidneys fail.

HUS patients, who compose between 2 percent and 7 percent of all victims of this strain of E. coli, often require dialysis and blood transfusions, according to the federal Centers for Disease Control and Prevention.

In the United States, HUS is the leading cause of acute kidney failure in children, and most cases are caused by eating undercooked beef or other foods infected with E. coli 0157:H7.

Some with HUS develop chronic kidney failure or neurological disorders, such as strokes or seizures. Some must undergo surgery to remove part of the bowel. About 8 percent have such lifelong complications, which can also include high blood pressure, blindness and paralysis.

Approximately 2,100 Americans yearly require hospitalization after infection with E. coli 0157:H7. For those who end up in intensive care, the death rate from HUS is 3 percent to 5 percent.

About a third of HUS survivors report abnormal kidney function many years later, and a few require long-term dialysis, the CDC reports on its Web site.

Given the potential risks, the Harvard Medical School Family Health Guide recommends that anyone experiencing symptoms of frequent and bloody diarrhea, abdominal pain and cramping, vomiting, nausea and a possible fever contact their doctor immediately. But in many cases, patients infected with E. coli have no fever.

While the harmful E. coli 0157:H7 bacterium is usually spread to humans through contaminated food, people can also get infected by drinking tainted water or unpasteurized milk and other beverages, and from contact with animal or human feces.

Produce such as spinach and lettuce can become infected in a variety of ways in their journey from the field to the supermarket shelf. Contamination can occur by use of manure, by tainted irrigation water; by farmhands who relieve themselves as they work, by inadequate washing by processors, and by insufficient refrigeration that promotes growth of bacteria in sealed bags of salad greens.

Although reports of human E. coli infection are common, the disease is actually relatively new. The first U.S. outbreaks were reported in Oregon and Michigan in a five-month period during 1982.

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