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Food Poisoning: Escherichia coli O157:H7

Hemolytic uremic syndrome (HUS) can result from exposure to the toxin produced by the bacteria E. Coli O157:H7.  This is a syndrome in which red blood cells are destroyed. The damaged cells can cause acute kidney failure.  HUS is severe and can be fatal. Symptoms usually start with diarrhea that can last from 2-14 days.  The diarrhea is often bloody as a result of the toxin damaging the inside of the stomach and intestines.  The patient may or may not have vomiting and usually does not run a fever.  This is often accompanied by abdominal pain and cramping.  HUS will develop with-in 4-6 days of development of the diarrheal illness.  Significant signs of illness can include less or no urine production, although this may be a later sign of toxicity.

There is no medication to treat HUS.  Therapy is centered on replacing lost fluids and electrolytes and supporting blood pressure and kidney function, in some cases requiring dialysis.  Antibiotics should not be given to suspected cases of E. coli exposure with diarrheal illness because it can slow down the transit of the toxin and damage the bacterial cells to release larger amounts of toxin at once.  Medications that treat diarrhea should be avoided because they slow down the movement of material through the intestines and therefore increase the amount of time it takes to expel the toxin.  This increases the likelihood of developing HUS.

E. coli O157:H7 (the strain that causes HUS) is found in 1% of healthy US cows.  The cows may or may not show diarrheal illness themselves.  Exposure to humans comes from consumption of undercooked/raw meat that contains the bacteria, unpasteurized fruit juices, and unpasteurized dairy products including raw milk.  Some cases have resulted from transmission between infected children in daycare settings. 

Raw milk is milk from cows, goats, sheep, or other animals that has not been pasteurized. Pasteurization is a process that involves heating the product to temperatures higher than 160° F for at least 15 seconds to reduce the number of illness-causing microbes.  This is not the same as sterilization where the microbes would be killed.  Pasteurization only extends the amount of time the milk can be safely consumed (when stored properly) before enough microbes grow back to cause disease.  Studies have shown that there is no benefit to drinking unpasteurized milk even if you are lactose intolerant.  Raw milk and pasteurized milk contain the same amount of lactose. 

The risk of getting sick from drinking raw milk is greater for infants and young children, the elderly, pregnant women, and people with weakened immune system, although anyone can become sick.  The CDC reports that food poisoning from raw milk is responsible for three times more hospitalizations than any other foodborne illness. The retail sale of unpasteurized milk and dairy products is illegal in Kentucky.

More information about the health risks of raw milk and dairy products is available here: http://www.cdc.gov/foodsafety/rawmilk/raw-milk-resources.html