Shiga Toxin-Producing Escherichia coli (STEC)

Disease Fact Sheet

What is Shiga toxin-producing Escherichia coli?

Shiga toxin-producing Escherichia coli is a type of enterohemorrhagic E. coli (EHEC) bacteria that can cause illness ranging from mild intestinal disease to severe kidney complications. Other types of enterohemorrhagic E. coli include the relatively important serotype E. coli O157:H7, and more than 100 other non-O157 strains such as O111 and O26.

What are the symptoms?

Typical symptoms include severe abdominal cramping, sudden onset of watery diarrhea, frequently bloody, and sometimes vomiting and a low-grade fever. Most often the illness is mild and self-limited generally lasting 1-3 days. However, serious complications such as hemorrhagic colitis, Hemolytic Uremic Syndrome (HUS), or postdiarrheal thrombotic thrombocytopenic purpura (TTP) can occur in up to 10% of cases.

How soon do the symptoms appear?

The incubation period ranges from 1 to 8 days, though typically it is 3 to 5 days.

How do you get Shiga toxin-producing Escherichia coli?

Cases and outbreaks of Shiga toxin-producing Escherichia coli have been associated with the consumption of undercooked beef (especially ground beef), raw milk, unpasteurized apple juice, contaminated water, red leaf lettuce, alfalfa sprouts, and venison jerky. The bacteria have also been isolated from poultry, pork and lamb. Person-to- person spread, via fecal->oral transmission, may occur in high-risk settings like day care centers and nursing homes. Further studies are being done to better understand the modes of transmission.

Who gets infected with Shiga toxin-producing Escherichia coli?

Although anyone can get infected, the highest infection rates are in children under age 5. Elderly patients also account for a large number of cases. Outbreaks have occurred in child-care facilities and nursing homes.

How is it treated?

For mild illness, antibiotics have not been shown to shorten the duration of symptoms and may make the illness more severe in some people. Severe complications, such as Hemolytic Uremic Syndrome, require hospitalization.

How can you keep from getting it?

• COOK meats and poultry thoroughly. Ground beef should reach at least 155 degrees F (until the meat is no longer pink and juices run clear).
• DO NOT consume raw milk or unpasteurized dairy products.
• WASH YOUR HANDS after using the bathroom or changing diapers and before preparing or eating food.

Produced by: Communicable Disease Epidemiology Program (303) 692-2700 Colorado Department of Public Health & Environment 3/2001