Alternate Names: Traveler's diarrhea - E. coli enteritis

Causes and Risks: E. coli enteritis is a type of bacterial enteritis or bacterial gastroenteritis. Endotoxins produced by the bacteria are responsible for the symptoms. The incubation period is 24 to 72 hours. In adults, the infection is usually not severe, but in children and infants, the infection frequently requires hospitalization, and in some cases is life threatening.

Certain types of E coli infection (usually caused by the Escherichia coli 0157:H7) are associated with hemolytic uremic syndrome, an acute disease characterized by distruction of the red blood cells, drastic decrease in the platelets, and sudden acute kidney failure.

Risk factors include recent family illness with E. coli, recent family illness with gastroenteritis symptoms, recent travel to an area endemic for E. coli, or exposure to untreated or contaminated water. The incidence is 3 out of 10,000 people.

Prevention: Careful handwashing may be helpful. Do not drink untreated or possibly contaminated water. Always cook meats aedquately, especially ground meats. Cook meats at high enough temperatures to kill organisms.

Symptoms:

• diarrhea that is acute and severe
• vomiting (although rare)
• loss of appetite
• abdominal pain

Signs and Tests: A stool culture grows E. coli.

Treatment: Cases usually resolve themselves in 1 to 3 days, and no treatment is required. Antidiarrheal medication may delay the elimination of the organism from the digestive tract, and therefore may not be recommended. Rehydration with electrolyte solutions may be necessary if dehydration from diarrhea occurs. People with diarrhea (especially in young children) who are unable to take oral fluids because of nausea may need medical attention and intravenous fluids.

People taking diuretics need to be cautious with diarrhea, and may need to stop taking the diuretic during the acute episode, as directed by the health care provider.

Prognosis: The illness usually runs its course without treatment in a few days.

Complications:

• dehydration
• prolonged diarrhea

Call for an appointment with your health care provider if diarrhea does not resolve in 3 to 4 days or blood in stools is noted.

Call your health care provider if symptoms of dehydration develop, symptoms worsen or do not improve with treatment, or new symptoms develop.