Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
E coli O157:H7 is a serotype of E. coli bacteria that form the predominant
members of one group of EEC. This EEC group is termed enterohemorrhagic E. coli
or EHEC. Unfortunately, other terms in the medical literature describe this
group (VTEC or Vero toxin-producing E. coli and STEC or Shiga toxin-producing
E.
coli). Research suggests that only a small number of E. coli 0157:H7 are needed
to cause infection (ingestion of about 10–100 organisms) instead of the
thousands to millions needed for infections by other E. coli serotypes.
Infection is aided by adhesive receptors (pili or fimbriae) that attach the
bacteria to human intestinal cells. The most problems caused by the bacteria are
due to two Shiga toxins, termed Stx 1 and Stx 2 and also termed Vero toxins.
(Toxins are chemicals that are produced by the bacteria and that damage human
cell.) These toxins are almost identical to toxins produced by another related
bacterium, Shigellaspp that can damage and kill intestinal cells and
occasionally cause anemia, damage to platelets, and death of cells in other
organs, especially the kidneys.
E. coli 0157:H7 is a major health problem. It is estimated to cause infection
in more than 70,000 individuals a year in the United States, and the U. S.
Centers for Disease Control and Prevention (CDC) suggests E. coli
0157:H7 is responsible for the majority of "E. coli" outbreaks in the U. S. It has been reported to cause
both large outbreaks as well as outbreaks in small numbers of individuals.
This
diarrheal illness was first recognized when the CDC personnel isolated E. coli
O157:H7 from patients in two separate outbreaks in Oregon and Michigan. The
illnesses were associated with eating hamburgers at the restaurants of a
national chain; some patients experienced
hemorrhagic colitis (inflammation and
bleeding of the colon). Thus, hemorrhagic colitis due to E. coli 0157:H7 is
commonly referred to as hamburger disease. Since that time, E. coli 0157:H7 also
has been associated with contaminated water, foods, and unpasteurized or
incorrectly pasteurized (heat treated) dairy products.
The most recent outbreak
(October/November of 2010) occurred in five states (California, Arizona,
Colorado, New Mexico and Nevada). The CDC linked the outbreak to Gouda cheese
sold and given away as free samples at Costco stores.
Urinary tract infection (UTI) is an infection of the kidney, ureter, bladder, and/or urethra. Not
everyone with a UTI has symptoms. Common symptoms include a frequent urge to
urinate and a painful, burning when urinating.
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, medication. Some of the renal causes of kidney failure are from sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
Gastroenteritis (viral gastroenteritis, stomach flu) is an infection caused by a variety of viruses that results in vomiting and/or diarrhea. Even though it is often called the "stomach flu," it is not caused by the influenza viruses. Viruses that can cause gastroenteritis (stomach flu) include: rotaviruses, adenoviruses, caliciviruses, astroviruses, Norwalk virus, and a group of Noroviruses. Gastroenteritis is not caused by bacteria. The main symptoms of gastroenteritis include vomiting and watery diarrhea, however, headache, fever, and abdominal cramps (stomach ache) may also be present.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Kidney infection (pyelonephritis) usually is caused from bacteria that have spread from the bladder from a UTI (urinary tract infection), poor hygiene, sexual intercourse, pregnancy, catheter, cystoscope exam, surgery, kidney stones, or prostate enlargement. Symptoms of kidney infection include: back pain, frequent urination, pain during urination, fever, and or pus or blood in the urine. Kidney infection is usually treated with antibiotics.
Anemia is the condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying capacity of the blood is, therefore, decreased.
Nosebleed is common in dry climates during winter months, and in hot dry climates with low humidity. Individual taking blood clotting medications, aspirin, or antiinflammatory medications may be more prone to nose bleeding. Other factors that contribute to nosebleed are trauma (including nose picking), rhinitis, and high blood pressure. Treatment depends on the severity of the condition.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
E. coli is the most common cause of bladder infections. Bladder infection symptoms and signs include frequent urination, burning urination, and foul smelling urine. Mild bladder infections may go away by increasing one's intake of fluid. More severe infections may be treated with a few days of antibiotics.
Sepsis (blood poisoning) is a potentially deadly infection with signs and symptoms that include elevated heart rate, low or high temperature, rapid breathing and/or a white blood cell count that is too high or too low and has more than 10% band cells. Most cases of sepsis are caused by bacterial infections, and some cases are caused by fungal infections. Treatment requires hospitalization, IV antibiotics, and therapy to treat any organ dysfunction.
Food poisoning is common, but can also be life threatening. The most common form of food poisoning is caused by bacteria and include symptoms such as fever, abdominal pain, diarrhea, nausea and vomiting.
Inflammation of the inner lining of the colon is referred to as colitis. Symptoms of the inflammation of the colon lining include diarrhea, pain, and blood in the stool. There are several causes of colitis including infection, ischemia of the colon, inflammatory bowel disease (Crohn's disease, Ulcerative colitis, or microscopic colitis). Treatment depends on the cause of the colitis.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Thrombocytopenia refers to a decreased number of platelets in the blood. There are many causes of thrombocytopenia such as decreased platelet production (viral infections for example rubella, mumps, chickenpox, hepatitis C, and HIV); increased platelet destruction or consumption (for example sulfonamide antibiotics, heparin, blood transfusions, and lupus); or increased splenic sequestration (enlarged spleen due to conditions for example liver disease, blood cancers, and more). Treatment of thrombocytopenia depends on the cause.
Gangrene may result when blood flow to a tissue is lost or not adequate to keep the tissue alive. There are two types of gangrene: wet and dry. All cases of wet gangrene are infected by bacteria. Most cases of dry gangrene are not infected. If wet gangrene goes untreated, the patient may die of sepsis and die within hours or days. Dry gangrene usually doesn't cause the patient to die. Symptoms of dry gangrene include numbness, discoloration, and mummification of the affected tissue. Wet gangrene symptoms include swelling, pain, pus, bad smell, and black appearance of the affected tissue. Treatment depends upon the type of gangrene and how much tissue is compromised by the gangrene.
Travelers' diarrhea is generally contracted by eating contaminated food or drinking contaminated water. Food is the primary source of travelers' diarrhea. Enterotoxigenic E. coli is the cause of up to 70% of all cases of travelers' diarrhea. There are five unique classes of E. coli that causes gastroenteritis. Other bacteria responsible for travelers' diarrhea include
Campylobacter, jejuni, shigella, and salmonella. Viruses such as rotavirus and Norwalk virus (norovirus) and giardia lamblia a parasite may cause travelers' diarrhea. Prevention is careful eating and drinking of water.
Fatigue can be described in various ways. Sometimes fatigue is described as feeling a lack of energy and motivation (both mental and physical). The causes of fatigue are generally related to a variety of conditions or diseases for example, anemia, mono, medications, sleep problems, cancer, anxiety, heart disease, drug abuse, and more. Treatment of fatigue is generally directed toward the condition or disease that is causing the fatigue.
Travelers should prepare for their trip by visiting their physician to get the proper vaccinations and obtain the necessary medication if they have a medical condition or chronic disease. Diseases that travelers may pick up from contaminated water or food, insect or animal bites, or from other people include malaria, meningococcal meningitis, yellow fever, hepatitis A, typhoid fever, polio, and cholera.
Septic arthritis, or infectious arthritis, is infection of one or more joints by bacteria, viruses, or fungi. Symptoms and signs of septic arthritis include fever, joint pain, chills, swelling, redness, warmth, and stiffness. Treatment involves antibiotics and the drainage of the infected joint.
Drug resistance (antimicrobial resistance) is the ability of bacteria, fungi, parasites, and viruses to grow, even in the presence of a drug that would normally kill it (or limit it's growth). Drug resistance is a growing problem, particularly for infections such as MRSA, VRE (vancomycin-resistant enterococci), tuberculosis, HIV, STDs, gonorrhea, flu, pneumonia, malaria, E. coli, salmonella, Campylobacter, which causes diarrhea and gastroenteritis. Learn how to protect yourself from resistance to drugs.
Hemolytic uremic syndrome (HUS) is a diseases in which blood clots within the capillaries. Causes associated with HUS include E. Coli, birth control pills, pneumonia, medications such as chemotherapy, Ticlid, and quinine. Symptoms of HUS include gastroenteritis, abdominal cramping, vomiting, and bloody diarrhea. Diagnosis of HUS includes medical history, physical examination, and medical tests. Treatment includes rest, fluids, possible hospitalization for blood transfusion or complications due to kidney failure.
NDM-1 (New Delhi metallo-beta-lactamase) is an enzyme produced by certain strains of bacteria that have recently acquired the genetic ability to make this compound. Bacteria that produce NDM-1 are resistant to all commonly used beta-lactam antibiotics. Klebsiella, Escherichia and Acinetobacter are known to possess the gene for NDM-1, which can turn these bacteria into superbugs. Symptoms and signs of NDM-1 infection include fever, fatigue, and shock. Treatment depends upon the NDM-1 strain.
Bioterrorism is a form of terrorism where there is the intentional release of biological agents such as viruses, germs, or bacteria. Diseases caused by bioterrorism agents include anthrax, botulism, plague, smallpox, tularemia, brucellosis, food poisoning, Q fever, ricin toxin poisoning, cholera, epidemic typhus, viral encephalitis, XDR TB, and MDR TB.
Enterovirulent Escherichia coli (E. coli) are strains of related bacteria that have a strong propensity to cause gastrointestinal tract infections. Examples of strains include: EHEC (enterohemorrhagic E. coli), ETEC (enterotoxigenic E. coli), EPEC (enteropathogenic E. coli), EIEC (enteroinvasive E. coli), EAEC (enteroadherent E. coli), and EAggEC (enteroaggregative E. coli). Symptoms may vary depending on the strain the individual contracts. Infection is spread generally through contaminated food or drink.
Recreational Water Illnesses (RWIs) are caused by germs spread by breathing in mists or aerosols, swimming, or having contact with contaminated water in hot tubs, water parks, water play areas, fountains, lakes, rivers, oceans, and swimming pools. Diarrhea is the most commonly reported recreational water illness. Diarrheal illnesses are caused by germs such as Crypto, Shigella, Norovirus, E. coli, and Giardia. Prevention of water born illnesses is key to avoid infection. Avoid swallowing water and practice good hygiene habits are a must.
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