Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In September 2006, the U.S. Food and Drug Administration advised consumers
not to buy or eat raw spinach from any source, citing a widespread outbreak of
E. coli infection that led to over 100 cases of illness, including one death.
The infections resulted from contamination of raw spinach by E. coli bacteria.
It is not clear if the bacterial contamination occurred in the field or during
processing of the spinach.
In 2007, a number of ground beef products were recalled after contamination
with E. coli was found, and outbreaks have continued. A restaurant in Effingham,
Illinois, was identified as the source of an E. coli outbreak that resulted in
at least six confirmed cases of E. coli 0157:H7 among customers in September
2007, and an outbreak also occurred among students at an Indiana elementary
In June 2009, multiple E. coli 0157:H7 infections occurred in people who
had consumed raw refrigerated cookie dough.
In April and May 2012, 14 individuals became infected in an outbreak
with the Shiga-toxin producing bacterial strain known as STE 0415 in six US
Shiga toxin-producing E. coli infection symptoms
E. coli 0157:H7 produces toxins that damage the lining of the intestines. The
result is severe, bloody diarrhea. Vomiting, abdominal cramps, and fever may
also be present.
Shiga toxin-producing E. coli infection transmission
The main source of E. coli 0157:H7 is healthy cattle, but other domestic and
wild mammals also can be sources. During the slaughter of cattle harboring this
strain, meat can become contaminated, and the bacteria are mixed into the beef
when it is ground. Most cases of E. coli 0157:H7 illnesses have occurred after
eating undercooked ground beef.
However, other products such as vegetables can
become contaminated with the bacteria, for example, if cow manure is used as a
fertilizer for produce that is often consumed raw, such as spinach.
contamination of water used for irrigation can also result in contaminated
produce. Disease-causing strains of E. coli have been previously identified on
lettuce, on alfalfa sprouts, and in unpasteurized fruit juices. It is important
to note that rinsing contaminated produce is not sufficient to eliminate the
bacterial contamination, but cooking the produce will destroy the E. coli
These bacteria may also be present on the cow's udders and contaminate the
milk and milk products. That is one of the dangers of drinking unpasteurized
milk and other raw dairy products.
E. coli from the stool of infected people can
be spread to others if hygiene is inadequate, which is particularly likely among
young children. Swimming and wading pools and hot tubs can harbor live
if the water is under-chlorinated.
E. coli can be spread from sewage-contaminated drinking water.
(This is a concern after hurricanes and other natural disasters.)
Shiga toxin-producing E. coli 0157:H7 infection complications