DOCTOR'S VIEWS ARCHIVE

E. Coli Outbreaks in Potato Salad and Wading Pool

Two different types of Escherichia coli (E. coli) bacteria have been held responsible for new outbreaks in the United States, one in Illinois and the other in Georgia.

Potato Salad in Illinois

In Orland Park, Illinois near Chicago, more than 4,000 people took sick after eating potato salad prepared by Iwan's Deli and Catering for more than 530 parties over the weekend of June 6, a busy weekend for graduations. This is the largest known outbreak in the U.S. of the enterotoxigenic strain of E. coli (ETEC).

ETEC has been generally viewed as a disease of developing countries. It is a common cause of diarrhea among children in the developing countries and among travelers to these countries. ETEC remains the most common cause of traveler's diarrhea or "Montezuma's revenge". However, the Illinois outbreak is an obvious reminder that ETEC is not foreign to the U.S.

ETEC infection is acquired mainly through eating food and drinking water that are contaminated with the bacteria. Toxins produced by the bacteria in the small intestine cause profuse diarrhea. Most people recover in 3-5 days, although severe dehydration can occur in the very young and the elderly.

Preventing and correcting dehydration is most important in treating traveler's diarrhea. In persons with mild to moderate symptoms, anti-diarrhea agents such as Imodium, Lomotil, and Pepto-Bismol can be used to decrease cramps and diarrhea. In more severe cases, early treatment with short courses of antibiotics such as doxycycline (Vibramycin), trimethoprim-sulfamethoxazole (Septra, Bactrim), and ciprofloxacin (Cipro) can help decrease the duration of illness.