What are the symptoms of E. coli 0157:H7 infections?
Initial symptoms of E. coli O157:H7 infection
The initial symptoms of E. coli O157:H7 infection usually appear about
three to five (though occasionally in as few as one day or as many as 10 days) after a
person ingests the bacteria; the symptoms include
- nausea,
- vomiting,
- stomach
cramps, and
- diarrhea that often is bloody.
The person may have a mild fever of
about 100 to 101F (37.7 to 38.3 C). These symptoms can be seen in infected children and adults.
Later symptoms E. coli O157:H7 infections
The majority of people (especially normal adults) are infected resolve the infection without antibiotics in about five to
seven days. However,
some people (about 10% of people infected, especially children under the age of
5 and the elderly) develop more severe signs and symptoms, and these people
usually require hospitalization and aggressive treatment. These patients develop
the usual symptoms listed above, but do not resolve the infection. They develop
symptoms that last longer (at least a week) and, if not treated promptly, the
infection may lead to disability or death.
These symptoms or complications fall
into three main categories;
- Hemorrhagic (bloody) diarrhea: Hemorrhagic (bloody) diarrhea
symptoms are an increased amount of blood in
the diarrheal stool that does not seem to resolve and is usually accompanied by
severe abdominal pain. Although this may resolve within a week, some individuals
can develop anemia and dehydration that can cause death.
- Hemolytic-uremic syndrome (HUS):
Hemolytic-uremic syndrome
symptoms of pallor (due to anemia), fever,
bruising or
nosebleeds (due to destruction of blood platelets that are needed
for blood to clot), fatigue,
shortness of breath, swelling of the body,
especially hands and feet, jaundice, and reduced flow of urine may be seen. HUS
symptoms usually develop about 7 to 10 days after the initial diarrhea begins. HUS
is the most common cause of kidney failure in children; children under 10 years
old are the most likely to develop HUS. E. coli 0157:H7 produces toxins that
damage the kidneys and destroys platelets that can lead to kidney failure,
excessive bleeding, seizures or death.
- Thrombotic thrombocytopenic purpura (TTP):
Thrombotic thrombocytopenic
purpura is caused by the loss of
platelets; however, the symptoms that occur are somewhat different and occur
mainly in the elderly. The symptoms are fever,
weakness, easy, rapid or
"spontaneous" bruising, renal failure, and mental impairment that can rapidly
progress to organ failures and death. Until the 1980's, TTP was considered a
fatal disease, but since the 1980's, plasma exchange and infusion techniques
have reduced the death rate in TTP patients to about 10%.
For most people (about 90%), the E. coli infection clears and a good outcome or prognosis occurs. However, if any of the above mentioned complications happen, the prognosis may range from good to poor. The variable prognosis depends on the severity of the complication, the quickness of diagnosis and treatment, the response of the individual to adequate treatment and the overall health of the individual. Children and the elderly are at higher risk for adverse outcomes.