Ask the Doctors: Handwashing, proper cooking, handling of food help avoid E. coli infection

Dear Doctors: It seems like there’s a new E. coli outbreak every week. We’re careful about washing our produce, but our son-in-law got pretty sick after eating a fast-food hamburger. How dangerous is E. coli? Is there any way to avoid it?

Dear reader: E. coli is short for Escherichia coli. It’s a large and diverse group of bacteria that make their home in the lower intestine and also can be found in food, untreated water and the environment.

E. coli are shaped like a rod, with a rounded end, studded with thin filaments that help with movement in liquid environments.

E. coli symptoms can range from mild to quite severe and can lead to death. How sick someone gets depends on the strain.

Most strains of the bacteria are harmless. In fact, E. coli are a natural part of the flora in our gut microbiome. They help with the synthesis of certain vitamins and play a role in preventing some pathogens from colonizing the colon.

But several strains cause illnesses including diarrhea, urinary tract infections, respiratory illnesses, pneumonia and neonatal meningitis.

Infection typically occurs by ingesting contaminated fecal material by eating raw or prepared foods or from touching a contaminated surface, then touching your mouth. Infections also can occur from contact with farm animals or at a petting zoo.

Symptoms begin from two to five days after infection. Abdominal pain, abdominal tenderness and cramping are soon followed by diarrhea. As the infection progresses, this becomes increasingly watery. Some strains of E. coli damage the lining of the small intestine, which can cause a bloody discharge.

In healthy people, the disease lasts about a week. Treatment consists of supportive care to maintain hydration and electrolytes.

A rare but dangerous kidney complication known as hemolytic uremic syndrome can occur in people whose immune systems aren’t robust. Infants and older adults with an E. coli infection are at particular risk. Symptoms include a decrease in the frequency of urination, exhaustion and a loss of pink color in the cheeks and the insides of the lower eyelids. This is a medical emergency requiring immediate hospitalization.

You can’t completely eliminate the risk of E. coli infection. But you can minimize it. Thoroughly washing produce before preparing and serving is a good idea. Also, always cook meats to their recommended internal temperature. Avoid cross-contamination by immediately cleaning any utensil or surface that’s come in contact with raw meat.

Always wash your hands thoroughly after using the bathroom or changing a diaper, before handling and preparing food and after contact with animals.

Dr. Eve Glazier and Dr. Elizabeth Ko are internists at UCLA Health.