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| Division of Public Health Services Disease Handbook for Childcare Providers | |
| Bureau of Infectious Disease Control REVISED –January 2018 | |
| E. COLI 0157:H7 | |
| E. coli 0157:H7 is an intestinal illness caused by a | |
| bacterium that can cause severe bloody diarrhea, | |
| anemia, and –in some cases- kidney failure. | |
| Who gets this disease? | |
| Anyone is susceptible to this particular category of | |
| E. coli 0157:H7, but it most seriously affects young | |
| children and the elderly. | |
| How is it spread? | |
| This bacterium lives in a small number of healthy | |
| cattle. When the infected animal is slaughtered, the | |
| meat can become contaminated. The bacteria may | |
| also contaminate raw milk by being present on the | |
| cow’s udder. | |
| E. coli 0157:H7 is spread by eating contaminated | |
| food – most often undercooked beef, especially | |
| undercooked ground beef. Contaminated meat | |
| looks and smells normal. Drinking unpasteurized | |
| milk and swimming in or drinking sewage - | |
| contaminated water can also cause infection. | |
| An infected person having diarrhea can pass the | |
| bacteria from one person to another if hand-washing | |
| habits are not adequate. This is more likely to | |
| happen among toddlers who are not toilet trained. | |
| Young children usually continue to shed the | |
| bacteria in their stool a week or two following their | |
| illness. | |
| What are the symptoms? | |
| They vary from mild diarrhea to a bloody diarrhea | |
| with severe abdominal cramps and little or no fever. | |
| Vomiting may o ccur late in the illness. A small | |
| percent may develop hemolytic uremic syndrome | |
| (HUS), a condition that destroys the red blood cells | |
| and causes kidney failure. This is more likely to | |
| occur in children under five years of age and the | |
| elderly, and may lead to death. | |
| How soon do symptoms appear? | |
| Symptoms appear 12 -72 hours after exposure with | |
| the average being 48 hours. | |
| Can a person have this disease without | |
| knowing it? | |
| Yes. The organism is identified through stool | |
| culture testing. Usually symptoms disa ppear in a | |
| few days but the bacteria can remain in the | |
| intestinal tract for several weeks. | |
| What is the treatment? | |
| Seek medical help for identification of the | |
| organism. Usually the person is treated for diarrhea | |
| dehydration with fluid replacement. | |
| How ca n the spread of this disease be | |
| prevented? | |
| 1. Wash hands thoroughly after diapering and | |
| using the bathroom. | |
| 2. Avoid eating undercooked beef, especially | |
| hamburger. | |
| 3. Avoid drinking from unknown water sources ,, | |
| raw milk, and unpasteurized apple juice. | |
| 4. Teach children good hand washing techniques | |
| Who should be excluded? | |
| Children who are infected with this bacterium will | |
| be excluded from childcare while they are | |
| symptomatic. Infected adults should be excluded | |
| from childcare centers, food handling, and direct | |
| care healthcare, until their stool cultures are free of | |
| E. coli 0157:H7 on two (2) consecutive specimens | |
| collected not less than 24 -hours apart. If antibiotics | |
| have been given, the initial cultures should be | |
| obtained at least 48-hours after the last dose. | |
| Reportable? | |
| Yes. E. coli 0157:H7 is reportable by New | |
| Hampshire law to the Division of Public Health | |
| Services, Bureau of Infectious Disease Control at | |
| (603) 271-4496. | |