Infection is transmitted to humans through ingestion of contaminated food or water or by person-to-person fecal-oral contact
Escherichia coli (E. coli) is a very common and not always “bad” Gram-negative bacterium. It lives as a diner (ie without causing and damaging and indeed collaborating with physiological functions) in many organisms, including the human body. But there are also very dangerous strains of E. coli. They are those that produce verocytotoxin or Shiga-toxin (Vtec or Stec), a powerful substance responsible for diseases that can be very serious.
The consequences
These bacteria are able to colonize the intestinal mucosa and are called enterohemorrhagic. The clinical manifestation ranges from diarrhea to hemorrhagic colitis, up to hemolytic uremic syndrome (Seu). The latter is the most serious manifestation of Vtec infections and mainly affects children. It is the most important cause of acute kidney failure in children, particularly in the first years of life.
Contaminated food
The infection is transmitted to humans through the ingestion of contaminated food or water. Another way of transmission of Vtec infections is the fecal-oral route from person to person. Among the foods most at risk are raw or undercooked meat, unpasteurized milk, cheeses and other derivatives based on unpasteurized milk. Vegetables (fruit, vegetables and sprouts) and juices can also carry the infection. The severity of the disease depends on the virulence of the bacterial strain, the age and general condition of the patient. The incubation time generally ranges from one to five days. There is no specific therapy and infections are treated with supportive therapies (rehydration, hemo-dialysis and / or peritoneal dialysis, plasmapheresis, blood transfusions). Antibiotic therapy is not recommended or even contraindicated, because it could favor the release of the toxin with worsening of the patient’s condition.
The toxin
“The toxin produced by E. coli is able to significantly damage intestinal cells and those of the vessel walls, thus giving rise to hemorrhage – he explains Marco Silano, director of the Operational Unit of Food, Nutrition and Health of the Istituto Superiore di Sanità -. The symptoms are bloody diarrhea, with very significant blood loss in the stool and very strong abdominal pain. Fever may not be there. Raw meat is the main vector of these infections, but the damage is caused by the toxin and not directly by E. coli. Furthermore, the toxin itself is not always fatal: in many cases, if the patient is followed in the hospital and supported from the hydro and electrolytic point of view, the infection resolves. However, there are some risk factors that can worsen the picture: the age of the patient (children and the elderly are more at risk), his state of hydration, any concomitant diseases (especially cardiovascular). Furthermore, the severity depends on the bacterial load present in the food that is consumed, even if the infection usually develops when a good quantity of contaminated product is consumed ». Is it possible to recognize infected meat? «It is not always possible, but if the contamination is heavy, there are usually some signs of sight, smell or taste: the meat can have a different color, smell or taste than usual – Silano underlines -. But it must be said that if the dish is seasoned with spices or marinated, the taste is totally masked ».
Prevention
The tips to prevent infections are to avoid the consumption of raw or undercooked meat, especially ground (hamburger, tartare) or carpaccio and to avoid the consumption of unpasteurized raw milk and derivatives. Furthermore, the contamination of ready-to-eat foods (e.g. salads) with raw meat must be avoided, for example by using the same knife or cutting board. In the event of intestinal Vtec infection, the patient’s family members must observe strict hygiene rules, but normal environmental cleaning and personal hygiene operations (in particular hand washing) are sufficient to avoid the spread of the infection.
July 29, 2022 (change July 29, 2022 | 09:59)
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