E.coli bacteria: 75 poisonings in France, symptoms, treatments

[Mise à jour le 31 mars 2022 à 09h32] The E.coli bacteria or Escherichia Coli is present in the intestine humans and some animals. Some strains dangerous can be found in food and lead to intestinal and/or urinary infections. With sometimes serious complications which characterize thehemolytic uremic syndrome” (HUS). Since January 1, 2022, French authorities are investigating serious cases of HUS in France. Epidemiological, microbiological and traceability analyzes have confirmed a link between several cases and the consumption of frozen pizzas from the Fraîch’Up range of the Buitoni brand contaminated with Escherichia coli bacteria that produce Shiga toxins. At March 28, 2022, according to Public Health France75 cases are under investigation, including 41 cases of HUS with similar characteristics, have been identified, i.e. 14 more cases compared to the last update on March 17. 34 additional cases are under investigation. These 75 cases occurred in 12 regions of France Metropolitan: Hauts-de-France (16 cases), New Aquitaine (11 cases), Pays de la Loire (10 cases), Ile-de-France (9 cases), Brittany (7 cases), Grand Est (5 cases) , Auvergne-Rhône-Alpes (4 cases), Center Val-de-Loire (4 cases), Provence-Alpes-Côte d’Azur (3 cases), Bourgogne Franche-Comté (2 cases), Normandy (2 cases) and Occitania (2 cases). The Sick children range in age from 1 to 18 years with a median age of 7 years. Two children died. Symptoms, what to do, treatments: all you need to know about this bacterium.

What is E.coli bacteria?

Escherichia Coli or “E.coli” is a bacteria present in the intestine humans and certain animals, especially ruminants. Useful, it prevents other bacteria from colonizing the intestinal flora and causing disease. When they are in the intestine, the majority of its strains are harmless and cause no symptoms. Some, however, are pathogens and cause intestinal disorders. E. coli bacteria can cause urinary tract infections (cystitis). These mostly affect women because of their anatomy. In effect, in the woman, the anus is close to the urinary tract, which is therefore easily colonized by bacteria. In rare cases, the bacteria can infect other organs such as the vesicle biliary. She can also cause meningitis in newborns.

The contamination of the intestines is done by fecal-oral route. Transmission to humans is often via meat contaminated and eaten raw or undercooked. The consumption of fruits and vegetables washed with contaminated water, raw milk, or bathing in dirty water, for example, can also cause these infections. “A growing number of outbreaks are associated with the consumption of fruits and vegetabless (sprouted seeds, spinach, lettuce, raw cabbage, salads) for which the contamination could be due to contact with faeces of domestic or wild animals at some stage of cultivation or handling” also reports WHO.

What is the incubation period?

The incubation period ranges from 3 to 8 days with a median duration of 3 to 4 days.

What are the symptoms of an E.coli infection?

When ingested, it can cause intestinal infections and therefore diarrhea. These can sometimes be bloody, associated with feverfrom vomitingfrom abdominal pain, dehydration (the classic symptoms of gastroenteritis). The incubation period is 4 days on average. Urinary tract infections as for them, they can manifest themselves by a frequent urination, pain in the lower abdomenburning when urinating and the presence of blood in the urine.

What is hemolytic uremic syndrome?

Most patients recover from an Escherichia Coli infection within 10 days, but for some the infection can progress to a serious, life-threatening form, such as haemolytic uremic syndrome (HUS). This is characterized by acute renal failure, hemolytic anemia and thrombocytopenia. (decrease in platelets).

The diagnosis is based on a clinical assessment (manifestations and symptoms of the disease, aspect of the stool), a cytobacteriological examination of the urineif urinary tract infection (ECBU) (it is advisable to carefully apply the rules of prior disinfection of the urethral meatus and to collect only the “midstream” not the first), complete blood count, a blood ionogram, urea and creatinine levels (kidney damage) and possibly a blood culture in the presence of fever. Coproculture (stool analysis) is useful in case of persistent diarrhoea.

What are the treatments for Escherichia coli bacteria?

► In case of intestinal infection: Dehydration related to diarrhea and vomiting can be very important, especially in infants and the elderly. Therefore, in the majority of casesthe only treatment is to drink plenty of water. If the symptoms affect a fragile person (child, elderly, chronically ill), if they include bloody diarrhea or if they last more than two days, consult a doctor. This one can prescribe antibiotics if he deems it necessary. “E.coli is part of the balance of the intestinal microbiota and lAntibiotic prescription should never be systematic due to the risk of disruption of the microbiota, the cause of many pathologies“, however, advises Dr Anne-Christine Della Valle, general practitioner.

► In case of urinary tract infection: Consult your doctor at the first symptoms, he can prescribe antibiotics and / or give you advice to make it disappear. the recommended treatment for uncomplicated E. coli cystitis in young women is fosfomycin orally in a single dose (“minute treatment”). Acquired resistance to fosfomycin remains rare, despite frequent use. This reduces the use of quinolones and cephalosporins which select strains resistant to these antibiotics useful in the treatment of severe infections. the treatment of pyelonephritis and bacteremia appeals to 3rd generation cephalosporins, aminoglycosides or fluoroquinolones. The treatment of neonatal meningitis is based on the combination of a 3rd generation cephalosporin IV at high doses (meningeal doses) and an aminoglycoside.

As part of the prevention of hemolytic-uremic syndrome in children, two categories of food are in particular in question: minced meat and the raw milk products. To avoid serious foodborne infectionaccording to the recommendations of the Ministry of Health :

• The minced meat by the butcher on request must be consumed during the dayand frozen ground beef must not have undergone a break in the cold chain or thawing.
• The cooking meats, especially minced beef, must be carried out to heart. To do this, you must ensure that the meat is cooked in the center and that it is no longer dew.
• the raw milk and cheeses made from raw milk should not be consumed by young children and in particular those under 5 years old; prefer cooked pressed cheeses (such as Emmental, Comté, etc.), processed cheese spreads and pasteurized milk cheeses.
• the Hand washing should be systematic before meal preparationwhen leaving the toilet or after changing an infant’s diapers.
• The vegetables, fruits and aromatic herbs should be thoroughly washed, especially when eaten raw.
• Ready meals and leftover food should be sufficiently reheated and consumed quickly.
• The children should not drink untreated water (well water…)
• Store raw foods separately from cooked or ready-to-eat foods.
• Kitchen utensils and worktops should be thoroughly washed, especially when they have previously come into contact with raw meat.

To avoid urinary tract infectionsit is recommended to drink at least 1.5L of water per day, to wipe from front to back after a bowel movement, and to urinate just before and after each sexual intercourse.

Thanks to Dr Anne-Christine Della Valle, general practitioner.

Source: Escherichia coli/Shigella. SFM-Microbiology.org