IT WAS just an ordinary day for Ciara marie Abalos, daughter of Mandaluyong City Rep. Benhur Abalos, when she was suddenly stricken by illness. Her family thought it was just mild sickness until three days later, when she was rushed to the hospital for continued vomiting, diarrhea, and high fever. The following night, after suffering from an internal hemorrhage and swollen organs, she finally died; and it was only after that when doctors discovered that the culprit was Escherichia coli (E. coli) bacterial infection.

“Generally, E. coli does not harm the body and only stays in the large intestine,” Edward Quinto, a Microbiology professor at the College of Science, said. “However, one particular strain, E. coli 0157:H7, produces a powerful toxin that can cause severe illness.”

Warning signs

Quinto said E. coli 0157:H7 (the combination of letters and numbers in the name of the bacterium refers to the specific markers found on its surface that distinguishes it from other types of E. coli) first invades the intestinal lining and damages the underlying cells, causing ulcers that bleed profusely and allow a considerable loss of fluid containing protein and water.

“After entering the intestine, it can multiply until it reaches a point where it can invade other parts of the body.”

Once it penetrates the epithelial cells, the E. coli strain can enter the blood vessels and infect the large organs of the body. “The E. coli penetrated through Ciara’s blood stream and were able to damage her organs,” Quinto said.

Most E. coli bacteria can be found in human stool and not in the blood.

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The complications caused by E. coli 0157:H7 are severe bloody diarrhea and abdominal cramps commonly known as hemorrhagic colitis. But sometimes the infection presents no symptoms, only little or sometimes not even that. Further, the illness usually resolves in five to 10 days, except severe complications which, as in Ciara’s case, can be fatally quick.

Dr. Ruth S. Pada of the UST Student Health Service said that a person who has been experiencing diarrhea for at least three consecutive days should seek medical help.

“If the person has been experiencing persistent diarrhea, whether bloody or non-bloody, his stool should be tested for possible E. coli bacteria. Persistent diarrhea is usually one of the first signs of E. coli infection,” Pada said.

According to the United States-based Centers for Disease and Control Prevention (CDCP), the E. coli infection can also cause hemolytic uremic syndrome, a condition where red blood cells die and kidneys fail. About two per cent to seven per cent of infections lead to this complication.

CDCP added that this syndrome is the principal cause of acute kidney failure in children due to E. coli. It may also lead to chronic kidney failure or neurologic impairment (seizures or stroke). Three to five percent of patients die due to these complications.

Spreading its kind

CDCP reports say that E. coli bacteria can be found in the intestines of healthy cattle. Contamination may come from improper slaughter and grinding. Bacteria present on cow’s breasts or on pumping equipment may also get into raw milk.

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According to CDCP, E. coli O157:H7 was first recognized as a cause of illness in 1982 during an outbreak of severe bloody diarrhea due to consumption of contaminated hamburgers. The bacterium was named after German bacteriologist Theodore Escherich.

Most E. coli infections have been associated with contact with cattle, eating undercooked meat, especially ground beef, sprouts, lettuce, salami, and drinking non-pasteurized milk and juice. But Quinto pointed out that eating undercooked beef doesn’t necessarily cause bacterial infection.

“Usually, E. coli bacterial infection only happens when the beef eaten was contaminated,” Quinto said.

Health officials worldwide have also advised the public to check potable water sources as transmission may also occur by ingesting water from contaminated lakes or pools.

In the country, although there are only isolated cases and no reports yet of an outbreak of E. coli infection, health officials remain alert for any new developments regarding the bacterial infection lest it claims more lives. Jordan Mari S. De Leon

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