May 7th, 2010
10:13 AM ET

What you should know about E. coli

By Elizabeth Landau
CNN.com Health Writer/Producer

In the latest food poisoning scare, Freshaway Foods says it's voluntarily recalling certain romaine lettuce products because they may be contaminated with E. coli, bacteria that can be lethal. Read about it on CNN's This Just In.

Most E. coli strains are harmless, but there are strains that cause severe illness. Diarrhea, urinary tract infections, pneumonia and other respiratory illnesses are just some of the consequences of ingesting certain kinds of the bacteria.

The Centers for Disease Control and Prevention says that cases of E. coli 0157, which can lead to sickness, decreased in 2009, CNN reported. But the strain in the latest outbreak is E. coli 0145, a different strain. There are about 76 million cases of food-borne disease in the United States each year, according to the CDC.

During the last year there have been E. coli outbreaks in foods such as ground beef and Nestle Toll House cookie dough.

Contaminated food, unpasteurized milk, water that hasn't been disinfected, cattle, and human feces can all pass E. coli onto you. It's actually small, usually invisible amounts of human or animal feces that spread the infections.

How do you know if you have E. coli? Symptoms include bloody diarrhea, severe stomach cramps, and vomiting. In some cases, there can be life-threatening complications. Web developer Dan Kruse spoke with CNN in 2008 about how he almost died of E. coli as a teenager - read the story.

To prevent the spread of food-borne illness, it's crucial to wash your hands, separate your raw meats and produce from each other, cook to proper temperatures and refrigerate leftovers. Here are more tips from the U.S. Department of Agriculture.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation

soundoff (54 Responses)
  1. kksharma

    It is really strange to note that food items i.e VEGETABLES are contaning POISION,one should now think TWICE BEFORE PURCHASING the vagatables,further so long the CHEMICALS are being used in growing these products,the problem will always remain there, and when some one will buy and eat he/she will get sick and he has run for treatments,adding another COST form one's pocket. The governments should take action againt these GROWERS who are using POISIONS & CHEMICALS unless this problem cannot be solved.

    May 7, 2010 at 11:57 | Report abuse | Reply
    • JC

      FYI: Chemicals are what our food is made up of, and as a matter of fat what our bodies are made up of. TOXINS are what we need to avoid.

      July 7, 2010 at 15:50 | Report abuse |
  2. Cynic

    I am almost 60 years old, and I find it ironic as hell that I never heard of E. coli outbreaks IN THE UNITED STATES until about five years ago. This NEVER happened in my younger years. Not to this extent. My English husband says that heads would fall if the food supply in England ever experienced the outbreaks that just seem to be routine and commonplace in the USA anymore. We are being sold out by the government that is supposed to protect us, and what a surprise! The United States looks more like a third-world country every day.

    May 7, 2010 at 12:01 | Report abuse | Reply
  3. J

    Factory farming, antibiotic use, massive feedlots, slaughterhouse practices... all contribute to spreading bacteria to other food supply systems. We need major reform in this country to stop the current practice of factory farms. It is making us ill and killing people.

    May 7, 2010 at 12:25 | Report abuse | Reply
  4. JS

    I have a question – I have seen conveyor belts at check out counters wet with juices from packaged meat and other animal products that may have been punctured or contaminated on the outside. If I put my lettuce or other salad vegetables on the same belt which never gets wiped, am I contaminating my veges, since I will be keeping them for many more days and eating raw?

    May 7, 2010 at 12:57 | Report abuse | Reply
  5. BillC

    Why don't any of these articles give simple procedure for washing raw vegetables and salad greens, in order to kill E.coli? It's my understanding that a simple solution of water and bleach is all it takes. It would be very beneficial if Dr. Gupts would tell people what proportions to use and how to wash.

    May 7, 2010 at 14:30 | Report abuse | Reply
  6. Sauney

    Everybody needs to do their best to get a little plot of land, We need to grow as much of our own vegetables, herbs, and fruit as we can. There should be adult classes available in communities all over the country teaching the Victory Garden, because many people don't understand what to expect. In addition, it cuts down on trips to the store, saving gasoline. And never eat in any restaurant between 2:00 p.m. and 5:30 p.m. The food has been held too long and it will make you sick.

    May 7, 2010 at 14:39 | Report abuse | Reply
  7. Mark

    There are produce bags in stores for a reason... then wash your vegetables before you eat it. America has one of the safest food supplies especially compared to developing countries. Expecting to buy sterile food at the grocery store is silly. We pay a very low percent of our income for food compared to other countries, and when the FDA would require more funding to increase its ability to inspect manufacturers nobody wants to pay. Sometimes it happens, companies have to cut corners in order to keep food cheap enough for customers to not cry about it. Clean your raw vegetables, and for the sake of your own health, cook your darn food!

    May 7, 2010 at 14:53 | Report abuse | Reply
  8. stephanie


    I'm sure there have been numerous other outbreaks of E. coli and other food-borne bacteria but you didn't hear about them because there wasn't media reporting on it. Food safety regulations and processes have greatly increased in the last couple of decades, but it's hard to protect from everything. There have always been food-borne bacteria and always will be, and people have suffered from diarrhea/vomiting/etc without knowing what caused it. Now they can just put a name to the symptoms.

    May 7, 2010 at 14:59 | Report abuse | Reply
  9. Stan Filbert

    More CAFOs!! I love beef! I must have Beef! It's so cheap and yummy, and it doesn't really hurt the environment. I mean, cows are vegetarian, so they must be healthy. And beef is so good. And the cows are, well, so far away from me that I don't really think about how they're treated, or their little pig buddies either. And every time I see a picture of a cow, like in the supermarket, it's always just peacefully hanging out in some grass field. So they have a good life. Until I eat them, I mean. And boy are they yummy!

    May 7, 2010 at 15:14 | Report abuse | Reply
    • anonymous

      Cows in this country are fed with grain and left over body parts. They need to eat grass only.That's why mad cow disease came about Eat organic, it's free from steroids, growth hormones etc

      August 7, 2010 at 04:19 | Report abuse |
    • Stina

      Taking up most of our land... Yes, killing innocent creatures and calling it the top of a food period despite the fact that high blood pressure, high cholesterol, diabetes, depression and heart disease can be reversed and/or cured/nonexistent by going vegetarian seems to be the 'American way'... Though, I've still experienced E.Coli on my veggies in the regular grocery, don't think I've met an organic vegetable yet that's infected me.

      August 18, 2014 at 13:30 | Report abuse |
  10. Rosey

    So, what would be the best way to "sterilize" salads before consuming it. I live on green salads and now my favorite existence is being threatened......:)

    May 7, 2010 at 15:47 | Report abuse | Reply
  11. Mfp

    Go look up irony in the dictionary, what you're noticing isnt "ironic as hell" E. coli isn't a new thing, people were just ignorant about the root causes of illnesses in your day. 19 people getting sick out of 300M total population is... 0.000006%. Not exactly a huge problem.

    May 7, 2010 at 16:12 | Report abuse | Reply
  12. AJ

    Watch the documentary 'Food, Inc' and support Kevin's Law (http://en.wikipedia.org/wiki/Kevin's_law)

    Seriously, if you aren't eating organic and still eating lots of processed foods, say hello to any number of diseases and health problems.

    May 7, 2010 at 17:19 | Report abuse | Reply
  13. Colin

    I actually grow E.coli for research and have a few of my very own strains, it is important to note that the vast majority of E.coli infections cause very brief food poisoning and are rarely even reported. The reason it may heave been less well known in the past is most likely that the illness was not reported, or not traced to the product. E.coli is incredibly resilient and despite anyones best efforts it still manages to show up in food sometimes

    May 7, 2010 at 22:24 | Report abuse | Reply
  14. Moonbeam

    @cynic: you are right. I believe the past administration has deregulated this country until it is turning into a "third word banana republic." An example: one of the lawyers I used to work for said they put people in jail in Europe for doing to meat what we are allowed to do to it in this country. More regulation would not be socialism - it would just help curb corporate greed and fascism (which used to be known as "corporatism").

    May 7, 2010 at 23:16 | Report abuse | Reply
  15. Moonbeam

    @Mr. Filbert: I too was "addicted" to meat, but it is very acidic in your body. I doubt you'd find it so yummy if you ever watched a slaughterhouse video. But I too have just tried not to think of where it came from because beef was my favorite meat. Also like pork ribs, but pigs are actually even slightly more intelligent than dogs, so I fee bad about eating them. I just feel more peaceful (and healthier) when I don't eat any flesh at all (but the salmon oil I need for my brain because flax doesn't have the same amount of DHA).

    May 7, 2010 at 23:20 | Report abuse | Reply
  16. Just a Mom

    If the public would just rent the movie Food, Inc. a lot of this would be understood! Our 10 year old daughter contracted E Coli 0157:H7 last summer from her first summer camp experience. She spent four days in the isolation unit at the hospital, with hospital staff wearing special masks and gloves every time they entered our room. We didn't find out what it was until the second day and then the head doctor said the only patient she ever had that died on her watch had this particular strain of E Coli. Once she was released, we had to wait and pray for two weeks to go by without her developing HUS (where the bacteria leaves behind a toxin that starts destroying organs). She was very lucky to pull out of it alive. We never thought this could happen to us. If it happened to us, it's just a matter of time until it will happen to you. When it happens to you (if you are lucky enough to survive) will you then be ready to demand changes in our food industry?

    May 7, 2010 at 23:30 | Report abuse | Reply
  17. JR

    Most of the contamination of our own food, eg 'food poisoning' is something that we do to ourselves by poor food handling practices. Yes, it's possible to get contamination in factories and fields, but oftentimes it's the fact that we contaminate ourselves in our own kitchens.

    So before you start railing at food manufacturers, look at yourself and your home. Soap and water on your hands every time you touch food before and after? When you bag your groceries, are the raw meats seperate from everything else? Do you put it on the same shelf in the refer? Are you aware that cantelope can be just as problematic as beef when it comes to e.coli? That your kitchen sink is probably more 'germy' than your toilet?

    Also know that raw food never shows up sterilized. Cook at the right temperatures until food is at the correct temperature for it's type and get those leftovers into the fridge soon after eating. . Raw veggies that are not cooked, need to be washed, but they still can be contaminated because if the plants uptake contaminated water, the bacteria can be INSIDE of the lettuce, etc.

    Not everything can be controlled, but a little microbiology information can go a long way. Learn what you need to know and then do it. Take the time to educate yourself and then the rest is just about crossing your fingers.

    Btw, to JS, yes that 'wet area' on the conveyor belt could be water and then again, it could be meat juices. Some grocery chains will stop and disenfect them but oftentimes they don't.

    Kksharma, e coli is a bacteria, not a 'poison'. It's a naturally occurring bug that lives in the intestine of many animals (including us). Some strains are more virulent than others. Some of the chemicals that are used in food production might be 'harmful' but you're talking apples and oranges when it comes to microorganism contamination. Pesticide and hormone usage is a different topic entirely, unless you're talking antibiotic usage and that would apply. Because you can have organic food that is contaminated with e. coli, too. There are a lot of natural things in the universe that can make you ill.

    May 8, 2010 at 08:10 | Report abuse | Reply
  18. ingnurse

    Ugh. It's not the chemicals that lead to e. coli folks. Improper sewage treatment, even manure used to fertilize can cause this. It's nothing to freak out about. If you're using proper hand hygiene, cooking your meat properly and washing veggies your risks are slashed drastically. If your lettuce says pre-rinsed and ready to eat, rinse it anyways! Also, local produce AND meat is your best bet.

    May 8, 2010 at 11:38 | Report abuse | Reply
  19. Meredith M Preble

    This site will tell you how to wash produce and more:


    May 8, 2010 at 12:55 | Report abuse | Reply
  20. Renee

    There are some interesting questions here, as a microbiologist, I'll try to answer some of them. First, Cynic, E. coli O157:H7 was first discovered as a pathogen in the 1980's. It has taken time for medicine to catch up with being able to track and diagnose it. That may be part of the reason you haven't heard of it your entire life. Also, outbreaks are sometimes of the small, "church picnic" kind, sometimes the larger national kind such as the tollhouse cookie dough fiasco that you heard about.

    BillC, a 10% bleach solution will kill everything, and you can use that for cleaning. Hot water and vigorous washing will work for your veggies, as will a vinegar solution.

    JS, you have a point about contamination of veggies by juices from uncooked meats. However, folks need to know that not all meat carries E. coli O157:H7. This bacteria lives only in the rectum of cows (and people who are sick, and carrying it), and so some meat may get contaminated in the meat packaging process. And as the article pointed out, feces are another carrier which is how it gets transferred. It is better to be safe and wash your veggies, but most of the time the conveyor belts are not swarming with E. coli O157:H7 (let's hope). I agree, though, they should be cleaned.

    May 8, 2010 at 17:52 | Report abuse | Reply
  21. BK

    The problem with Americas food supply is that is too sterile. My dog can eat Goose Feces off the ground and some how stomach it but americans coddled stomachs are so weak any sort of minimal bacteria can cause major damage. Somehow the Mexicans have no problem drinking their own water, but Americans cannot tolerate it? The problem here is being too clean and not allowing your body to build up a reasonable amount of tolerance to almost unavoidable circumstances. I never wash my hands and im never sick, food poisoning that would put someone else in the hospital just gives me a mild stomach ache.

    May 8, 2010 at 18:32 | Report abuse | Reply
  22. P-Tricky

    Read The Omnivore's Dilemma and learn a whole bunch about E. coli and your food. A lot of people on the comments seem to be referencing the book. Many strands of E. coli are from many years of feeding cattle corn (rather than grass) and pumping them full of antibiotics because a corn-fed diet is unnatural for a cow. A cow's stomach is not programmed to digest corn. Do some research and read the book. Some interesting reading at the least even if you aren't convinced.

    May 8, 2010 at 19:09 | Report abuse | Reply
  23. Typical lazy govt employee :)

    If you only know that the Food and Drug Administration only has the funding to test approximately 3 percent of the foods in the country you might not complain out them "selling you out." The govt. is in trillions of dollars in debt, Americans are complaining and rightfully so, but then the budget for doing this regulatory testing is cut. Sadly, we can have everything we want or need. But the CDC, FDA, UDSA and State and local regulatory systems are trying. You have to realize, we eat this stuff too!!!! Everyone hates govt intervention until something like this happens then they are not doing their job. Push you representatives for more funding or the laws that allows us jurisdiction to punish those who produce poor quality products without bureaucrats stopping the cases. Or just do some research before you complain about something you know nothing about.

    May 8, 2010 at 21:54 | Report abuse | Reply
  24. Sonya

    Wow! Another outbreak! How many have their been in the past few years. To many to count. I was poisoned myself several times by eating peanut butter 3 years ago before I realized what was making me so sick. Unfortunately I had an early pregnancy that failed. I still blame it on the salmonella that I injested several times while I was pregnant. It's disgusting what is happening to our food supply because our government refuses to do more to protect us. Every time you put something in your mouth that was purchased at a grocery store or go to a restaurant to eat, it's like playing Russian Roulette with your health. Don't we have enough to worry about already without having to worry about poison food too?

    May 8, 2010 at 23:08 | Report abuse | Reply
  25. ryon

    Actually E.coli is an indicator of fecal contamination, E.coli is used because the tests for it are cheap, fast and easy, so there are other things that you should be worred about like, food that has feces and whatever the feces has in it. I would not be worred about e.coli that is on the lettuce per say but the other things such as HEP virsus for one, how about giardia, or cryptosporidium. A good rinse will wash off most material, a wash and soak in light beach solution and a second wash with tap water will get most of the other stuff, but is not a cure all for everything. Be aware, know your supplier and do more than eat the status quo.

    May 9, 2010 at 01:19 | Report abuse | Reply
  26. Andrea

    A few years ago I was travelling and managed to be infected by e-coli. It was the most horrendous experience I have ever had. At first, I didn't realize what the problem was – I just assumed the change in food and water was affecting me. My fiance and I were scheduled to go on a day trip, so I unsuspectingly took some medication, and we went on our way. By the tme we got back to the hotel, I had a fever and was sick to my stomach. The real trouble was yet to come, and as a result I was hospitalized. The moral of the story: if your body is rejecting something, just let it happen....do not take any medication to suppress it; you will end up doing more harm than good.

    May 9, 2010 at 04:38 | Report abuse | Reply
  27. Cheryl Lee

    my son almost died from HUS, complication of e.coli, twenty years ago. He ate hamburger purchased from a local farmer who raised cows "organically". Don't ever assume it you buy your meat that way you are protected. The bacteria could have happened where the meat was processed or from the organic methods used to raise the cow. And I did not cook it well done – 20 years ago there was not the publicity we have now regarding how important that is. Anyhow, after being in the life support unit for 30 days, undergoing multiple blood transfusions, being on peritoneal dialysis with nurses working on him round the clock, and being blessed with the appropriate medical care at children's hospital, my son survived – and not only survived but thrived. He is a 25 year old adult today living his life to the fullest. Be careful – better yet, do not eat ground beef unless it is burned to a crisp – or better yet, don't eat it at all.....................concerned mom

    May 9, 2010 at 07:47 | Report abuse | Reply
  28. WTF

    @ Stan Filbert – LOL. That was one of the funniest comments I've ever read on a forum ๐Ÿ˜‰ Oh and yes, they're very yummy. hehe

    May 9, 2010 at 07:51 | Report abuse | Reply
  29. Denise Kling

    Thirty some years ago, I knew a family of five who was told by a doctor that their illness was due to food being handled by people who had not washed their hands after using the restroom. (This particular family ate take-out food all the time.) Their doc said, also, that he'd seen a lot of this type of illness for years. Nobody called it E. coli back then, but I'm sure that's what it was; E. coli is nothing new, we just know what to call it now.
    To avoid ingesting the E. coli bacteria simply eat out less, eat take-out food less, and wash your hands well before handling food. Also, stop using anti-bacterial soap to wash your hands (unless you're performing surgery). People's immune systems become stronger if they are exercised by fighting off some bacterias. I've believed this for years, and now doctors are telling patients this very thing.

    May 9, 2010 at 10:46 | Report abuse | Reply
    • Shante's mom

      I have had food poisening twice in my life. Both times it was from a restaurant. I never eat fast food. But be sure, I am ex-tremely careful of how I handle my food at home. Right now I have a son that is back home for a while and I have to wash everything he washes. He thinks I'm nuts because I insist on hot, sudsy water for washing and hot water for rinsing. You only have to be sick from food once to know you never want to experience that again.

      July 15, 2010 at 12:55 | Report abuse |
  30. brad1001

    "America has one of the safest food supplies especially compared to third world countries" ? Really? Why isn't that comforting to know? I'm doing my best to grow and can and pickle my own. Corporate farming is making us sick.

    May 9, 2010 at 10:55 | Report abuse | Reply
  31. Mark

    Take some responsibility!! It isn't up to our government to pass legislation and new, expensive to administer laws and guidelines, just wash, cook and properly store/handle your food! This isn't rocket science, just basic food handling practice. This culture of "protect me from myself" that people are embracing is why our expensive, bloated government is in the mess it's in, and why more and more people work for our government (see also "tax burden") rather than actually producing something of value for our economy.

    May 9, 2010 at 12:24 | Report abuse | Reply
  32. Ugh

    The e coli outbreaks from vegetables are often (usually?) a result of the rivers of poop running from factory farms (CAFOs) of cattles, chicken, etc. And yes, you bet, chicken poop CAN have e coli in it. Washing vegetables will not get rid of some strains of e coli if the vegetables have been grown using water contaminated by these CAFOs. The deadly outbreak in Locust Grove Oklahoma a few years ago was likely a result of wells contaminated by chicken poop from the Tyson chicken factory farms in that area. The only safe way to eat vegetables in this country anymore are grow your own or cook them long enough to kill any possible contaminates. Sad state of affairs, but this is what happens when factory farms and the beef and chicken industry rule our agricultural system.

    May 9, 2010 at 13:43 | Report abuse | Reply
  33. Jack

    This was probably the most useless blog entry I've every encountered. Synopsys: "Hey everybody, you can get sick! Hey, wash your hands and food!" No mention of how e-Coli gets onto the food. No mention of how the food processors can change their methods to prevent e-Coli. No mention of how resturants can change their methods to prevent e-Coli. No facts on where is the most common place to get e-Coli ... step it up!

    May 9, 2010 at 14:08 | Report abuse | Reply
  34. Julia Gangloff

    Watch "Food, Inc." on PBS for an education on our food system. You will learn why it is important to be on guard, even though you haven't been sick in the past.

    May 9, 2010 at 15:20 | Report abuse | Reply
  35. marysue3

    doesn't a good rinse remove the e-coli?

    May 10, 2010 at 11:42 | Report abuse | Reply
  36. Randolph

    I sometimes wonder if our drive to be "ultra-sanitary" is starting to have a negative effect on our health; in certain instances. E. Coli has been around longer than we can imagine. Yet, in the past it would seem we had a somewhat natural immunity to the malicious E. Coli since we would usually come in contact with it in some way and our immune systems would ultimately be able to recognize the bacteria and fight it off before it could cause serious harm to us. Just think, you really don't hear of E. Coli outbreaks in the 50s and 60s when America was predominately farmland; not to say they never happened – just that they would be more infrequent. Yet, using manuere for crops has been going on for hundreds of years. Now people are ultrasanitary. But that extra sanitation deprives our immune system of coming in contact with foreign invaders that it would otherwise learn how to deal with. So, maybe a little dirt ain't that bad after all.

    May 11, 2010 at 13:35 | Report abuse | Reply
  37. Mama Girl

    Seems to me that not many who have commented here have seen the conditions and circumstances on farms. Farm workers do not always have access to modern facilities (read: restrooms). So, guess where they relieve themselves. Yes, the fields. That contributes to contamination. We have eaten very fresh produce in this home for years, but because I grew up in an agricultural area and watched this happen, we always, always wash our produce very carefully. We use hydrogen peroxide followed by vinegar, and then we rinse thoroughly. We don't use commercial "cleaners," because those contain more chemicals. We soak our leafy greens in a solution of one part vinegar to three parts water for ten minutes. Take the time to wash your produce, folks. It can mean the difference between health and illness. In over 10 years of using this procedure, we've only had one incident that might have been linked to food-borne illness - when we trusted packaging that said "Prewashed." Never again.

    May 11, 2010 at 18:39 | Report abuse | Reply
  38. Gretchen Vickery

    I wish some of the scientists contributing to this discussion would explain how the e. coli gets into produce like lettuce by absorbing tainted water. I would have thought that water would be absorbed by osmosis through the membrane of the roots and that that would be a barrier to non-soluble organisms? When we lived in Africa many years ago, we washed all our produce in a weak solution of potassium permanganate – "pinky water" it was called – because local farmers used manure for fertilizer – it was all they had. We never got sick so it must have worked – wonder if it is still a good idea?

    May 18, 2010 at 16:12 | Report abuse | Reply
  39. judy bell

    Can vegetables become contaminated with ecology if planted on a sandmound.

    May 25, 2010 at 00:15 | Report abuse | Reply
  40. s.ramesh babu

    dear dr i am a poultry farmer i am directly involved in farm work for the past 20 years and my farm birds have ecoli will ecoli affect me kindly answer me thro my email thank you by ramesh babu.s

    September 29, 2012 at 03:21 | Report abuse | Reply
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    For good health, it is important that you eat a balanced and varied diet. Follow carefully any diet program your health care professional may recommend. For your specific dietary vitamin and/or mineral needs, ask your health care professional for a list of appropriate foods.;.,.

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