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Bacterial & Viral Infections

E. Coli

Lea este articulo en EspanolThere’s nothing like a hamburger with all the trimmings when you’re hungry or a cool, refreshing cup of juice on a hot day. But when that burger is undercooked or the juice is not pasteurized, it could cause a nasty E. coli infection.

Infections due to Escherichia coli bacteria can cause severe, bloody diarrhea. Some cases can even result in kidney failure or other serious complications.

Luckily, most healthy kids who get the infection do not develop serious problems and recover on their own without needing treatment.

How It Spreads

Some strains of E. coli are harmless and live naturally in human intestines. Others, such as E. coli O157:H7, are infectious and spread through contaminated food or water, or from other infected people or animals.

Most often, E. coli spreads when someone eats food that contains the bacteria. At-risk foods include undercooked ground beef (such as in hamburgers); produce grown in animal manure (of cows, sheep, goat, or deer) or washed in contaminated water; and unpasteurized dairy or juice products.

The bacteria also can spread from person to person on unwashed hands and surfaces, by swimming in contaminated water, and from touching animals at farms or petting zoos.

Symptoms & Complications

Some types of E. coli bacteria make a toxin (a poisonous substance) that can damage the lining of the small intestine. This can lead to bad stomach cramps, vomiting, and diarrhea (often with blood in it). When that happens, people can get dehydrated.

Symptoms usually start 3-4 days after exposure and end within about a week. An infection is contagious for at least as long as the person has diarrhea, and sometimes longer.

Most kids recover completely, although some develop a serious kidney and blood problem called hemolytic uremic syndrome (HUS). Signs of HUS include decreased urination (peeing), a pale or swollen appearance, unexplained bruises, bleeding from the nose or gums, extreme tiredness, and seizures. HUS can be life threatening and requires treatment in a hospital.


A doctor might take a stool sample to look for E. coli bacteria. Blood tests may be used to check for possible complications.

Antibiotics aren’t helpful in treating infections caused by E. coli O157:H7 and can, in fact, be harmful. Likewise, anti-diarrheal medicines can increase the risk of complications and should not be used.

Kids with an E. coli infection should rest as much as possible and drink plenty of fluids to avoid dehydration. Those who are dehydrated might need to be hospitalized to get IV fluids, and those with HUS may need dialysis for kidney failure and/or blood transfusions.

While recovering from an infection, kids can resume normal activities after two stool cultures are free of the bacteria. Don’t let kids use swimming pools or water slides until 2 weeks after their symptoms have gone away.


E. coli outbreaks have been tied to a wide variety of foods, such as fresh spinach, hamburgers, ground beef, bologna, hazelnuts, packaged cheeses, shredded lettuce, and prepackaged cookie dough.

Being careful about safe food preparation can go a long way toward protecting your family from E. coli infections:

  • Cook meat thoroughly until it reaches a temperature of at least 160ºF/70ºC at its thickest point.
  • Thoroughly clean anything that comes into contact with raw meat.
  • Choose pasteurized juices and dairy products.
  • Clean raw produce well before eating.

Teach your kids the importance of regular, thorough hand washing, especially after going to the bathroom, touching animals, or playing outside, and before eating or preparing food. They should avoid swallowing water while swimming.

When to Call the Doctor

Call your doctor if your child has any symptoms of an E. coli infection, especially stomach pain or persistent, severe, or bloody diarrhea.

Call immediately if your child shows signs of dehydration, such as decreased urination. Also call immediately if your child has signs of hemolytic uremic syndrome, especially after a recent gastrointestinal illness.

Reviewed by: Larissa Hirsch, MD
Date reviewed: July 2014