E. coli-tainted romaine lettuce threatens the frail, sick most

(HealthDay)—U.S. health officials have warned all Americans to stay away from romaine lettuce this holiday season, due to potential contamination with E. coli.

So far, 32 people across 11 states have been sickened. Although no one has died, illnesses have been so severe that in 13 cases patients had to be hospitalized, the U.S. Centers for Disease Control and Prevention said Tuesday.

So who's most at risk from E. coli?

Dr. Robert Glatter is an emergency physician at Lenox Hill Hospital in New York City who's seen the effects of infection with the gastrointestinal bug firsthand. It's not a minor ailment, he said.

"In general, symptoms of E. coli infection generally begin about three to four days after consuming the bacteria, and may include abdominal cramping, nausea, vomiting, and watery or bloody diarrhea, along with fever," Glatter said.

And while healthy people who battle a bout of E. coli typically recover within five to seven days, the illness can be more protracted—and even deadly—for people already made vulnerable by chronic disease or advanced age.

"People with diabetes, kidney disease or those with cancer or autoimmune disease run the risk of a more severe illness," Glatter explained.

The particular strain of E. coli detected in the current lettuce outbreak—E. coli O157:H7—is particularly nasty, he noted.

"Most strains of E. coli do not actually cause diarrhea, but E. coli O157 produces a powerful toxin that injures the inner lining of the small intestine, leading to bloody diarrhea," Glatter said. Even a tiny amount of ingested bacteria could spur this type of illness.

"It can make people much more ill, and may lead to hemolytic uremic syndrome, a type of kidney failure, in some cases," he said.

Indeed, the CDC has reported one such case already in the latest outbreak.

In many cases, antibiotics are used to help beat back an E. coli infection, but these drugs can affect the kidneys, Glatter noted.

"Antibiotics may be necessary in certain cases, so it's important to see your doctor if you have continued and severe symptoms such as fever, bloody diarrhea, and you are not able to eat or drink," he said.

However, in the case of E. coli O157:H7, "taking antibiotics may actually increase your risk of developing kidney failure, so it's important to speak with your health care provider if you should develop severe symptoms," Glatter advised.

And if you do think you might be sick with E. coli, or any other foodborne illness, make sure you don't spread it to those near you.

The bacterium "can be transmitted person-to-person, so it's vital that anyone who is potentially infected wash their hands thoroughly and not share utensils, cups or glasses," Glatter said. "This also goes for bath towels. Linens also need to be washed in hot water and treated with bleach."

He noted that "ground beef, unpasteurized milk, fresh produce, and contaminated water are common sources of E. coli bacteria."

As for the current outbreak, cases have so far been reported in California (10 cases), Connecticut (1 case), Illinois (2 cases), Massachusetts (2 cases), Maryland (1 case), Michigan (7 cases), New Hampshire (2 cases), New Jersey (3 cases), New York (2 cases), Ohio (1 case) and Wisconsin (1 case).

The U.S. Food and Drug Administration noted that romaine lettuce typically has a shelf life of about 21 days, so contaminated produce could still be on store shelves or in people's refrigerators. For that reason, "consumers throughout the U.S. should not eat romaine lettuce until further notice," the agency advised.

The exact source of the outbreak remains unclear, but tests are being done on romaine lettuce throughout the U.S. market.

"The quick and aggressive steps we're taking today are aimed at making sure we get ahead of this emerging outbreak, to reduce risk to consumers, and to help people protect themselves and their families from this foodborne illness outbreak," FDA Commissioner Dr. Scott Gottlieb said in an agency news release on Tuesday. "This is especially important ahead of the Thanksgiving holiday, when people will be sitting down for family meals."

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