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Report: E. Coli in New Orleans

A New Orleans official says that E. coli bacteria have been found in the floodwaters of New Orleans, according to reports Tuesday.

Though this hasn’t been confirmed, it would be of no surprise given the health circumstances in the area. E. coli bacteria are found in abundance in human stool.

So what does it mean now that E. coli has reportedly been found?

What is E. coli?

Escherichia coli (E. coli)is a bacterium that normally lives in the intestines of people and animals. Most strains of E. coli are harmless. They are simply part of the normal intestinal bacteria. However, there are some kinds of E. coli that are capable of causing disease.

Depending on the type of E. coli, symptoms of infection most commonly include severe, potentially bloody, diarrhea. A particular strain, called E. coli 0157:H7, produces a powerful toxin that can cause a potentially deadly infection with bloody diarrhea and kidney failure.

Other symptoms include fever, feeling very ill, severe dehydration, and abdominal cramps.

Who is most likely to get E. coli?

Although E. coli can cause disease in people of any age, it severely strikes the very young (children under age 5) and the elderly. Infection usually appears within 24 hours of ingesting the bacteria.

What causes E. coli infection?

E. coliinfection is caused by coming in contact with contaminated food or water. Therefore, conditions such as in the New Orleans area would be ripe for such an infection.

Infection can also occur after swimming in or drinking sewage-contaminated water.

Though unusual, previous outbreaks of E. coli have occurred at water parks where children have become ill from swimming in contaminated water as well as large gatherings where people have come in contact with contaminated food.

How likely are the people in the flooded area to get E. coli infection?

“The E. coli that’s going to be in that water is unlikely the E. coli that causes some very severe illnesses that we read about with the infected ground beef and stuff like that. It’s a different situation,” says George Jackson, MD, director of employee occupational health and wellness at Duke University in Durham, N.C. “You’ve got sewage treatment that is obviously broken down and is not functional, and so the normal E. coli that all of us have inside of us is out there in the water. And that’s primarily an indicator of dirty water, more so than necessarily a big-time pathogen.”

What should people in the area do to prevent E. coli infection?

“No. 1, try to keep the water out of your mouth,” Jackson says. “We’re surrounded byE. coli all the time, and for the most part, as long as you don’t ingest it, you’re going to do just fine. If you ingest E. coli, there’s not a whole lot you can do about it after the fact, and there’s certainly no vaccination or anything of that nature.

“The real trick there, obviously, is … if you’re going to that area you want to make sure that you know how you’re going to get clean water for yourself because that’s probably in short supply.”

How is E. coli diagnosed?

During the early phase of infection, large numbers of E. coli are excreted in the feces. Contaminated feces samples can be examined in the laboratory for diagnosis for infection-causing strains of E. coli.

How is E. coli infection treated?

The greatest concern in treating E. coli infection is to replace the fluids and electrolytes lost in the diarrhea. This can be done by mouth or by intravenous (IV) therapy in severe cases.

Antibiotics are also used to treat certain strains of E. coli.

In general, how can E. coli infection be prevented?

Since E. coli is more common in developing countries where sanitation is not as stringent, it’s best to be particularly careful when traveling to certain areas.

--Be careful about what fluids you drink. Drink mineral and other processed water. Drink bottled beverages. Drink fruit juices.

--Be careful about what foods you eat. Eat breads. Eat only fruits and vegetables that can be peeled. Eat foods that are served steaming hot.

E. coliis one of the many reasons that restaurants often have a sign reminding employees to wash their hands before leaving the restroom.

If people have to walk through the floodwater, are there other things they should do?

Jackson says, “It would be a luxury, probably, to be able to wash your legs and pants off once you got out of that water so that you’re not dragging that contaminated whatever around with you. If people have open lesions on their legs and their skin, and so forth, the potential for that to get infected is increased a bit.

"Again, that varies with the individual. If the person has diabetes, I would encourage them not to get involved in something like this because they’re setting themselves up for problems. The average individual that’s healthy otherwise is going to be able to walk in all sorts of nasty muck and they’ll do just fine. Their legs will get wrinkled and white because they’re in the water all that time, but they won’t necessarily get any dreaded diseases from that.”

What else might be in the water because there is E. coli there?

Could there be hepatitis A?

“Sure. Water is a great conveyor of hepatitis A,” Jackson says. “And so if the E. coli represents fecal material from Sam Jones and Sam Jones has hepatitis A as well, then that water is also going to be infected with his viral illness. And so it’s more of an indicator that the water is very dirty.”

By Michael W. Smith, MD, reviewed by Brunilda Nazario, MD

SOURCES: MedicineNet.com, a WebMD company. CNN. CDC. George Jackson, MD, director of employee occupational health and wellness, Duke University, Durham, N.C.