By: Ryan Robinson, PhD

As calls are coming in concerning the latest E. coli outbreak related to The Chicken & Rice Guys, we are fielding a lot of FAQs. We at UnsafeFoods have made a handy list of fast facts for anyone needing more information about E. coli. Without further ado…


  • What is Ecoli?

Escherichia coli, or E. coli is a tiny, rapidly-growing, rod-shaped bacterial organism that is present in nearly every environment on Earth. Most E. coli strains are harmless, and some are even beneficial. In fact, non-pathogenic E. coli is found among the natural gut flora in healthy adults, where it aids metabolism by producing Vitamin K.

Some E. coli strains are pathogenic and harmful. Contact with pathogenic E. coli can result in infection and serious illness. The most severe E. coli infections are life-threatening and may require hospitalization.

  • How do pathogenic coli strains cause illness?

The most common form of illness caused by E. coli is bacterial enteritis. Bacterial enteritis is caused by harmful pathogenic strains of bacteria growing in the gastrointestinal tract. Diarrhea, stomach cramps, vomiting, and other symptoms of foodborne illness are a result of the body attempting to purge the infectious organisms.

Particularly virulent strains of E. coli produce dangerous toxic compounds (toxins). These toxins disrupt a variety of normal physiological and metabolic functions, and may result in serious illness requiring hospitalization.

  • What is E. coli enteritis?

 E. coli enteritis is the most common cause of “Traveler’s Diarrhea”. It is among the most prevalent forms of foodborne illness in the world. The primary symptoms of E. coli enteritis are stomach cramps, diarrhea (with or without blood), fever, nausea, and vomiting.

E. coli enteritis is the direct result of a pathogenic E. coli infection in the gastrointestinal tract, and is generally caused by consuming food that has been improperly handled.

  • What is STEC/Shiga Toxin?

Shiga toxin is a toxic compound produced by several different bacterial strains, including E. coli strain O157:H7. E. coli strains that produce Shiga toxin are known as Shiga Toxin-producing E. coli, or STEC.

Shiga toxin has been classified as a bioterrorism agent by the United States Centers for Disease Control and Prevention.

Shiga toxin blocks protein synthesis, and exposure to Shiga toxin (often through E. coli infection) can result in a dangerous and potentially life-threatening condition known as Hemolytic-Uremic Syndrome.

  • Is E. coli the same thing as Salmonella?

No, despite presenting very similar symptoms (diarrhea, abdominal cramps, fever), Salmonella and E. coli are two entirely separate types of bacteria. Both infections are usually the result of consuming food that has been improperly handled. 

  • What is O157 / O157:H7?

The O157:H7 strain, often referred to as just O157,  is a strain of Shiga toxin-producing E. coli that is particularly dangerous. O157:H7 has been identified as the causative agent in several [1, 2, 3] national outbreaks of foodborne illness.

O157:H7 is particularly virulent, and results in a far higher incidence of hospitalization and fatality than non-STEC pathogenic E. coli strains.

  • How do you contract a pathogenic coli infection? / How do you prevent it?

According to the Mayo Clinic, Most E. coli infections are the result of consuming food that was mishandled (stored at the wrong temperature, not cooked or washed properly, or contaminated).

Other risk factors include working with or around livestock, and direct contact with bodily fluids from other infected individuals.

It is fairly common for adults to contract pathogenic E. coli infections by handling bodily fluids from infected children.

The best way to avoid a pathogenic E. coli infection is to wash your hands regularly, clean all produce thoroughly, and make sure that any meat you consume is cooked to a proper temperature.

  • How dangerous is Ecoli?

Most strains of E. coli are completely harmless. Even most pathogenic strains, which result in illness and severe discomfort, are not likely to result in hospitalization or fatality in healthy adults.

Foodborne illness and E. coli infections should not be taken lightly, though. Some strains of E. coli, like O157:H7 and other STEC strains, can be very dangerous. The CDC estimates that O157:H7 results in about 60 deaths annually.

  • How prevalent are Ecoli enteritis / severe E. coli infections in the United States?

That’s very difficult to say.

Most cases of E. coli enteritis go undiagnosed because they do not cause symptoms that are severe or persistent enough to prompt medical intervention. Even in the event of hospitalization, an E. coli infection may not be specifically differentiated from another bacterial strain, or any other cause of foodborne illness.

In the event of large regional or national outbreaks the CDC and other public health organizations may track incidences of infection to identify a specific source. A list of identified public outbreaks is published by the CDC here.

Incidents of infection that are caused by several specific, highly virulent strains of E. coli are meticulously tracked by the CDC and World Health Organization. For example, the CDC estimates that the O157 strain infects about 73000 people annually.

  • How do I know if I have an Ecoli infection?

Only a licensed healthcare provider can diagnose an E. coli infection. Because most infections do not require intervention, you may not know if E. coli or another organism is causing your symptoms.

If you have severe symptoms consistent with an E. coli infection, or if you have eaten at a restaurant or consumed food that was the source of a recent outbreak, you should consult a physician or another licensed healthcare provider for medical advice.

  • Who is most at risk from coli enteritis/foodborne illness?

Foodborne illness is a risk that everyone faces. Virulent strains of E. coli like O157:H7 can cause serious symptoms, even in healthy adults.

Some individuals are at a particularly high risk for foodborne illness. As with most other infections, foodborne illnesses are very dangerous for young children, the elderly, and anyone with a suppressed immune system.

  • How is an Ecoli enteritis treated?

Current guidelines generally indicate a “watch and wait” strategy for managing non-serious cases E. coli enteritis. As with other infections that result in diarrhea and vomiting, it is important that infected individuals stay hydrated and get plenty of rest.

Antibiotics and anti-diarrheal medications are not generally suggested for treatment of E. coli enteritis, as they may exacerbate or prolong the infection.

To avoid spreading the infection, special care should be taken when handling bodily fluids from infected individuals, and family members should employ good handwashing practice.

In the event of a severe infection resulting in complications like Hemolytic-uremic syndrome, hospitalization may be necessary, and supportive care (IV fluids/dialysis) may be administered by trained medical personnel.