E. Coli Infection in Children

E. coli is commonly found in the intestines of people and animals; the bacteria is also rampant in the environment and food. But some types of E. coli can prove harmful causing severe illnesses. Let us find out more about the disease-causing E. coli and learn how to protect children from it.

What is E. Coli Infection

Escherichia coli (E. coli) is a group of bacteria present in the intestines of both humans and animals that help to break-down and digest food eaten. But some strains of E. coli bacteria are infectious and spread through contaminated food, water or other infected people or animals. E. coli is a concern among parents as when it is contracted by children it could cause a host of infections like diarrhoea, respiratory illness, urinary tract infections and blood infections.

What Causes Escherichia Coli Infection

By ingesting a small amount of E. coli from raw food or contaminated water, one could easily fall prey to the bacteria. Potential sources of E. coli infection are:

1. Contaminated Food

One of the most common forms of acquiring an E. coli infection is by eating contaminated food such as beef, unpasteurized milk and fresh produce. When cattle are slaughtered and processed, the bacteria in the intestine can get into the meat and contaminate it. Bacteria on the cow’s udder or milking equipment could get into raw milk. Fresh produce like spinach and lettuce could be contaminated by cattle farms in the vicinity.

2. Contaminated Water

Faeces from humans and animals could pollute groundwater including rivers, lakes and water used to irrigate crops. Municipal water supplies, private wells, rural water supplies run a risk of being contaminated even though have been treated with disinfectants. Swimming pools are also a place where people can be contaminated.

3. Personal Contact

Several outbreaks of E. coli have been linked to visits to the zoo and barns where children pet animals. Infected adults and children could transmit the infection if they don’t wash their hands properly.

4. Improper Handling of Food

Unhygienic and unsafe handling of food and other aspects related to preparation of food could cause contamination. Failure to wash hands before preparing food, dirty utensils, chopping boards, expired dairy products or foods not stored at the right temperature could cause contamination.

Risk Factors of E. Coli

Although E. coli could affect anyone exposed to the bacteria, there are some people more likely to develop problems than the rest. Risk factors include:

1. Age

Young children and older adults at a higher risk.

2. Weak Immune System

People with a weak immune system or those suffering from terminal illnesses could become ill from ingesting E. coli.

3. Consumption of Certain Foods

Uncooked meat, unpasteurized milk or expired food products could pose a risk of infection.

4. Certain Seasons/Time of the Year

An outbreak of E. coli generally happens during the monsoon season between June to September.

5. Decreased Levels of Stomach Acids

Stomach acids offer protection against E. coli and if you are taking medication that decreases the production of acids, you could find yourself susceptible to E. coli infection.

Signs and Symptoms of E. coli Infection

Although E. coli mostly affects the intestines, it can affect other parts of the body as well. The following points explain the various signs and symptoms of an E. coli infection:

1. Symptoms of E. Coli in Urinary Tract

Uropathogenic E. coli that live in the colon are responsible for urinary tract infections. They are usually transferred when children clean from the back to the front i.e. when children clean the anus first, and then their genitals; this leads to the E. coli (that is commonly found near the anal opening) to be brought in contact with the urinary opening (near the genitals). From here, the bacteria move to the bladder and kidneys resulting in the following symptoms:

• Constant urge to urinate
• Burning sensation while urinating
• Fever and chills
• Pain in the abdomen, hips or lower back
• Urine that may be cloudy or bloody

2. Symptoms of E. Coli in Brain

The K1 strain E. coli is responsible for meningitis in the brain. Newborns could get infected at birth or later from the hospital or home. Most common symptoms include:

• Difficulty in breathing
• Diarrhoea
• Lethargy and irritability
• Either very warm or very cold skin
• A protrusion on the head
• Refusal to feed

3. Symptoms of E. Coli in Lungs

E. coli can cause bacterial pneumonia and the common symptoms include

• Fever
• Chills and shivers
• Shortness of breath
• Chest pain while breathing or coughing
• A cough with phlegm

4. Symptoms of Intestinal E. Coli Infection

Strains of E. coli bacteria mostly affect the intestine and symptoms manifest within seven days of contracting the infection. Symptoms include:

• Starts with stomach cramps leading to watery diarrhoea
• Watery Diarrhea lasts for about a day
• Bright Red stools for the next few days
• Approximately 10 bowel movements in a day
• Lethargy and irritability
• Fever, weakness and vomiting

Diagnoses and Tests for E. Coli Infection in a Child

Your doctor will start the diagnosis of E. coli with a physical examination that involves

• Monitoring child’s temperature
• Checking blood pressure and pulse
• Checking the skin for paleness
• Checking the stomach for tenderness
• A rectal exam to check for blood in the stool

Your doctor will also ask several questions about the duration of diarrhoea, the presence of blood in stools, fever and nausea from the time your child experiences symptoms. Your doctor will suggest the following tests if he suspects the presence of E. coli bacteria

1. Stool Culture

A stool sample to be submitted to the pathologist from the moment your child experiences symptoms to determine the strain of E. coli.

2. Urine Test

A urine test will be recommended to ensure the child does not acquire HUS.

3. Blood Test

An E. coli infection could give rise to blood complication like septicaemia in children and a doctor will recommend a blood test to rule out any harmful effects.

4. Rapid Enzyme Immunoassay

A non-culture test prescribed for determining STEC infection. The test is available only in big laboratories and hospitals so it is unlikely that your doctor may prescribe it.

5. Imaging Tests

If a child develops a UTI infection, the doctor may perform a rectal ultrasound and voiding cystourethrography.

Types of Intestinal E. Coli Infection

Here are some of the strains of E. coli bacteria that infect the intestine:

1. Enterotoxigenic E. Coli

Also called traveller’s diarrhoea, this strain of bacteria attaches itself to the intestinal cilia and produces toxins that cause diarrhoea and fever

2. Enteroinvasive E. Coli

This serotype of E. coli infects the lining of the colon, causing fever and diarrhoea.

3. Enteropathogenic E. Coli

This pathotype of E. coli is common in developing countries and causes watery or bloody diarrhoea in infants.

4. Enteroaggregative E. Coli

This E. coli strain form clumps on the intestinal lining and uses the toxin to prolong diarrhoea and is common among children.

Health Problems due to E. coli Infection

Some common health issues related to E. coli infection are as below:

1. Hemolytic Uremic Syndrome (HUS)

HUS is a complication of E. coli that is characterised by a low red blood cell count (haemolytic anaemia), low platelet count (thrombocytopenia) and kidney damage (renal failure). Symptoms include tiredness, bleeding due to low platelets, less urination, oedema or swelling and weight gain owing to kidney failure. It is surprising to note that diarrhoea treated with antibiotics could post a risk for developing HUS. Electrolyte replacement, blood transfusion and dialysis are some common treatments used to treat HUS.

2. Urinary Tract Infection (UTI)

E. coli in babies urine could lead to urinary infections. If a child develops UTI due to E. coli, he will be prescribed antibiotics for treatment. Common medications prescribed are ciprofloxacin and trimetho-primp sulfamethoxazole. However, if the child is resistant to the above drugs, more aggressive treatment will be needed with the help of stronger antibiotics such as fosfomycin and nitrofurantoin. UTI’s are generally treated with oral antibiotics and only if a child does not have vomiting as a symptom. The course of treatment is for about 10 days.

Treatment for E. Coli Infection

In most cases, E. coli is not treated with medication and left to be treated on its own. Doctors generally let the illness take its course. However, the doctor will monitor the child during the infection to ensure it does not worsen or lead to HUS. It is important for you to monitor the symptoms such as check the blood in the stool, monitor the number of bowel movements and check for any bleeding or other symptoms. E. coli toddler treatment generally includes adequate rest, intake of lots of fluids in the form of water or electrolytes to prevent dehydration. In cases of dehydration, doctors may put the child on IV fluids. It is also important to follow a light diet constituting of rice, low-fat foods, and fruits and avoid spicy foods. Do not administer any medicines for diarrhoea unless suggested by the doctor.

Ways to Prevent E. Coli for Parents and Kids

There are several precautionary measures that kids and parents can take to prevent contracting E. coli:

1. Washing Hands

It is important for both parents and kids to wash their hands after they use the bathroom or change diapers.

2. Ensure Proper Hygiene while Preparing Food

It is important to wash vegetables and meat thoroughly as this will destroy the bacteria. Do not prepare food if you are suffering from stomach ailments.

3. Clean Surroundings and Kitchen

Make sure your kitchen top is clean and has no stains of left-over food. Clean your toilets as it is a common place where bacteria spreads. Do not store raw meat with ready-to-eat food items.

4. Drink Clean and Treated Water

Make sure that your boil water or invest in a water filter that will filter the water before you drink it.

5. Educate Children

Inculcate the habit of personal hygiene and cleanliness in kids. Make sure they wash their hands after using the toilet, after petting animals.

6. Avoid Fingers in The Mouth

This holds good for both parents and children alike. It is important that one does not put their hand into their mouth. Children are fond of putting their fingers in their mouth, sucking their thumb or biting nails. Dissuade your children from forming such habits.

7. Use Pasteurized Dairy Products

Do not drink unpasteurized milk or juice or dairy products like cheese etc.

8. Stay Away from Animal Manure

Teach your child to stay away from animal faeces as they contain E. coli and stay longer even after being eliminated from the digestive tract of animals

9. Avoid Contact with Impure Water

Make sure you keep your child away from dirty pools, streams and lakes as they are a potential source of E. coli bacteria.

10. Stay Informed

Be up-to-date with the information of any cases of an outbreak of E. coli to track the source and take necessary precaution to avoid contracting the illness.

FAQs

1. Are E. coli Infections Contagious?

An E. coli infection is contagious, for at least as long as the person suffers from diarrhoea or even after that. It can also spread from person-to-person contact.

2. When to Call The Doctor?

• You must seek medical consultation if your child has
• Severe diarrhoea lasting longer than 2-3 days
• Shows sever signs of dehydration (less urination, excessive thirst, dry mouth)
• Blood in stool
• Lethargic, irritable
• Swelling in the hands, feet or face
• Fever over 100 degrees
• Seizures

E. coli as an infection could be taxing on your child. However, most infections go away within a week of manifestation without any medication. But it is important to monitor the symptoms and seek medical advice in case of emergencies to rule out any further complications like kidney failure or blood-related problems.