NAME: Escherichia coli, enterohemorrhagic
SYNONYM OR CROSS REFERENCE: Enterohemorrhagic Escherichia coli (EHEC), Verotoxin producing Escherichia coli (VTEC), Shiga toxin producing Escherichia coli ( STEC)
CHARACTERISTICS: Gram negative rod; motile, aerobic; produce Vero / Shiga toxins (VT/STx), 2 types, VT1/Stx1 and VT2/Stx2; serotyping to determine somatic and flagellar antigens
PATHOGENICITY: Hemorrhagic colitis, intestinal disease accompanied by cramps and abdominal pain; initially watery, followed by bloody diarrhea; low grade fever; last about 8 days; 5-10% of hemorrhagic colitis victims may develop hemolytic uremic syndrome (HUS); affects all ages, higher death rates occur in elderly and young; can cause thrombocytopenic purpura (TTP) in elderly
EPIDEMIOLOGY: Sporadic and in outbreaks of bloody diarrhea; associated with 15-30% of patients where no other pathogen has been identified; main EHEC serotype in North America from infections is E. coli 0157:H7
HOST RANGE: Humans; animals (O157:H7 - piglets, calves and cattle)
INFECTIOUS DOSE: Appears to have low infectious dose, may be similar to that of Shigella spp.,10 organisms by ingestion
MODE OF TRANSMISSION: Ingestion of contaminated food (undercooked hamburger meat, unpasteurized milk); fecal-oral transmission; person-to-person transmission (extremely high)
INCUBATION PERIOD: 2-8 days (median of 3-4 days)
COMMUNICABILITY: Communicable for duration of fecal excretion (7-9 days); 3 weeks in one third of children
RESERVOIR: Infected persons, animals (sheep, goats, pigs, poultry, calves, cattle)
ZOONOSIS: Yes - direct or indirect contact with infected animal and waste
VECTORS: birds may be a vector
DRUG SUSCEPTIBILITY: Sensitive to a wide spectrum of antibiotics
SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to many disinfectants - 1% sodium hypochlorite, 70% ethanol, phenolics, glutaraldehyde, iodines, formaldehyde
PHYSICAL INACTIVATION: Heat sensitive, inactivated by moist heat (121° C for at least 15 min) and dry heat (160-170° C for at least 1 hour)
SURVIVAL OUTSIDE HOST: Butter - up to 50 min; cream - 10 days; hamburger meat - survives well; does not survive long in slurry systems (innoculum of 108 cfu/mL became undetectable after 9 days); survives well in contaminated feces and soil, only small reduction in organism number over 2 months
SURVEILLANCE: Monitor for symptoms; confirm bacteriologically, DNA probe to detect Verotoxins VT1 and VT2
FIRST AID/TREATMENT: Electrolyte fluid therapy; antibiotics may be administered in very severe cases
IMMUNIZATION: None
PROPHYLAXIS: Not usually administered
LABORATORY-ACQUIRED INFECTIONS: 4 reported cases of labortory infections with E. coli since 1981
SOURCES/SPECIMENS: Contaminated food (raw milk, hamburger, apple juice and water); feces
PRIMARY HAZARDS: Ingestion
SPECIAL HAZARDS: None
CONTAINMENT REQUIREMENTS: Biosafety level 2 practices, containment equipment and facilities for activities involving cultures and infected clinical materials
PROTECTIVE CLOTHING: Laboratory coat; gloves when contact with infectious materials is unavoidable
OTHER PRECAUTIONS: Good personal hygiene and frequent handwashing essential
SPILLS: Allow aerosols to settle; wearing protective clothing, gently cover spill with absorbent paper towel and apply 1% sodium hypochlorite, starting at perimeter and working towards the centre; allow sufficient contact time (30 min) before clean up
DISPOSAL: Decontaminate before disposal; steam sterilization, chemical disinfection
STORAGE: In sealed containers that are appropriately labelled
Date prepared: January, 2001
Prepared by: Office of Laboratory Security, PHAC
Although the information, opinions and recommendations contained in this Material Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.
Copyright ©
Health Canada, 2001
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