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Communicable Disease Control

E.coli ( Escherichia coli Infection)

Escherichia coli is a bacterium (germ) found in feces of animals such as cattle, sheep and goats. Some types of E.coli bacteria, particularly the strain E.coli O157:H7, can cause illness in people when they consume water or food that has come in contact with the bacteria. If people touch contaminated material, they can transfer the bacteria from their own hands to their mouths. E.coli can also be spread from one person to another.

Symptoms of E.coli O157:H7 infection include diarrhea or bloody diarrhea, which may be accompanied by abdominal cramps, nausea and vomiting. Fever is not usually present. Young children may also develop anemia and kidney failure, known as hemolytic uremic syndrome (HUS). Prompt medical treatment is essential, especially for young children.

The incubation period—the time from exposure to the bacteria to becoming ill—is from 2 to 8 days or longer, but is usually 3-4 days. Most outbreaks in the U.S. have been associated with ground beef, unpasteurized milk, unpasteurized apple cider, and other raw or undercooked food products. People can also get E.coli from direct contact with farm animals or their feces.

Good hygiene, especially frequent and thorough handwashing, is important to prevent spread of the disease, particularly after using the restroom, after changing diapers, and before preparing food, eating or drinking.

Any child with diarrhea or bloody diarrhea may have E.coli infection. Since a sick child can easily spread E.coli to others, parents should not send sick children to day care or to school. Day care centers and schools should send sick children home to avoid person-to-person spread, especially among diapered children.  

E.coli is a reportable disease in North Carolina. Physicians, lab directors, day care center operators, and school principals are required by law to report cases within 24 hours to the local health department, which in turn reports to the North Carolina General Communicable Disease Control Branch, Division of Public Health.

The number of cases of E.coli in the state is usually well under 100 cases per year. In 2003, North Carolina had 38 cases. In Nov. 2001, Robeson County experienced a large E.coli outbreak with over 200 cases reported. The outbreak started in elementary school students, spread to younger and older siblings, and subsequently spread to day cares and high schools and to some household adult contacts. The source of the outbreak was traced to butter made for a school fair using unpasteurized milk.

For more information: Especially for Health Departments:

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Page last updated on August 22, 2008