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In recent years, you may have seen the term E coli in the newspaper, most often in describing food-borne infections. E coli is short for Escherichia coli. It has been in the newspaper headlines when both children and adults have become ill from eating E coli–contaminated undercooked ground beef, mostly at fast-food restaurants.

There are many strains of E coli bacteria, most of which are harmless and normal inhabitants of the gut. However, at least 5 types of diarrhea-producing E coli have been identified, some of which are a common cause of traveler’s diarrhea. An especially nasty strain that doctors have labeled E coli O157:H7 can produce toxins or poisons that have caused many cases of severe illness and even death.

According to the Centers for Disease Control and Prevention, about 73,000 cases of E coli O157:H7 infections occur each year in the United States. These bacteria live in the gut of cows. They are present in cow manure and unpasteurized milk. Most cases in people are caused by eating contaminated undercooked ground beef. It can also be transmitted by water or juices made from fruits that are contaminated with cow manure. Person-to-person transmission occurs in child care settings.

Signs and Symptoms

Depending on the strain of E coli he has, your child may have watery diarrhea, diarrhea with blood and mucus, or a combination of both. Severe abdominal cramps and fever may be present. With certain strains of E coli, especially those that cause traveler’s diarrhea, the diarrhea tends to be watery and can lead to dehydration.

In a small number of cases, a serious complication called hemolytic uremic syndrome (HUS) can develop in children usually younger than 5 years, frequently about 2 weeks after the diarrhea has begun. In the United States, most cases of HUS are associated with the E coli O157:H7 strain. Children with HUS have low red blood cell and platelet counts (red blood cells carry oxygen and platelets help with blood clotting) and may develop kidney failure.

How Is the Diagnosis Made?

An E coli infection is diagnosed by testing the stool for the presence of the bacteria.


A child’s symptoms will usually last for about a week before he gets better. Always try to prevent dehydration by giving your child plenty of fluids whenever he has diarrhea. On your doctor’s recommendation you can give him oral rehydration solutions available over the counter or made at home. Older children with watery diarrhea may benefit from antidiarrheal medicines, but only under the advice of your pediatrician.

When HUS is present, a child will have to be hospitalized to receive treatment, which could include blood transfusions and kidney dialysis.

What Is the Prognosis?

Most children will recover fully without treatment. Children with HUS usually recover completely, but a few will have lasting damage to the kidneys.


To keep your child from being exposed to E coli O157:H7, cook ground beef thoroughly to kill bacteria. Make sure there is no pink meat left and the juices are clear. Your youngster should also avoid raw or unpasteurized milk and drink only pasteurized apple juice. He should wash his hands with soap and warm water before eating.

When traveling abroad, take precautions such as making sure your food is thoroughly cooked and the water is boiled. Avoid salads, raw vegetables, fruits that have already been peeled, and food from street vendors. Consume safe beverages such as carbonated drinks with no ice and tea and coffee prepared with boiled water. If your child visits a petting zoo, be sure he thoroughly washes his hands after contact with the animals and of course, before eating.


Last Updated
Immunizations & Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.