Shiga toxin-producing E. coli O121 infections associated with Wonder Coffee and Sports Bar in Seattle

About STEC

E. coli germs (bacteria) normally live in the intestines (gut) of humans and animals. Many strains of E. coli bacteria exist, and most of them are harmless or beneficial to human health. STEC are strains of E. coli that produce Shiga toxin (such as E. coli O121) and can make people very sick.

STEC infections can happen when eating raw or undercooked ground beef and other beef products; unpasteurized (raw) milk, cheese, and juice; contaminated raw fruits, vegetables, sprouts, and herbs; water contaminated with animal feces (poop), or by direct contact with farm animals or their environment. Ready-to-eat foods can also be contaminated with STEC through contact with raw beef or raw beef juices in the kitchen.

STEC and other foodborne infections occur throughout the year but may increase during late spring and summer months.

Symptoms of STEC include diarrhea (which often becomes bloody) and stomach cramps, with mild or no fever. Illness typically lasts several days and people can spread infection to others even after symptoms resolve.

• STEC infections usually resolve in 5–7 days but people may still spread the bacteria in their poop when no longer sick. Up to 33% of children may continue to shed STEC in their poop for as long as 3 weeks after they are no longer sick.
• Around 5–10% of people who are diagnosed with a STEC infection can have a potentially life-threatening complication known as hemolytic uremic syndrome (HUS). Clues that a person is developing HUS include decreased frequency of urination (peeing) and feeling very tired. People with HUS should be hospitalized because their kidneys may stop working and they may develop other serious problems. Most people with HUS get better in a few weeks, but some suffer permanent damage or die.
• Sick people with suspected STEC infection should not work in food handling (like restaurants), patient care (like hospitals), or childcare/daycare, and sick children with suspected STEC infection should not go to daycare/childcare until they have seen a healthcare provider (doctor) and been tested for STEC infection, even if their sickness is mild. People with STEC infections who work in food handling (like restaurants), patient care, or childcare/daycare or go to childcare/daycare must be cleared by Public Health before returning.

Prevention

General advice for reducing risk of getting STEC:

• Avoid eating high-risk foods, especially undercooked ground beef and other beef products, goat products, and sheep products, unpasteurized (raw) milk or juice or cheese, and raw sprouts.
• Wash hands with soap and water before preparing food for yourself or your children, before eating food, after handling raw meats, after going to the bathroom or changing diapers, and after contact with cows, sheep, or goats, their food or treats, or their living environment.
• If soap and water aren’t available, use an alcohol-based hand sanitizer with at least 60% alcohol (check the product label to be sure). These alcohol-based products can quickly kill the number of germs on hands sometimes, but they cannot replace washing with soap and running water.
• Wash fresh produce very well before eating.
• If washing "pre-washed" or "ready to eat" produce items like bags of salad mix, be sure it does not come into contact with unclean surfaces or utensils.
• Wash cutting boards and areas used for meat or poultry (like chicken) preparation immediately after use to avoid cross contaminating other foods.
• Cook all meats until well done, especially ground beef. Use a food thermometer to make sure meats have reached a safe internal temperature.

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More information about STEC

• STEC facts, Public Health - Seattle & King County
• E. coli facts, Foodsafety.gov
• E. coli, Centers for Disease Control and Prevention
• Food Safety & Meat, Foodsafety.gov
• Four Food Safety Steps, Centers for Disease Control and Prevention