Case of Suspected E.coli

Issued by NHS Highland

An 8 year old boy in Primary 4 at Muirtown Primary School in Inverness has suspected E coli O157 infection following a holiday abroad.  This is an infection which can cause diarrhoea, vomiting and stomach pains.  A small number of cases can develop serious kidney problems.

Dr Ken Oates, Consultant in Public Health Medicine for NHS Highland, said:

"We have today written to all parents at the school advising them of this case and asking them what to do if their children become unwell.  The boy was already unwell when the school term re-started so the school is definitely not the source of his infection. However, the affected pupil was in school for part of this week and did have some diarrhoea in the boys’ toilets at Muirtown Primary.  The toilets are cleaned every evening and are today undergoing a further thorough clean and disinfection." 

"At present the diagnosis is only suspected by the microbiology lab at Raigmore Hospital. Samples have been sent to an Edinburgh lab which will confirm the diagnosis, or otherwise, early next week."

"It is very unlikely that anyone else at Muirtown will catch this infection.  Nonetheless it is important that if a child develops any gastrointestinal symptoms such as vomiting, diarrhoea or stomach cramps within the next week the parents should contact their general practitioner. If a child has diarrhoea or vomiting he/she should not attend school or nursery until 48 hours after full recovery."

The boy is at home under the care of his GP.

Background Information

What is E.coli O157?

Escherichia coli (E. coli) is a common bacterium inhabiting the gastrointestinal tract of man and other animals. Most strains are harmless, however several – including E. coli O157 - are pathogenic and cause a variety of human illness.

What illness results?

E.coli O157 can cause a range of symptoms, from mild diarrhoea to bloody diarrhoea. A small number of people develop complications such as kidney damage, and problems with blood clotting, both of which require urgent hospital treatment.

Where does E.coli O157 come from?

The main source of infection is the intestine of healthy cattle, but it has also been found in the intestines of sheep, horses, farmed deer, goats, dogs, and wild birds.

How does it spread?

• Direct contact with infected animals, or their faeces
• Eating undercooked meat
• Drinking unpasteurised dairy products
• Drinking water that is contaminated with animal faeces – this is more likely to occur with private supplies, or stream water
• Eating unwashed/unpeeled fruit or vegetables that are contaminated with infected manure
• Contact with the faeces of an infected person

Only very small numbers of the bacteria are needed to cause illness.

The incubation period, which is the time from first swallowing the bacteria to becoming ill, can range from 1 to 14 days, but is usually 3 to 4 days.

Should I see my GP?

You should consult your GP if one or more of the following applies to you:
• there is blood in your diarrhoea
• you have severe abdominal pain
• the diarrhoea has lasted for 48 hours

How are infections treated?

There is no specific treatment, and antibiotics are not useful. It is important to drink plenty to make sure that you don’t become dehydrated. Clear fluids like water and diluted fruit juice are recommended. Your GP may wish to do some blood tests to make sure no complications are developing.

How can infection be prevented?

• Wash hands thoroughly after contact with all animals and their faeces
• If you work with animals launder your overalls separately, and remove work footwear before going into the house
• Wash hands after using the toilet or changing nappies
• Make sure meat is always thoroughly cooked
• Use separate chopping boards for cooked and uncooked meats, and raw vegetables
• Store cooked meats in the fridge separately from raw meat
• Avoid drinking unpasteurised milk
• Never drink from streams or rivers
• Owners of private water supplies should ensure they are properly maintained. Advice can be obtained from your local Environmental Health Officer
• If you or a member of your family have E.coli O157 infection, make sure the toilet and bathroom fittings (e.g. door handles) are cleaned and disinfected thoroughly

All persons with diarrhoea should remain off work or school until they have had no symptoms for 48 hours.

There are certain groups of people (for example, food handlers, healthcare workers, young children), who may have to remain off work or school until stool samples have been tested to show that they are no longer carrying E.coli O157.

How should hands be washed?

Always use warm, running water and a mild, preferably liquid, soap. (It is not necessary to use soaps labelled as antiseptic or antibacterial.)

• Wet hands and apply a small amount of soap
• Rub hands together vigorously for 10-15 seconds
• Pay special attention to areas between fingers, finger tips, and palms.
• Rinse hands under warm running water
• Dry thoroughly on a clean dry towel.

For further information see:

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18 Aug 2006