Director, Emergency Services, Bikur Cholim Hospital
Ever hear of Escherichia Coli? Let me introduce this trouble-
making bacterium living in your body (in your colon). He is a
gram negative rod, and under the microscope that is exactly
how he appears: like a non-distinct rod.
Where does he cause trouble? Let us start in the urinary
tract. If you are a young female, you may have already had to
deal with E. Coli, as it is the most common cause of an
infection there in young women. Fortunately, it is easily
dealt with by short courses of antibiotics. This, however,
often leads to yeast infections, so killing the bug is often
not so simple. Experts think that since it lives in the
colon, it takes a short jump to the urinary tract and that is
how infection starts.
Ever travel and get diarrhea from the water? Blame Mr. Coli
again. This may again be due to poor sanitation. This is
easily prevented or controlled by antibiotics or Bismuth
preparations.
A new E. coli came out 20 years ago and forced the closure of
the whole Jack-in-the-Box hamburger chain in America. This
bug, termed 0H:157, causes diarrhea, sometimes followed by
kidney and liver failure and often resulting in death.
However, in this case antibiotics just make things worse.
They kill the bug and allow it to release all of its
toxins.
Investigation showed that this came from undercooked meat.
Now this has been found in sprouts, apple cider, cabbage,
lettuce, petting zoos and most recently spinach, that killed
several people a month ago. Scary, yes? But not so once you
consider many points.
We said this bug lives in the gut. Apple cider and many other
organic and "naturally" grown products use manure, not
chemical fertilizer, meaning that apples that have touched
the ground can pick up this bug.
This was the case with the spinach as well that was grown on
an organic farm. I am not against organic produce in general,
but be careful. The plant cannot distinguish between chemical
and animal fertilizer.
Meat is a different story. This bug has found a place in the
USA because cows are raised in pens and given lots of feed.
This results in a lot of manure that washes into the water
supply and in the bug finding easy access to jump from one
cow to another. Therefore, the bug spreads quickly to meat
and vegetables.
Most of Israel's meat is from cows that are not penned in but
rather eat in pastures, giving less ability for the bug to
gain a foothold. I have not heard of cases of this bug in
Israeli meats or vegetables. Nevertheless, it pays to be
aware. If you live in a very industrialized country, or a
country that imports a lot of its produce (like the UK),
following these simple rules will prevent this illness from
ever being a problem.
1) Be careful with organic products. Buy only those that you
can cook.
2) Cooking kills this bug. Undercooked meat, uncooked spinach
are the problem. Frozen spinach (which is always cooked) and
fully cooked meats and vegetables are never a problem.
3) I would not recommend eating sushi.
4) Wash fruit carefully. Israeli products, by the way, are
usually very clean. If you buy produce in the Arab sector or
on a trip, wash it carefully. Or avoid it altogether.
5) Boiling water in foreign countries will make your water
tasteless, but will kill this bug.
6) Wash your kids' hands immediately after going to a petting
zoo, even in Israel. Did you know that turtles carry
Salmonella? Or that birds carry avian virus and Psittacosis?
Rodents carry the hanta virus? Wash their hands before they
put them in their mouths. People often eat at zoos, so it is
important to practice good hygiene. Bring baby wipes if soap
is unavailable.
The New England Journal of Medicine from Nov. 9 was
the source of this article.
Write me in care of the Yated.
