EHEC - what is it?

introduction

The acronym EHEC stands for “enterohaemorrhagic Escherichia coli”.
This is a form of bacteria that can be found mainly in the intestines of cattle, sheep, goats, deer or deer.
The bacteria are able to produce various toxins, but these do not pose any danger to the animals.
If such toxins are transferred to humans, however, severe gastrointestinal complaints can be caused.

In particularly severe cases, the bacteria can cause life-threatening intestinal infections.
In Germany, the EHEC pathogen spread rapidly and dangerously in 2011.

You can find out everything about the Escherichia coli bacterium here: Escherichia coli

What Causes EHEC Infection?

Many millions of Escheria Coli bacteria can be found in the intestinal flora of humans.
These bacteria belong to the natural intestinal flora and have important functions for the body there.
The EHEC infections are triggered by a special strain of the bacterium Escheria coli (E.coli), which does not occur in the natural intestinal flora of humans. This special strain can only be found in ruminants, which can excrete the bacteria in the feces.

The causes of an infection are then contact with the bacteria via food, contaminated water, contaminated objects or, in the case of small children, direct contact with the animals.

So is the transmission route

The path of transmission of the bacteria begins with the excretion of the bacteria in the faeces.
Enterohaemorrhagic Escheria coli can survive in the environment for a very long time and are therefore still contagious to humans even after several weeks.

A direct transmission path can be from animals to humans.
Since the animals can still be contaminated with a few traces of faeces, the EHEC pathogen can easily be transmitted through contact with the animals.
Playing in the meadows where the ruminants are kept is a source of infection, especially for children.

Another way of transmission can be through food.
If, for example, the vegetables are fertilized with the help of manure, the bacteria can be transferred to the food in this way and thus lead to a possible infection.
Insufficiently heated food or raw meat can also lead to an infection with the EHEC pathogen.

The bacterium can also easily be transmitted from person to person.
People who have been infected with the EHEC bacterium also excrete the pathogen through stool.
Infection can also occur through touching the stool of an affected person.

However, in order for the bacterium to show its actual pathological effect on humans, the bacterium has to get inside the body.
This usually happens when you put your hand in your mouth, as is often the case with children, or when the pathogen is transferred from your own hand to food, which then gets into the mouth and finally also into the stomach and intestines.
This transmission path can be prevented by hand disinfection.

How contagious is the EHEC?

Since the EHEC bacterium can survive for several weeks outside of the animal's body, a high risk of infection and particular caution is required, especially in jobs that have a lot of contact with cattle, goats or deer.
Once the bacterium has entered your own body, it can usually only be excreted through your own stool.

Particular caution should also be exercised when consuming food that has been fertilized with the help of liquid animal manure.
It is always important to ensure that it is cleaned well before consumption.

In addition to being transmitted directly from animal to person or from person to person, the bacterium can also be transmitted through contaminated water.
This can get into the body of the person affected by drinking or bathing.

In general, the EHEC bacterium is very contagious compared to other bacteria.
Just 10 bacteria are enough to cause infection.

Duration of an EHEC infection

An EHEC infection can take on a wide variety of dimensions and therefore the course of the disease can vary in length.
Sometimes it even happens that a person infected with EHEC does not feel any signs.

The incubation period, i.e. the time between infection with the bacterium and the first signs of infection, is usually between two and ten days.
After the infection, the course of the disease takes on different dimensions.
Many sufferers initially complain of watery diarrhea and severe nausea.
Although this is extremely uncomfortable, it also promotes healing in the same way.
Because of the diarrhea, the bacteria are eliminated from the body as quickly as possible, so that they cannot cause any further complications.
The diarrhea can last a few days to two weeks.

If the symptoms persist for more than two weeks and if there are other symptoms such as weakness, decreased urine output or a general tendency to bleed, it can be assumed that the EHEC bacterium has also brought another clinical picture, the hemorrhagic-uremic syndrome, with it .
This syndrome can take on drastic proportions with no treatment or treatment that is too slow.
In the worst case, life-long damage and the associated dialysis obligations can be caused.
However, if the syndrome is discovered and treated quickly, it should be cured in a few weeks.

What is the course of the disease?

With an EHEC infection, the disease can take different courses.
Depending on the severity of the infection, it can rarely even be life-threatening.

The first sign of an infection is usually watery and often bloody diarrhea.
If such symptoms occur, a doctor should definitely be consulted.
In addition to diarrhea, nausea and vomiting are often seen.
The vomit can also contain slight traces of blood.
In most cases, after a few days to weeks, these symptoms subside and the disease appears to be cured.

The infection can rarely cause other diseases, such as HU syndrome.
In this case, diarrhea and vomiting may subside, while other symptoms such as paleness, weakness and urinary retention occur.
If this is the case, the course of the disease is prolonged and can last up to several weeks.
In the most severe case, the HU syndrome can also cause persistent kidney failure, so that the person affected is dependent on external blood detoxification using dialysis for life.

incubation period

The incubation time is the time that elapses between infection and the outbreak of the infection within the body.
It therefore describes the time that the bacterium needs to develop its effects within the body.

In the case of an EHEC infection, the incubation period is two to ten days.
An average of three to four days are given.
The haemolytic uremic syndrome (HUS) caused by the EHEC infection shows the first signs after about a week.
The first symptoms of HUS only show up after the EHEC infection has broken out.

This is how you treat the infection with EHEC

There are different approaches to treating an EHEC infection.
Since enterohaemorrhagic Escheria coli are bacteria, antibiotic therapy can be considered.
This is generally only recommended in exceptional cases, as it would delay the excretion of bacteria.
As a result, the bacteria would have a longer time to release their toxins.

Treatment of the EHEC infection is therefore usually symptom-specific.
There are no direct drugs for the infection.
The aim is to remove the disease-causing bacteria from the intestines as quickly as possible, before they can cause worse diseases.
Due to the high loss of fluid and nutrients, an intake of potassium, sodium and fluid is of great importance.
This supply usually takes place via infusions or tablets.

A treatment of the EHEC infection with the help of diarrhea medication is, however, absolutely not recommended.
Even if diarrhea is an extremely uncomfortable situation, it excretes the pathogenic bacteria.

If the EHEC bacterium has already caused the HU syndrome (hemolytic uremic syndrome), its symptoms must also be treated as soon as possible.
If there is no quick, specific treatment, the hemolytic-uremic syndrome can lead to death.
Treatment involves stimulating the weakened kidney function with various drugs, for example diuretics.

If this treatment option is unsuccessful, dialysis must be used, as this is the only way to remove the toxins from the blood of those affected.

These symptoms show that you have an EHEC

EHEC infections in adults can often take place without any external signs.
The bacteria are then excreted again after a few weeks without any further symptoms.
However, to recognize an EHEC infection, various symptoms can be described.

The first signs of an EHEC infection are usually nausea and the resulting diarrhea.
Abdominal cramps and fever are also among the typical EHEC symptoms.

In individual cases, the EHEC infections are very severe.
In addition to the usual symptoms, severe intestinal inflammation also occurs.
Elderly people, infants and people with a compromised immune system are particularly sensitive to such levels.
In this case, those affected complain of severe abdominal cramps and bloody diarrhea.
This type of intestinal inflammation is also known as hemorrhagic colitis.

In addition to the intestinal inflammation, the EHEC infection can also cause the so-called haemolytic uremic syndrome (HUS) in rare cases.
This is characterized by anemia and kidney weakness.
In this case, the EHEC toxins attack the blood cells, which eventually perish.
Hemolysis results in anemia (anemia).
If such a case occurs, those affected usually feel weak and pale in the face and extremities.

In addition, an increased tendency to bleed can be associated with the clinical picture.
There is an increasing number of smaller hemorrhages or larger hematomas on the surface of the skin.
The HUS has other effects on the kidneys.
This can no longer properly excrete the water, which leads to water retention, especially in the legs.
Confusion and seizures can also be a rare side effect.
This is because the kidneys can no longer carry out their usual detoxification function.

diarrhea

Diarrhea is generally spoken of when the person has stool more than three times a day that is not in its normal form.
The diarrhea during an EHEC infection appears as watery.
The amount of stool excreted usually exceeds the usual amount.
It is also important to consult a doctor for diarrhea that lasts for over three days, as important nutrients are lost through frequent bowel movements.

Read more on the subject at: Diarrhea like water

Another typical feature of diarrhea in the case of an EHEC infection is that little to a lot of blood can mix in.
The reason for this is that toxins are formed in an EHEC infection, which can damage blood vessel walls in particular.
This damage leads to bleeding in the bowel area, which is eventually excreted with the stool.

You can find out how to treat diarrhea with home remedies at:
Home remedies to treat diarrhea

Vomit

An infection with the enterohaemorrhagic Escheria coli (EHEC) bacterium can lead to watery, bloody diarrhea and severe vomiting.
However, this symptom does not always appear when compared to diarrhea.
Sometimes people only complain about a feeling of nausea.

If vomiting occurs, it may also contain few traces of blood.
Since the toxins of the EHEC not only attack the intestinal vessels, but also some of the vessels in the stomach, this ultimately leads to bleeding, which has to get out through vomiting.

Also, check out which home remedies can be used to treat vomiting:
Home remedies to treat vomiting

What complications can arise?

The most serious complication that can be triggered by an enterohaemorrhagic Escheria coli infection is the haemorrhagic syndrome (HU syndrome).
The toxins of the EHEC bacterium attack the red blood cells, causing them to perish and leading to anemia.
In addition, the blood vessel walls and the platelets are also severely impaired, which leads to an increased tendency to bleed.

These complications can be checked for simple symptoms.
Because of the anemia, the person concerned feels very weak, tired and pale in the face and extremities.
Due to the damage to the blood vessels and the destruction of the platelets, there are also small and larger hematomas that have arisen without direct external influences.

In particularly severe cases, the kidneys are also affected, so that little or no more fluid can be excreted through the urine.
This can cause two complications.
On the one hand, this means that the blood can no longer be detoxified, so that one has to rely on external detoxification in the form of dialysis.
If the toxins cannot be excreted in the urine or otherwise, it can also lead to severe confusion or even seizures.
In addition, the reduced water excretion can lead to water retention, especially in the legs.

Is there a vaccination?

There is currently no general vaccination for the EHEC bacterium.
The production of vaccines against enterohaemorrhagic Escheria coli is considered controversial.
This is due to the fact that the bacterium that causes the disease is constantly changing.
It still causes the same disease, but the genes change in such a way that a previously manufactured vaccine becomes useless and a new vaccine would have to be developed accordingly.
This is associated with high costs and does not promise any guaranteed effectiveness.

What is a permanent eliminator?

Permanent eliminators are people who, after infection with bacteria or viruses, continue to reproduce and eliminate them even after more than ten weeks.
Those affected still excrete the bacteria or viruses even though the symptoms of the disease no longer occur.

Because the bacteria or viruses are still being excreted by the person affected, the stool or some of the vomit are still infected and thus contagious.
Particular caution is required when the disease progresses, as the person concerned is usually ignorant of the risk of infection.

This is how the diagnosis is made

If an EHEC pathogen is suspected, the person concerned usually presents to his family doctor because of severe diarrhea symptoms.
In order to finally be able to make the diagnosis of an EHEC infection, different examinations are carried out.

First, an examination of the stool sample is taken.
The stool sample may show blood in the stool.
If an EHEC infection is suspected, a special stool examination can also be carried out.

A blood and urine test can provide a further elucidation criterion for an EHEC infection.
In addition to its actual effect, the EHEC infection can also cause a so-called hemolytic-uremic syndrome (HUS).
This can be demonstrated by determining blood cells and platelets in the blood.
Changes in kidney values ​​can also indicate impairment of the kidney due to the EHEC infection.

A clear diagnosis can be made by determining the EHEC toxins.
The suspect bacteria are carefully examined for their genes and poison production.