Over 100 cases of E. Coli O157:H7 were diagnosed in the St. Louis area in early November, the majority of which affected Rockwood Summit students and community members. Alongside the outbreak, questions and concerns about the bacteria surged as well in hopes to better understand E. Coli and how to handle it. When science teacher Sarah Moonier’s daughter was diagnosed with the infection, she also looked to learn more about it and the treatments available. She said that, after talking to Dr. Phillip Tarr at St. Louis Children’s Hospital, she was able to gain an inside look into the team’s work with E. coli.
“The team there is at Children’s is one of the leading researchers for E coli, and they basically came up with this kind of new standard of care, and it’s all meant to prevent the effects of that toxin that’s released. The doctor was teaching me all of this, and I told him I was an anatomy teacher, and when I told him that, he actually invited me to go on rounds with him, and I learned how all the doctors communicate to treat their patients,” Moonier said.
To understand the treatment, though, it’s important to understand what the bacteria is in the first place. According to science teacher Sarah Moonier, everyone has E. coli to aid digestive processes, but it is dangerous when consumed.
“E. coli is naturally in your gut, and it actually helps break down plant matter that you couldn’t break down on your own, and things like that. So it’s actually a healthy part of your colon, but if you eat E. coli, it’s in the wrong part of your GI tract, and that will make you sick,” Moonier said.
Usually, E. coli is spread through contaminated food, often food that has not been heated to high temperatures to kill bacteria, like fresh produce and undercooked meat. Unpasteurized milks and juices are also high risk. Spread from person to person is possible, but only through transfer of fecal matter. Moonier said that it is a common misconception that the bacteria can be spread through sneezing or coughing.
“People think it’s respiratory, or that you’re just going to catch it from somebody. If you have good hand hygiene and wash your hands, that’s what’s going to prevent it from spreading,” Moonier said.
E. coli O157 is a strain of the bacteria that produces the Shiga toxin. The most common symptoms of an infection are diarrhea and abdominal pain, with blood often appearing in stool due to cell damage in the small intestine. However, infections can also cause complications with the kidneys, such as hemolytic uremic syndrome, a kidney disease that at least two E. coli patients have developed. As the bacteria causes cell death, clots begin to form, which Moonier says can form blockages in the kidneys.
“When you get infected with this type of E coli, it releases this toxin called the Shiga toxin, and when it goes into your bloodstream, it causes the lining of your vessels to die. So it basically goes into the cells of the blood vessels, and when they die, they release a chemical that creates a big immune response. Then the platelets go and they clot, and those little clots are like part of your body’s way of fixing the problem. But obviously, little clots in your blood cause lots of problems, right? So all of [the clots] go to your kidney, and your kidney has these very tiny little spaces where it filters out your blood, and the clots get lodged in those spaces. That’s why [the bacteria] is dangerous, because it can cause kidney failure,” Moonier said.
Moonier said that treatment approach shifts depending on how much the infection has progressed.
“If you’re [diagnosed] really early, it’s still gonna be in your gut, so you’re trying to flush that out of your gut. You actually get rid of the E coli after three or four days, but then you still have to deal with the clots in the blood, so then you have to think about the kidneys later on. Early on, they’re doing more prevention, and later on, they’re restoring the body back to its health,” Moonier said.
Due to the risks of using antibiotics, Moonier said that treatments largely focus on water in order to keep blood clots moving, decreasing their risks.
“You can’t give antibiotics to this E coli, because when you kill the E coli with antibiotics, you actually release more toxins. So they actually treat it with just water, so they want to flush it out of the body. This treatment that they’re studying is where they give the person a higher amount of water, and that makes your blood volume increase so you have more water going through your vessels, and then it basically makes more space for those clots to get through, instead of clogging up your kidneys,” Moonier said.
