Key TakeawaysWhile mostE. colistrains are harmless,E. coliO157:H7 can cause a severe intestinal infection in humans.E. colioutbreaks are often associated with leafy greens like lettuce and spinach, partially because of the way they’re grown in soil that’s prone to contamination.Most people in the United States also eat these vegetables raw, which increases the risk of gettingE. coli.

Key Takeaways

While mostE. colistrains are harmless,E. coliO157:H7 can cause a severe intestinal infection in humans.E. colioutbreaks are often associated with leafy greens like lettuce and spinach, partially because of the way they’re grown in soil that’s prone to contamination.Most people in the United States also eat these vegetables raw, which increases the risk of gettingE. coli.

Lauren Bush never expected to feel so sick from a regular spinach salad—bloody diarrhea and extreme abdominal pain forced her through multiple hospitalizations and medical consultations.

She was one of the many victims of a multi-stateE. colioutbreak in 2006, which resulted in 102 hospitalizations, 31 cases of kidney failure, and three deaths.

Escherichia coli (E. coli)are bacteria that live in the intestines of animals and humans. They’re mostly harmless, but certain strains likeE. coliO157:H7 can cause illness in people. The most common symptoms include severe bloody diarrhea, abdominal cramps, and fever. And they usually being two to five days after consuming foods contaminated with the bacteria.

Severe cases ofE. coliinfections can lead to hemolytic uremic syndrome, a complication that might result in kidney failure and death.

A study from 2013 also suggested thatE. coliinfections are associated with a higher risk of developing high blood pressure and kidney problems later in life.

In the years following her infection, Bush has come down with similar symptoms five times. In some cases, she had to be isolated to avoid infecting other people.

“Unfortunately, once your body gets imbalanced, it can’t quite recover,” Bush said.

Why IsE. ColiOften Found in Lettuce and Spinach?

Leafy greens often fall victim toE. colicontaminations because of the way they’re grown, saidMitzi Baum, the CEO of Stop Foodborne Illness, a patient advocacy organization. Romaine lettuce and spinach are grown in the soil, which can be exposed to animal feces or contaminated water.

The produce is at risk of contamination from irrigation water especially if it’s grown near animal production facilities where the animals may be infected withE. coli.

There’s also a seasonal aspect toE. colioutbreaks associated with the harvest season for lettuce in different areas. For instance, the fall lettuce harvest in coastal California is associated with a higher likelihood ofE. colioutbreaks.

Another reason people are more susceptible toE. colifrom lettuce or other leafy greens is that they often eat these vegetables raw. While washing the vegetables alone may not get rid ofE. colientirely, boiling or cooking them can kill the bacteria.

How to Prevent anE. ColiInfection

As scary asE. colisounds, you don’t have to stop eating salads or burgers completely. However, you can take precautions to protect yourself:

These steps may not be enough to keep you 100% safe from risks. So, if you believe you have eaten food contaminated withE. coli, stay hydrated and seek medical care.

What This Means For YouE. colican cause intestinal infections through contaminated food or water. Wash your hands thoroughly before and after preparing food. Make sure to wash your vegetables, or cook them to kill the bacteria whenever possible.

What This Means For You

E. colican cause intestinal infections through contaminated food or water. Wash your hands thoroughly before and after preparing food. Make sure to wash your vegetables, or cook them to kill the bacteria whenever possible.

Correction - September 6, 2022: This article was updated to reflect the correct symptoms of Lauren Bush while she had an E. coli infection.

6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Multistate outbreak ofE. coliO157:H7 infections linked to fresh spinach (final update).Johns Hopkins Medicine.Escherichia coliO157:H7.Centers for Disease Control and Prevention.E. colioutbreak with unknown food source.Hizo-Abes P, Clark WF, Sontrop JM, et al.Cardiovascular disease after Escherichia coli O157:H7 gastroenteritis.CMAJ. 2013;185(1):E70-E77. doi:10.1503/cmaj.112161Leonard SR, Simko I, Mammel MK, Richter TKS, Brandl MT.Seasonality, shelf life and storage atmosphere are main drivers of the microbiome andE. coliO157:H7 colonization of post-harvest lettuce cultivated in a major production area in California.Environ Microbiome. 2021;16(1):25. doi:10.1186/s40793-021-00393-yCenters for Disease Control and Prevention.Outbreak ofE. coliinfections linked to leafy greens.

6 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Multistate outbreak ofE. coliO157:H7 infections linked to fresh spinach (final update).Johns Hopkins Medicine.Escherichia coliO157:H7.Centers for Disease Control and Prevention.E. colioutbreak with unknown food source.Hizo-Abes P, Clark WF, Sontrop JM, et al.Cardiovascular disease after Escherichia coli O157:H7 gastroenteritis.CMAJ. 2013;185(1):E70-E77. doi:10.1503/cmaj.112161Leonard SR, Simko I, Mammel MK, Richter TKS, Brandl MT.Seasonality, shelf life and storage atmosphere are main drivers of the microbiome andE. coliO157:H7 colonization of post-harvest lettuce cultivated in a major production area in California.Environ Microbiome. 2021;16(1):25. doi:10.1186/s40793-021-00393-yCenters for Disease Control and Prevention.Outbreak ofE. coliinfections linked to leafy greens.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Centers for Disease Control and Prevention.Multistate outbreak ofE. coliO157:H7 infections linked to fresh spinach (final update).Johns Hopkins Medicine.Escherichia coliO157:H7.Centers for Disease Control and Prevention.E. colioutbreak with unknown food source.Hizo-Abes P, Clark WF, Sontrop JM, et al.Cardiovascular disease after Escherichia coli O157:H7 gastroenteritis.CMAJ. 2013;185(1):E70-E77. doi:10.1503/cmaj.112161Leonard SR, Simko I, Mammel MK, Richter TKS, Brandl MT.Seasonality, shelf life and storage atmosphere are main drivers of the microbiome andE. coliO157:H7 colonization of post-harvest lettuce cultivated in a major production area in California.Environ Microbiome. 2021;16(1):25. doi:10.1186/s40793-021-00393-yCenters for Disease Control and Prevention.Outbreak ofE. coliinfections linked to leafy greens.

Centers for Disease Control and Prevention.Multistate outbreak ofE. coliO157:H7 infections linked to fresh spinach (final update).

Johns Hopkins Medicine.Escherichia coliO157:H7.

Centers for Disease Control and Prevention.E. colioutbreak with unknown food source.

Hizo-Abes P, Clark WF, Sontrop JM, et al.Cardiovascular disease after Escherichia coli O157:H7 gastroenteritis.CMAJ. 2013;185(1):E70-E77. doi:10.1503/cmaj.112161

Leonard SR, Simko I, Mammel MK, Richter TKS, Brandl MT.Seasonality, shelf life and storage atmosphere are main drivers of the microbiome andE. coliO157:H7 colonization of post-harvest lettuce cultivated in a major production area in California.Environ Microbiome. 2021;16(1):25. doi:10.1186/s40793-021-00393-y

Centers for Disease Control and Prevention.Outbreak ofE. coliinfections linked to leafy greens.

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