Dozens are sick in E. coli outbreak linked to carrots. Here’s what to know about symptoms and how it spreads

By Sam Tupper, CNN

(CNN) — An E. coli outbreak connected to several recalled brands of bagged organic carrots led to one death and over a dozen hospitalizations, according to the US Centers for Disease Control and Prevention.

Anyone who purchased the carrots is urged to avoid eating them. Instead, throw them away and wash any item and surface that might have come into contact with them using hot, soapy water.

What is E. coli?

The type of bacteria involved in this outbreak is E. Coli O121:H19, a strain of the dangerous Shiga toxin-producing E. coli, or STEC, which has been linked to ground beef, romaine lettuce and water in the past, the CDC says. The Shiga toxin can penetrate and kill cells, causing tissue damage.

While most kinds of E. coli are harmless and can help with food digestion, others can cause health problems like urinary tract infections, pneumonia, sepsis and serious kidney problems like hemolytic uremic syndrome.

How do you get E. coli?

People typically get E. coli by consuming food or water that is contaminated with infected animal feces or through contact with feces from a person who’s infected.

Previous research has shown that about half of organic food outbreaks are linked to produce and that may be due to farming methods.

In order for agricultural products like fruits and vegetables to be certified organic by the US Department of Agriculture, farmers and growers need to avoid using prohibited substances, such as synthetic ingredients, when managing pests, weeds, disease and soil.

“In general, organic farms have less oversight than large, traditional-type farms,” said Dr. Nicole Iovine, an infectious disease specialist and chief hospital epidemiologist at the University of Florida Health. “Organic farms are more likely to use compost or manure rather than commercially bought fertilizers. If the compost is not properly processed such that pathogens naturally present in animal stool survive, the soil will become contaminated.”

What are the symptoms of E. coli infection?

The tricky part, Iovine says, is that most of the symptoms associated with E. coli infection – such as vomiting, diarrhea and stomach cramps – are also common with other foodborne illnesses, so it can be difficult to tell if you have an E. coli infection.

Symptoms usually start around three to four days after consuming the bacteria. Young children and older adults are more vulnerable to severe infections.

“Most infections resolve on their own,” according to Dr. Leana Wen, an emergency physician and clinical associate professor at George Washington University. She previously was Baltimore’s health commissioner, with responsibilities that included overseeing food safety. “Patients need supportive treatment with hydration but do not need specific therapy. Some benefit from antibiotics. Then there are some infections, notably O157:H7, where antibiotics are not used and in fact could worsen illness.”

Patients with severe stomach cramps, bloody diarrhea or who are unable to keep down fluids should seek medical attention, Wen said.

How to prevent an E. coli infection?

Iovine says the best way to avoid E. coli infections is to stick with the CDC’s recommendations: Wash your hands frequently, follow safe food preparation guidelines, and wash fruits and vegetables before eating them, even if the package says they are already washed.

“Don’t ever trust that [label]. Always wash your vegetables,” she said. “It’s the last opportunity to remove any harmful bacteria that may be present. I’m really aware of things that grow in the dirt. I will rinse them, and then I remove whatever the outer layer is. If it’s an onion, I remove that outer layer. If it’s carrots, I always peel them, because you can’t get all the dirt off.”

The CDC also encourages drinking only water from safe sources. When you’re hiking, camping or traveling, make sure water is purified before consuming it. Avoid swallowing water when swimming or playing in outdoor water sources like lakes, ponds or pools.

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