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E. coli
Up one level2007 Beach Water Quality Testing Program
The Health Unit has started the 2007 beach water quality testing program. We will be monitoring 9 public beaches throughout the Windsor-Essex County area.
About Beach Water Quality
To ensure that the water at public beaches is safe for swimming, the Windsor-Essex County Health Unit will be monitoring 9 public beaches on a weekly basis throughout the summer.
E. coli
E. coli are bacteria that many animals and humans have in their intestines. Some types of E. coli are not harmful but others like E. coli 0157:H7 can cause serious illnesses. How can you get sick? People can get E. coli infection from eating: - Undercooked or improperly stored animal meat sources like: beef, ham, turkey, sandwich meats, or cheese - Unpasteurized apple cider and milk - Unwashed, raw vegetables - Contaminated waterOnce someone has eaten contaminated food, they can pass the infection to another person from hand to mouth contact. Poor hand washing and improper food handling can lead to the spread of the illness. In adults the bacteria is contagious for one week or less. Iin one third of children it is contagious for three weeks. E. coli does not survive on countertops, tables, or in the air, and it is not spread through casual contact, or by coughing or kissing. What are the symptoms? Symptoms can occur 2 to 10 days after exposure to the E. coli bacteria. Common symptoms include: - Diarrhea (sometimes bloody) - Severe stomach cramps - Nausea & vomiting - Fever (occasionally)A serious complication could develop called, Hemolytic Uremic Syndrome (HUS). Someone with HUS may not urinate as much and as often as they should. They may also have swelling in the face, hands and feet, paleness of the skin, irritability and fatigue (tired). HUS can lead to kidney failure. Continue to watch for signs of HUS, even if diarrhea has stopped. If you develop these symptoms, seek immediate medical attention. What treatment is available? Usually E. coli passes through the intestines naturally in 5 to 10 days. Antibiotics and anti-diarrhea medications are not recommended because they can increase the risk of complications. How can E. coli infections be prevented? - Cook meat thoroughly, until juices run clear & the meat is not pink. - Be sure the milk and apple cider you drink is pasteurized. - Wash all fruits and vegetables before eating. - Wash hands often and thoroughly with warm water and soap. It is very important to wash hands before preparing food or eating, and after using the toilet, handling pets or changing diapers. - Clean and sanitize countertops and utensils after preparing raw meats and poultry. - Only drink water from a safe water supply. Do not drink from open streams or lakes. Do not prepare or handle food if you have diarrhea.Note: Infants, children, food handlers and healthcare workers should remain at home until they have been diarrhea free for at least 24 hours. During a community outbreak people may be asked to stay home longer. Sources: 1. Heymann D.L. (Ed.). (2004). Control of Communicable Diseases Manual, (18th ed.). Washington, DC: American Public Health Association 2. Centers for Disease Control & Prevention. Escherichia coli O157:H7. Retrieved June 2005, from http://www.cdc.gov/ncidod/dbmd/diseaseinfo/escherichiacoli_g.htm Revised June 2005-kc
Enterobacter (for the health care provider)
What are enterobacter? Enterobacter are gram-negative bacteria found in the environment, on human skin, and in our intestinal tract. While many are harmless, several species are opportunistic pathogens present in hospital settings. The most common pathogenic species are E. cloacae and E. aerogenes. Although enterobacter rarely infect healthy people, they can cause significant morbidity and mortality in immunocompromised patients. Enterobacter, similar to other gram-negative bacteria like salmonella and E. coli, produce an endotoxin that causes inflammation. The best and most effective infection control measure is simple and easy to do. Wash your hands thoroughly, regularly, and often. Why are enterobacter a concern? Infections caused by enterobacter bacteria are a concern because they are increasingly common and are often caused by antibiotic resistant strains. Between 5% and 15% of hospital in-patients develop an infection during their admission and patients in an intensive care unit (ICU) are 5 to 10 times more likely to get a hospital acquired infection than those in general wards (Lim and Webb, 2005). Of these infections, enterobacter represent 6% of all hospital-acquired isolates and 11% of all pneumonia isolates. They are the most frequently isolated gram-negative organisms in intensive care unit (ICU) bloodstream infections and they are the third most common pathogen isolated in cases of ICU pneumonias. Because of their prevalence and pathogenisis, antibiotic resistance in this bacterium is particularly alarming. Recent studies have found that 35 - 50% of Enterobacter involved in nosocomial infections are resistant to second and third generation cephalosporins and broad spectrum penicillins. The rates are much lower for fourth generation cephalosporins and carbapenems, but are increasing (Goossens, 2005). These rates are significant because infections caused by resistant organisms are thought to result in higher morbidity and mortality, prolonged hospitalization, and increased costs compared with infections caused by sensitive strains. What are the symptoms? Symptoms of enterobacter infections are not specific to the bacteria and present as other gram-negative bacilli infections. The urinary and respiratory tracts are the most common sites of enterobacter infection. However, these bacteria can cause infections at many different sites, such as: - The lower respiratory tract - Urinary tract - Joint - Skin - Heart - Intra-abdomen - Soft tissue - Bone - How is an enterobacter infection treated? Antimicrobial therapy is indicated in virtually all infections caused by enterobacter. However, there is concern over the levels of resistance of these bacteria to a number of antibiotics. Second and third generation cephalosporins and broad spectrum penicillins shouldn’t be used to treat confirmed enterobacter infection, regardless of the apparent in-vitro susceptibility. Carbapenems are therefore the current antibiotics of choice to treat enterobacter infections. Who is at risk? Patients are most susceptible to enterobacter infections if they stay in the hospital, especially the ICU, for extended periods. Patients under the age of 2 and over the age of 65 are especially susceptible to infection. Other risk factors include: • Prior use of antimicrobial agents. • Underlying diseases. • Ulcers of the upper gastrointestinal tract. • Presence of intravenous catheters. • Serious conditions such as burns or mechanical ventilation. • Immunosuppression. FYI Catheters and other invasive devices are the # 1 exogenous cause of hospital-onset infections. What you can do: • Use catheters only when essential. • Make sure the right catheter is used. • Follow proper insertion and catheter-care protocols. • Remove catheters when no longer essential. How are enterobacter infections spread? Enterobacter are spread like other gram-negative bacteria, such as salmonella. This means that they spread through contact with the bacteria on patients, contaminated surfaces, and medical equipment. Once a health care worker gets the bacteria on his/her hands, it then spreads to patients and other contact items. The spread of pathogenic bacteria in health care facilities can be stopped. It’s every health care worker’s responsibility to always follow basic infection control procedures. This should be done with all patients at all times, regardless of diagnosis or infectious status. What can I do to stop the spread? Infection control procedures are critical to control the spread of pathogenic bacteria. These procedures must be followed at all times and are essential to provide a high level of protection to patients, health care workers, and visitors. Standard infection control measures: • Wash your hands and use hand-sanitizers thoroughly, regularly, and often. • Practice good hand hygiene. • Use personal protective equipment when handling blood, body substances, excretions, and secretions. • Handle patient care equipment and soiled linen with care in order to prevent exposure to skin, clothing, and other objects. • Always handle waste appropriately. • Know and follow infection control guidelines of your facility. • Move and transport patients only for essential purposes. For more information For a detailed description of infection control procedures check with your infection control specialist and the World Health Organization guidelines for infection control in health care facilities. References: Conly, J. (2002). Antimicrobial resistance in Canada. Canadian Medical Association Journal, 167, 885-91. Goossens, H. (2005). European status of resistance in nosocomial infections. Chemotherapy 26, 177–181. Health Canada. (2001). Office of laboratory security data sheet - infectious substances: Enterobacter spp. Retrieved on March 11, 2008 from http://www.phac-aspc.gc.ca/msds-ftss/msds59e.html Lim, SM, Webb, SA. (2005). Nosocomial bacterial infections in Intensive Care Units I: organisms and mechanisms of antibiotic resistance. Anaesthesia, 60,887–902.
Food Service Establishment Guidelines for Boil Water Advisories
Food service establishments may continue to operate during the boil water advisory as long as the following measures are strictly adhered to (based on the above water treatments):
Mandatory Boil Water Advisories - What you need to know!
A mandatory boil water advisory means that E. coli has been detected in your water. Your water is unsafe to drink!