Toxicology Expert Witness – Long Term Effects of E Coli

Toxicologist from Texas

As we eat in places other than our kitchen, poor sanitation and contamination of food sources becomes a significant problem. Although the FDA has established a series of guidelines for food safety, CDC incidence reports of Listeria, Salmonella and E.coli 01 57:H7 are on the rise. Some of the acute clinical symptoms related to these types of bacterial infection appear to be self limiting, but the reality is that life-long problems persist. Of interest to the lawyer and patient, is to ensure that these significant risk factors are considered when the damages to the person are assessed.

Ranging from beef to watermelon, exposure to the enterohemorrhagic E.coli 01 57:H7, can result in death. In addition to the most common symptoms of acute infection, i.e. addominal cramps, diarrhea, vomiting, fever, chills, malaise, nausea, and headache, the more severe cases quickly progress to hemorrhagic colitis and/or hemolytic uremic syndrome (HUS) with renal failure. Of those people, usually children and elderly, who do get HUS, approximately 5% die and at least 30% have life-long complications. Although diarrhea (sometimes bloody) is a common characteristic, at least 10% of the affected people with HUS never develop diarrhea. Also, because many physicians are not trained in the diagnosis of E.coli 01 57:1-17, a number of unnecessary appendectomies are done each year. Thus, there are secondary complications and the symptoms can persist for years.

Conditions that are often not recognized as related to the acute infection, are specific long-term sequelae: atherosclerosis, reactive arthritis, stroke, seizure, blindness, coma, pancreatitis, diabetes mellitus, pleural and pericardial effusions, cholelithiasis, colonic stricture, and cognitive impairment. As a result of the verocytotoxins produced by the E. coli 01 57:H7, there is significant insult to the body. The verocytotoxins cause damage to numerous organs and tissues, leading to aberrant responses from the immune system, cardiovascular complications, and neurological dysfunction. Since the E. coli 01 57:H7 may remain in the body for extended periods of time, as evidenced by continued shedding of the bacteria for weeks after the acute

clinical symptoms may seem to have resolved, other complications are common. People who have been diagnosed with HUS, are at a significant risk for life-long renal dysfunction or failure, and neurological problems, ranging from seizures through blindness.

At the present time, there is no effective antibiotic that ensures the decreased spread of the bacteria through the food supply. Since most of this spread is through contamination, health care officials and toxicologists have reason for concern. We know that control of the bacteria truly requires a community effort.


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