Consider this your friendly reminder to wash produce and cook meat carefully.

By Blake Bakkila
Updated March 27, 2019

Every year there are at least a handful of E. coli outbreaks reported to the Centers for Disease Control and Prevention (CDC). In 2018, two outbreaks linked to romaine lettuce made headlines; in total more than 100 people were hospitalized, and the leafy green was recalled widely.

Knowing that an E. coli outbreak is likely to happen again, here's everything you need to know to stay safe.

What is E. coli?

Escherichia coli, or E. coli, is a bacteria that inhabits the gut of humans as well as other animals, says Pritish Tosh, MD, an infectious disease physician and researcher at the Mayo Clinic. Many types of E. coli are normal, harmless parts of the flora of the gut.

The strain that contaminated romaine lettuce in 2018 was Shiga toxin-producing E. coli (STEC), according to the CDC. It's one of the nasty, pathogenic types of E. coli that can sicken a person who consumes food harboring the bacteria. How does E. coli end up on leafy greens? One way is through tiny, even invisible amounts of animal or human fecal matter. When you dive into your chef salad, you might unknowingly ingest fecal particles that contain E. coli. (Gross, yes.)

Contamination with E. coli can occur at any point in the food production cycle, from when it's picked to when it's processed and packaged. Says Dr. Tosh: "Let’s say a person is making a chicken salad in their own kitchen, and doesn’t use good food preparation habits, like handwashing first. That could contaminate the vegetables in the salad.”

E. coli symptoms to watch for

Dr. Tosh says that common symptoms of an E. coli infection are diarrhea, fever, and abdominal cramping. You’ll typically get sick with bloody diarrhea about three to four days after you’ve been contaminated, and most people recover in a week with proper rest and hydration, says Laura Gieraltowski, PhD, MPH, an epidemiologist at the CDC. “It’s a tough week, but it’s usually over within a week.”

Sometimes, however, an E. coli infection turns into the much more serious hemolytic uremic syndrome. HUS is most common among children under the age of 5, older adults, and people with weakened immune systems, says Gieraltowski. Symptoms include fever, abdominal pain, pale skin tone, and decreased urination. Anyone who has these symptoms should seek emergency medical care, advises Gieraltowski.

How to stay safe

During an E. coli outbreak, follow CDC and FDA recommendations about which foods are safe to eat. Specific brands may be recalled and you may be advised to discard recalled food you've already purchased.

Of course, continue to follow basic meal prep hygiene rules: Always wash your hands before and after preparing food, and wash or scrub all produce before cutting, cooking, and eating. Cook meats thoroughly, and carefully wash anything raw meat touches, advises the CDC.

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This post was originally published on April 23, 2018 and has been updated for accuracy.