Shiga toxin-producing organism (E. coli O157 and other STEC)
Escherichia coli (E. coli) are bacteria that cause diarrheal illness. There are many different kinds of E. coli bacteria. Although most strains are harmless and live in the intestines of healthy people and animals, some produce a toxin that can cause severe illness; these strains are called Shiga toxin-producing E. coli (STEC). The most commonly reported in the United States are E. coli 0157:H7, which can cause a type of kidney failure called hemolytic uremic syndrome. People become infected when they ingest contaminated food, unpasteurized milk or apple cider, and soft cheeses made from unpasteurized milk. Infection can also occur when people swallow lake water, and by not washing hands before eating after visiting animal exhibits.
Actions Required and Control Measures
Reporting Requirements - Category 2
Escherichia coli O157:H7 is physician reportable by mail within 12 hours of recognition or strong suspicion to both the Connecticut Department of Public Health (DPH) and the local health department (LHD). The director of any clinical laboratory must also report laboratory evidence of Escherichia coli O157 to both the DPH and the LHD. Additional laboratory requirements: Isolates of E. coli O157 must be submitted to the DPH State Public Health Laboratory for confirmation. To assure you have the most up-to-date information concerning reportable diseases, please visit the Reporting of Diseases, Emergency Illnesses, Health Conditions, and Laboratory Findings page.
National Surveillance Case Definitions
Case Investigation
LHD Responsibility: If a person spends time in a high-risk setting, the LHD will work with DPH to implement control measures and/or investigate and identify a common source of infection.
DPH Responsibility: The DPH, through FoodNet/FoodCORE, will interview all cases of STEC infection and will notify the LHD if a person is in a high-risk setting.
Control Measures
Food Handler: Refer to DPH Food Protection Program at 860-509-7297.
Health Care Worker with Direct Patient Contact: Individuals with laboratory-confirmed infection should be restricted from direct patient care until diarrhea ceases and two consecutive negative stool cultures spaced at least 24 hours apart are obtained. If person was treated with antibiotics, cultures should be collected at least 48 hours after last dose.
Day Care Setting: Children and/or staff with laboratory-confirmed infection should be excluded from day care until diarrhea ceases and two consecutive negative stool cultures spaced at least 24 hours apart are obtained. If the person was treated with antibiotics, cultures should be collected at least 48 hours after last dose. Any other daycare attendees and/or staff with diarrhea should be identified and cultured. Improved sanitation and personal hygiene should be emphasized in day care settings. Proper hand hygiene by staff and children should be stressed, especially after using the toilet or handling soiled diapers.
Household Contacts: Household contacts with diarrhea should be excluded from food handling, day care, and care of patients until diarrhea ceases and two (2) consecutive negative stool cultures taken at least 24 hours apart are obtained. Asymptomatic household contacts involved in food handling, day care, or care of patients should have at least one stool specimen cultured. Stress good hand washing technique. Asymptomatic household contacts should not be restricted from work or day care pending culture results.
This page last updated 11/9/2022.