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Long after first bout with E. coli, other sickness, problems can arise with serious consequences
By Lauran Neergaard
Associated Press
Published on Tuesday, Jan 22, 2008
WASHINGTON: It's a dirty little secret of food poisoning: E. coli and certain other foodborne illnesses can sometimes trigger serious health problems months or years after the initial bout.
Scientists only now are unraveling a legacy that has largely gone unnoticed.
What they've spotted so far is troubling. In interviews with the Associated Press, they described high blood pressure, kidney damage, even full kidney failure striking 10 to 20 years later in people who survived severe E. coli infection as children; arthritis after a bout of salmonella or shigella; and a mysterious paralysis that can attack people who had just mild symptoms of campylobacter.
''Folks often assume once you're over the acute illness, that's it, you're back to normal and that's the end of it,'' said Dr. Robert Tauxe of the Centers for Disease Control and Prevention. The long-term consequences are ''an important but relatively poorly documented, poorly studied area of foodborne illness.''
These late effects are believed to make up a very small fraction of the nation's 76 million annual food poisonings, although
no one knows just how many people are at risk. A bigger question is what other illnesses have yet to be scientifically linked to food poisoning.
And with a rash of food recalls — including more than 30 million pounds of ground beef pulled off the market last year alone — these questions take on new urgency.
''We're drastically underestimating the burden on society that foodborne illnesses represent,'' contended Donna Rosenbaum of the consumer advocacy group STOP (Safe Tables Our Priority).
Horror stories
Every week, her group hears from patients with health complaints that they suspect or have been told are related to food poisoning years earlier, like a woman who survived severe E. coli at 8 only to have her colon removed in her 20s. Or people who develop diabetes after food poisoning inflamed the pancreas. Or parents who wonder whether a child's learning problems stem from food poisoning-caused dialysis as a toddler.
''There's nobody to refer them to for an answer,'' Rosenbaum said.
So STOP this month is beginning the first national registry of food-poisoning survivors with long-term health problems — people willing to share their medical histories with scientists in hopes of boosting much-needed research.
Consider Alyssa Chrobuck of Seattle, who at age 5 was hospitalized as part of the Jack-in-the-Box hamburger outbreak that 15 years ago this month made a deadly E. coli strain notorious.
She's now a successful college student but ticks off a list of health problems unusual for a 20-year-old: high blood pressure, recurring hospitalizations for colon inflammation, a hiatal hernia, thyroid removal, endometriosis.
''I can't eat fatty foods. I can't eat things that are fried, never been able to eat ice cream or milkshakes,'' Chrobuck said. ''Would I have this many medical problems if I hadn't had the E. coli? Definitely not. But there's no way to tie it definitely back.''
The CDC says foodborne illnesses cause 325,000 hospitalizations and 5,000 deaths a year. Among survivors, some long-term consequences are obvious from the outset. Some require kidney transplants. They might have scarred intestines that promise lasting digestive difficulty.
Proof difficult
But when people appear to recover, it is difficult to prove that later problems really are a food-poisoning legacy and not some unfortunate coincidence. It might be that people prone to certain gastrointestinal conditions, for instance, also are genetically more vulnerable to germs that cause foodborne illness.
For now, some of the best evidence comes from the University of Utah, which has long tracked children with E. coli. About 10 percent of E. coli sufferers develop a life-threatening complication called hemolytic uremic syndrome, or HUS, in which the kidneys and other organs fail.
Long-term effects
Ten to 20 years after they recover, between 30 percent and 50 percent of HUS survivors will have some kidney-caused problem, says Dr. Andrew Pavia, the university's pediatric infectious diseases chief. That includes high blood pressure caused by scarred kidneys, slowly failing kidneys, even kidney failure that requires dialysis.
''I don't want to leave the message that everyone who had symptoms . . . is in trouble,'' Pavia said.
Miserable as E. coli is, it doesn't seem to trigger long-term problems unless it started shutting down the kidneys the first time around, he said. ''People with uncomplicated diarrhea, by and large we don't have evidence yet that they have complications.''
Doctors have little way to predict which food poisoning survivors will suffer long-term consequences. But survivors of the worst E. coli infections have a high enough risk for later kidney-caused problems that the University of Utah recommends a yearly exam for them in hopes of catching brewing illness early.
WASHINGTON: It's a dirty little secret of food poisoning: E. coli and certain other foodborne illnesses can sometimes trigger serious health problems months or years after the initial bout.
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