Enteroinvasive E. coli

Enteroinvasive E. coli cause a dysentery-like illness by invading the epithelial cells of the large intestine where they cause necrosis, ulceration and inflammation.

They cause sporadic outbreaks of diarrhoea in older children and adults, some of which are food-borne.

Enteroinvasive serotypes include 0124, 0136, 0143 etc.

Reservoir:

• Gastrointestinal tract of humans and animals

Epidemiology:

• may be associated with travel to developing countries
• may cause cases of gastroenteritis and outbreaks in developed countries

Transmission:

• faecal-oral from person to person (EPEC), foodborne (ETEC, EPEC, EIEC) or waterborne (ETEC, EPEC, EIEC) spread

Incubation period:

• Reported range from 1 hour to 7 days. Most cases within about 10-50 hours (ETEC, EIEC) or about 8-18 hours (EPEC, EAEC)

Common clinical features:

• Diarrhoea (all types), often watery. Abdominal pain common (ETEC, EPEC, EIEC). Nausea, vomiting and fever may occur (all) and/or blood and mucus (EIEC, EAEC)

Infectivity:

• Whilst symptomatic and for 48 hours after diarrhoea has stopped

Notes:

• Excretion often longer than 48 hours after remission, but infectious risk low if normal stools

Reference:

• PHE (2019). Recommendations for the Public Health Management of Gastrointestinal Infections