普通微生物學（二）作業

丘義德 食科 2A
01132048

Hemorrhagic Diarrhea

Hemorrhage is the medical term for bleeding. It most often refers to excessive
bleeding. Hemorrhagic diseases are caused by bleeding, or they result in bleeding
(hemorrhaging). So Hemorrhagic Diarrhea (出血性腹瀉) literally means bloody diarrhea. It
is caused by Enterohemorrhagic Escherichia coli (EHEC) infection. The disease starts by
feeling severe abdominal cramps that begin suddenly along with watery diarrhea, which may
become bloody within 24 hours. The diarrhea usually lasts 1 to 8 days. Fever is usually absent or
mild but occasionally can exceed 102° F (39° C).

Escherichia coli (E. coli) are normal bacterial flora of the human gastrointestinal tract and
can be classified by their O and H antigens. When these strains acquire certain genetic material,
they can become pathogenic. Enterohemorrhagic Escherichia coli (EHEC) (腸出血性大腸
桿菌) are strains capable of producing Shiga toxin, the toxin causes damage to the lining of the
intestinal wall and typically cause bloody diarrhea. Enterohemorrhagic E. coli (EHEC) use
a type 3 secretion system (T3SS) to inject dozens of effector proteins into the host cell. The
effectors manipulate host cell processes including the host cytoskeleton, immune response, cell
survival, and gut integrity. The incubation period of EHEC is 2–10 days, with a median of 3–4
days for most serotypes.

An EHEC infection can make you very ill. Symptoms usually begin 2 to 5 days after
ingesting contaminated foods or liquids, and may last for up to 8 days or more. The symptoms
may vary for each person but often include severe stomach cramps, diarrhea (often bloody), and
vomiting. Recovery for most people with this illness usually occurs within 5 to 10 days. It is
important to drink plenty of fluids to prevent dehydration. Some infections are very mild, but
others are severe or even life–threatening. Antibiotics and antidiarrheal medicines are not used
with this type of infection. They may increase the risk of Hemolytic uremic syndrome (HUS), a
serious complication that can cause symptoms of decreased urination, extreme fatigue, pale
skin, and anemia. If a person develops HUS, hospitalization in an intensive care unit may be
required. Treatment may include blood transfusions and kidney dialysis.

EHEC is spread from animals to people by eating raw or uncooked ground beef, pork,
lamb, or sausage, unpasteurized milk, apple juice or apple cider, or contaminated spinach,
lettuce, sprouts, or water. Not washing hands after using the bathroom and working with cattle
can also increase the risk of getting the infection. The Centers for Disease Control and
Prevention (CDC), the national public health agency of the United States have a complete list of
recommendation for preventing this infection, they are;

 Cook all ground beef, pork, lamb, or sausage thoroughly. Make sure that the cooked meat is gray
or brown throughout (not pink), any juices run clear, and the inside is hot.
 Use a digital instant-read meat thermometer to make sure the temperature of the meat has reached
a minimum of 160° F.
 If you are served an undercooked hamburger in a restaurant, send it back.
 Wash all vegetables and fruits with water, especially if you do not plan to cook them.
 Use only pasteurized milk and milk products. Avoid raw milk.
 Use only pasteurized juices and ciders.
 Keep raw meat separate from ready-to-eat foods.
 Make sure that infected people, especially children, wash their hands carefully and frequently
with soap to reduce the risk of spreading the infection.
 Drink municipal water that has been treated with adequate levels of chlorine, or other effective
disinfectants.
 Avoid swallowing lake or pool water while swimming.
 Wash hands thoroughly after using the toilet or changing diapers.
 Wash hands thoroughly after handling animals, animal bedding, or any material contaminated
with animal feces.
 People with diarrhea should not: swim in public pools or lakes, bathe with others, or prepare food
for others.

By following those recommendation, the risks of getting Hemorrhagic Diarrhea that are caused by
Enterohemorrhagic Escherichia coli (EHEC) infection are going to be very low.
Recent researches Literature :

Chronic Diarrhea, Hemorrhagic Colitis, and Hemolytic-Uremic

Syndrome Associated with HEp-2 Adherent Escherichia coli in Adults
Infected with Human Immunodeficiency Virus in Bangui, Central
African Republic
Christian Mossoro,1 Philippe Glaziou,2 Simon Yassibanda,3 Nguyen Thi Phuong
Lan,1 Claudine Bekondi,1 Pierre Minssart,4 Christine Bernier,5 Chantal Le
Bouguénec,5 and Yves Germani1,*

ABSTRACT

In human immunodeficiency virus (HIV)-infected adults from the Central

African Republic, the occurrence of chronic diarrhea due to HEp-2
adherent Escherichia coli (EAEC) harboring virulence markers (eaeA,
BFP, EAF, astA determinant of EAST/1, positive FAS test,
enteropathogenic E. coli O serogroup) was shown to be associated with
AIDS. We also show that EAEC that produce verotoxin (Stx2) but do not
harbor the genetic markers for classical enterohemorrhagic E. coli are
involved in hemorrhagic colitis and hemolytic-uremic syndrome in
patients with HIV.

在中非共和國感染人類免疫缺陷病毒(HIV) 的成年人中，由於 HEp-

2 黏附性大腸桿菌(EAEC) 攜帶毒力標記物（eaeA、BFP、EAF、
EAST/1 的 astA 決定子、陽性）而發生慢性腹瀉。FAS 檢測（腸致
病性大腸桿菌 O 血清群）被證明與愛滋病相關。我們也證明，產生
維羅毒素（Stx2）但不帶有經典腸出血性大腸桿菌遺傳標記的
EAEC 與 HIV 患者的出血性結腸炎和溶血性尿毒症綜合症有關。