Symptoms normally begin around three to four days after being exposed to STEC, but it can range from one to 10 days. STEC symptoms can vary and illness can range from mild to severe. Common symptoms include:

• Diarrhea (sometimes bloody)
• Stomach cramps
• Vomiting
• Low-grade fever

Most people will start to feel better in five to seven days. If it does develop, HUS normally appears around seven days after symptom onset and when diarrhea is improving. Symptoms of HUS include:

• Decreased frequency of urination
• Fatigue, or feeling very tired
• Irritability
• Losing pink color in cheeks and inside the lower eyelids

Diagnosis

STEC infections are normally diagnosed through laboratory testing of a poop sample. Shiga toxin positive specimens must be sent to the Indiana Department of Health Lab for confirmation and additional testing.

Treatment

STEC infections should be treated with supportive therapy, such as hydration. There is also no evidence that treating STEC infections with antibiotics is helpful, and they should not be used since they may increase the risk of HUS. Antidiarrheal agents like Imodium® may also lead to an increased risk of HUS and should be avoided.

• Practice good hand hygiene and use good handwashing techniques
  • Wash your hands after using the restroom, before and after preparing food, and after contact with animals or their environments
• Follow food safety guidelines
  • Clean food preparation work surfaces, equipment, and utensils with soap and water before, during, and after food preparation
  • Separate raw and cooked foods
  • Wash fruit and vegetables under running water before eating or cooking
  • Cook meat to a safe temperature to kill harmful bacteria
    • Ground beef and pork should be cooked to a minimum internal temperate of 160 degrees F (70 degrees Celsius)
    • Beef steaks and roasts should be cooked to an internal temperature of at least 145°F (62.6˚C)
• Consume only pasteurized dairy products and juices
• People with diarrhea and/or vomiting should not prepare food or provide health care for others and should limit direct contact with others as much as possible
• Avoid swallowing water when swimming or playing in lakes, ponds, streams, swimming pools, or other bodies of water

Once you or your child start having symptoms of the illness, such as diarrhea, do not attend work (specifically for food handlers, healthcare workers, daycare workers) or attend daycare or school until a healthcare provider or someone from your local health department says you are clear to go back.

If you believe you have STEC and have not yet been treated or spoken to a doctor, please be sure to do so. You should be evaluated by a doctor to confirm that you have STEC, and that you get the correct treatment. You should also respond to requests to be interviewed by your local or state public health department. An investigation will take place for every confirmed case of STEC. It is important that you answer the call from your local or state health department so that other people in your home or near you are not at risk of getting STEC as well. An investigation may also look into your exposures to check if other people are at risk.