Dr. Murray McQuigge
Chance of Long-term Effects
the Walkerton Outbreak
Walkerton who were sick with gastrointestinal illness as a result of Walkerton
water contamination have asked for information on the long-term effects of the
The risk of
suffering long-term effects from E. coli 0157:H7 is small.
Only 2-10% of those who experienced E. coli symptoms might have long-term
problems. Even more rare are
long-term complications from campylobacter infection; campylobacter is another,
usually less severe, bacterial contaminant associated with the Walkerton
two fact sheets outlining possible problems that can arise from E. coli 0157:H7
and campylobacter bacteria. People
with health concerns should talk to their family physicians.
The Grey Bruce Health Unit has provided information to the
doctors of Bruce and Grey Counties regarding the potential consequences of E.
coli and campylobacter.
might occur after E. coli 0157:H7?
and adults who develop diarrhea due to E. coli O157:H7 infection recover
completely. This means that 90-98% of
people who have been ill with E. coli O157:H7 will recover from their diarrheal
illness and remain well.
may experience post-infectious irritable bowel syndrome, a condition that can
occur after a variety of gastrointestinal infections and that resolves with
time. Symptoms such as bloating, gas, stomach discomfort, loose stool or
constipation may develop as the bowel returns to normal. Increased awareness of
bowel function may also have a role. A few people report that foods containing
lactose (e.g., milk and other dairy products) or fructose (e.g., fruits,
juices), or other foods upset their stomach leading to a temporary food
intolerance. These consequences are usually not severe and resolve with time.
consequences of E. coli O157:H7 infection may occur in people who developed "hemolytic
uremic syndrome" (HUS). HUS is a serious complication of E. coli
infection that can lead to kidney failure. The syndrome occurs in less than 10%
of individuals infected with E. coli O157:H7. Symptoms of HUS include a decrease
in the amount of urine produced, swelling in the face, hands, and feet, paleness
of the skin, irritability and fatigue. Young children, especially those under 5
years of age, and the elderly are most at risk for HUS. Anyone with these
symptoms should see their doctor immediately.
who have developed HUS, long-term consequences depend on how severe their
illness was. While some people with HUS recover fully, about one third of people
with HUS will continue to have abnormal kidney function, and a few will require
long-term dialysis. Other complications for people who have had HUS include high
blood pressure, gallstones, seizures, blindness, paralysis and the effects of
having part of the bowel removed.
consequence that may occur weeks after illness is the development of
"strictures" or narrowing of the bowel. This occurs mostly in people
with HUS, but has been observed in at least one person without HUS. Bowel
strictures can lead to a change in bowel pattern - concerned individuals should
be assessed by a doctor.
physicians, general practitioners and pediatricians in Bruce and Grey Counties
have received information on potential consequences of E. coli 0157:H7
infections as well as Campylobacter infections. See your doctor if you are
concerned about your health.
If you have
questions, call the Grey Bruce Health Unit.
might occur after Campylobacter?
there are many different strains of Campylobacter, this fact sheet provides
information on the Campylobacter species linked to the Walkerton outbreak.
children and adults who develop diarrhea due to Campylobacter infection recover
completely and without specific treatment. The
diarrhea, which may be bloody, usually resolves within 10 days. Some people
don't have any symptoms at all. However,
some adults will have prolonged illness and diarrhea
can reoccur. If this is the
case, you should see your doctor.
condition that has been associated with Campylobacter infection is called
Guillane-Barre syndrome (GBS). This very rare syndrome has been shown to occur
in about 1-2 per 2,000 cases of Campylobacter infection. Symptoms typically
develop within 2-3 weeks of infection. The syndrome leads to paralysis of arm
and leg that can progress to respiratory muscles over 2-3 weeks. Recovery can
take weeks to months with a minority of people having permanent effects of the
paralysis. Death from GBS can also occur. GBS following Campylobacter infection
tends to be more severe than GBS that occurs without prior infection.
Fortunately, GBS after Campylobacter infection is rare.
potential consequence of Campylobacter is the development of joint pain called
"reactive arthritis" (also called Reiter's Syndrome). This form of
arthritis has also been linked to other gastrointestinal infections. Leg and
lower back joints are most commonly affected. Reactive arthritis usually occurs
within 7-30 days after the onset of diarrhea. About 1% of people with
Campylobacter diarrhea develop reactive arthritis, especially if they carry a
specific genetic marker called HLA B27.
can sometimes cause illness in other body parts including the gall bladder,
pancreas, liver, urinary tract, blood stream, skin, bone or joints. People who
develop these illnesses often have other significant health problems. Symptoms
from these body sites usually occur at the same time as the diarrhea and usually
make people quite ill. Infection of these sites does not usually occur after
Campylobacter symptoms have resolved. Although Campylobacter infection might
increase the risk of miscarriage slightly, the developing baby is not thought to
be affected. Anyone concerned should follow up with his/her doctor.
Fortunately, almost everyone with
Campylobacter diarrhea recovers fully within 2-10 days.
Family physicians, general practitioners and pediatricians in Bruce and Grey Counties have received information on potential consequences of Campylobacter infections as well as E. coli 0157:H7 infections. See your doctor if you are concerned about your health.If you have questions, call the Grey Bruce Health Unit.