The Symptoms of E. coli in Children

A child with a goat at a State Fair
Animals at petting zoos and State Fairs have been a source for E. coli infections. Photo by Justin Sullivan/Getty Images

Fortunately, when most kids get diarrhea, it is caused by a virus and they quickly get better in 5 to 7 days. Even more severe viral infections typically only cause dehydration, which can be treated with a few days of treatment in the hospital.

It seems like we are hearing about more and more cases of food poisoning as a cause of diarrhea these days, though, including outbreaks of Escherichia coli.

According to the CDC, Escherichia coli O157:H7 causes about 95,000 infections, just over 2,000 hospitalizations, and 30 deaths each year in the United States.


Although these infections are not as common as other causes of food poisoning, parents should be aware of the symptoms of E. coli O157:H7 infections, which can include:

  • Non-bloody diarrhea that becomes bloody diarrhea after a few days
  • Stomach pain that comes and goes (cramping pain)
  • Low-grade fever (less than 101˚F), although the fever usually goes away once the child has bloody diarrhea, and some people don't have a fever at all
  • Vomiting
  • Irritability

See your pediatrician if you think that your child has any symptoms of an E. coli infection.

Is It E. coli?

But how do you know if your child has an E. coli infection and not a simple stomach virus or other infection?

One important clue could be that your child was recently exposed to a source of the E. coli bacteria.

Did your child's symptoms start about 3 to 4 days after (the incubation period) being exposed to farm animals or animals at a petting zoo, etc.?

Or did your child recently drink raw milk or eat an undercooked hamburger, something that was recently recalled, or some other high-risk food?

Hemolytic Uremic Syndrome

Hemolytic uremic syndrome or HUS is a complication of E. coli O157:H7 that includes hemolytic anemia (a low red blood cell count), thrombocytopenia (a low platelet count), and renal failure (kidney damage).

Symptoms of HUS can include:

  • Feeling tired because of the anemia
  • Bleeding because of the thrombocytopenia
  • Decreased urination, edema (swelling), and weight gain because of the renal failure

These symptoms begin in about 10% of people with E. coli O157:H7 infections about 2 to 14 days after they begin having diarrhea.

Surprisingly, being treated with antibiotics for the diarrhea is a risk factor for developing HUS.

E. coli Outbreaks

E. coli normally lives in the intestines of people and animals and outbreaks can occur when food or water gets contaminated with this bacteria.

Some sources of E. coli outbreaks include:

  • Undercooked meat
  • Unpasteurized milk, juice, or cider
  • Raw vegetables, alfalfa sprouts, clover sprouts, and fruits that were grown or washed in contaminated water
  • Contaminated drinking water, lakes, or swimming pools
  • People who don't wash their hands well after using the bathroom or changing diapers
  • Petting zoos

Recalled and contaminated foods are also a source or E. coli outbreaks, including Chipotle (2015), ground beef (2014), raw Nestle Toll House cookie dough (June 2009), frozen pizza (2007), Taco Bell (2006), and fresh spinach (2006).

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Article Sources
  • Tserenpuntsag et al. Hemolytic Uremic Syndrome Risk and Escherichia coli O157:H7. Emerging Infectious Diseases. Vol. 11, No. 12, December 2005
  • Scallan et al. Foodborne illness acquired in the United States—major pathogens. Emerg Infect Dis. 2011 Jan
  • CDC. Escherichia coli O157:H7.