For health professionals: E. coli (Escherichia coli) infection

Find detailed information for health professionals on illness due to E. coli infection.

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What health professionals need to know about E. coli infection

E. coli bacteria are in the family Enterobacteriaceae, and can cause food-borne and water-borne illness.

Verotoxigenic E. coli infections are national notifiable diseases. All health professionals are to report cases to their provincial or territorial public health authorities.

Clinical manifestations

Patients with E. coli enteritis usually have an abrupt onset of watery diarrhea that does not contain:

  • pus
  • blood
  • mucous (nondysenteric)

The diarrhea is usually mild to moderate in severity. Some patients may have severe fluid loss.

The following symptoms may also be present:

  • nausea
  • abdominal pain
  • low-grade fever

A self-limited course, with resolution in 2 to 5 days, is most common in adults who acquire the disease. However, some strains of the organism may produce a disease lasting much longer, with a 7-day median duration of illness. 


Stool culture is a common method used to identify E. coli. Bacteria can be detected using:

  • non-radioactively labeled oligonucleotides DNA probes
  • a polymerase chain reaction (PCR) targeted against the heat-labile and heat-stable genes

An enzyme-linked immunosorbent assay (ELISA) can also be used to detect heat-labile and heat-stable genes.


Antimicrobial therapy is generally not indicated for E. coli infections.

Treatment of fluid and electrolyte loss is usually achieved through oral rehydration. The use of the World Health Organization oral rehydration salts (ORS) solution has been recommended.

Dehydration may become severe or life-threatening in neonates and children, necessitating aggressive fluid and electrolyte replacement.

Intravenous rehydration may be necessary for:

  • infants
  • those with severe dehydration
  • individuals with excessive vomiting

Bismuth subsalicylate may decrease the:

  • duration of disease
  • amount of diarrhea

For additional information on treatment, refer to your jurisdiction-specific guidelines.


Health professionals in Canada play a critical role in identifying and reporting cases of E. coli infection. See the surveillance section for more information on surveillance in Canada.

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