Ebstein's anomaly

Ebstein's anomaly

Definition:

Ebstein's anomaly is a rare heart defect that's present at birth (congenital). In Ebstein's anomaly, your tricuspid valve — the valve between the chambers on the right side of your heart — doesn't work properly. Blood leaks back through the valve, making your heart work less efficiently. Ebstein's anomaly may also lead to enlargement of the heart or heart failure.

If you have no signs or symptoms associated with Ebstein's anomaly, careful monitoring of your heart may be all that's necessary. If signs and symptoms bother you, or if the heart is enlarging or becoming weaker, treatment for Ebstein's anomaly may be necessary. Treatment options include medications and surgery.

Symptoms:


Mild forms of Ebstein's anomaly may not cause symptoms until later in adulthood. If signs and symptoms are present, they may include:

• Shortness of breath
• Fatigue, especially with exertion
• Leg swelling
• Heart palpitations or abnormal heart rhythms (arrhythmias)
• A bluish discoloration of the lips and skin caused by low oxygen (cyanosis)

When to see a doctor
If you or your child has signs or symptoms of heart failure — such as feeling easily fatigued or short of breath, even with normal activity — or is showing blue skin coloration around the lips and nails (cyanosis), talk to your doctor. He or she may refer you to a doctor who specializes in heart disease (cardiologist).

Causes:

Ebstein's anomaly is a heart defect that you have at birth (congenital). Why it occurs is still unknown. To understand how Ebstein's anomaly affects your heart, it helps to know a little about how the heart works to supply your body with blood.

How your heart works
Your heart is made up of four chambers. The top two chambers are called the right and left atria (plural for atrium). The two lower chambers, the ventricles, are larger, thicker walled chambers that do the work of pumping blood. Separating the atria from the ventricles are valves, which keep the blood flowing in the right direction through the heart. Each valve consists of two or three strong, thin flaps (leaflets) of tissue. When closed, a valve prevents blood from flowing to the next chamber or from returning to the previous chamber.

Blood returning from your body, which lacks oxygen, flows into the right atrium, through the tricuspid valve and then into the right ventricle, which pumps the blood to your lungs to receive oxygen. On the other side of your heart, oxygen-rich blood from your lungs flows into the left atrium, through the mitral valve and then into the left ventricle, which then pumps the blood to the rest of your body.

What happens in Ebstein's anomaly
In Ebstein's anomaly, the tricuspid valve is farther down into the right ventricle than it would be in a normal heart. This makes it so that a portion of the right ventricle becomes part of the right atrium (becomes atrialized), causing the right atrium to be larger than usual. Because of this, the right ventricle can't work properly.

In addition to the problems with the placement of the tricuspid valve, the valve's leaflets are abnormally formed. This can lead to blood leaking backward (regurgitating) into the right atrium. In severe cases, the leaflets may be tethered to the wall of the heart, leading to severe leakage of blood into the atrium.

Where the valve is placed and how poorly it's formed varies from person to person. In some people, the valve is only mildly abnormal. In others, the valve may be extremely displaced, and it may leak severely. The more the valve leaks, the more the right atrium enlarges as it receives more blood. At the same time, the right ventricle enlarges (dilates) as it tries to cope with the leaky valve and still deliver blood to the lungs. Thus, the right-sided chambers of the heart enlarge, and as they do, they weaken, leading to heart failure.

Other heart conditions associated with Ebstein's anomaly
Other heart conditions may be associated with Ebstein's anomaly. Three common conditions are:

• Atrial septal defect. About half the people with Ebstein's anomaly have a hole between the two upper chambers of the heart called an atrial septal defect (ASD). This hole may allow deoxygenated blood in the right atrium to mix with oxygenated blood in the left atrium, decreasing the amount of oxygen available in your blood. This causes a bluish discoloration of the lips and skin (cyanosis). The ASD associated with Ebstein's anomaly can increase your risk of a blood clot passing from the veins in your heart into the blood vessels leading to your brain and causing a stroke. If you have surgery to repair your tricuspid valve, your surgeon will also close the ASD at the same time.
  
• Abnormal heartbeats (arrhythmias). Some people with Ebstein's anomaly have an abnormal heart rhythm (arrhythmia) characterized by rapid heartbeats (tachycardia). These types of arrhythmias (tachyarrhythmias) can make your heart work less effectively, especially when the tricuspid valve is leaking severely. In some cases, a very fast heart rhythm may cause fainting spells (syncope).
  
• Wolff-Parkinson-White (WPW) syndrome. Some people with Ebstein's anomaly may also have a condition known as Wolff-Parkinson-White syndrome — an abnormal electrical pathway in the heart. The presence of WPW syndrome can lead to very fast heart rates and fainting spells.

Complications:


Many people with mild Ebstein's anomaly have few complications. However, you may need to take some precautions in certain situations:

• Being active. If you have mild Ebstein's anomaly with a nearly normal heart size and no heart rhythm disturbances, you can probably participate in most physical activities. Depending on your signs and symptoms, your doctor may recommend that you avoid competitive sports, such as football or basketball. Your doctor can help you decide which activities are right for you.
  
• During pregnancy. In many cases, women with mild Ebstein's anomaly can safely have children. But pregnancy does have risks. If you plan on becoming pregnant, be sure to talk to your doctor ahead of time. He or she can tell you if it's safe for you to become pregnant and help decide how much extra monitoring you may need throughout pregnancy and childbirth.
  
  Being pregnant puts additional strain on your heart and circulatory system not only during pregnancy, but also during labor and delivery and for a period of time after your baby's birth. There is an increased risk of stroke if you have a hole between the upper chambers of the heart (atrial septal defect). Rarely, women with Ebstein's anomaly develop severe complications that can cause death during pregnancy.
  

Other complications that may result from Ebstein's anomaly include heart failure, heart rhythm problems and, less commonly, sudden cardiac arrest or stroke.

Treatments and drugs:


Treatment of Ebstein's anomaly depends on the severity of the defect and your signs and symptoms. The goal of treatment is to reduce your symptoms and avoid future complications, such as heart failure and arrhythmias. Treatments may include:

Regular monitoring
If you have no signs or symptoms or abnormal heart rhythms, your doctor may recommend only careful monitoring of your heart condition with regular checkups. Checkups typically include a physical exam, electrocardiogram, chest X-ray, echocardiogram and, if necessary, a Holter monitor test. Your doctor may also ask you to undergo an exercise test, such as walking on a treadmill. This test checks your heart's response to physical activity.

Medications
If you have heart rhythm disturbances, medications may help control heart rate and maintain normal heart rhythm. Doctors commonly use medications, including calcium channel blockers, beta blockers, digitalis and anti-arrhythmic drugs, such as amiodarone.

Your doctor may also prescribe medications for signs and symptoms of heart failure, if you need them. These may include diuretics and other medications.

Surgical heart repair
Your doctor may recommend surgical repair when your signs and symptoms are affecting your quality of life or when your heart begins to enlarge and overall heart function begins to decrease. Because Ebstein's anomaly is rare, choose a surgeon who's familiar with the defect and who has experience performing procedures to correct it. Different types of procedures can be used to surgically treat Ebstein's anomaly and associated defects, including:

• Tricuspid valve repair. This involves reducing the size of the valve opening and allowing the existing valve leaflets to come together to work properly. This procedure is usually done when there's enough valve tissue to allow for repair.
  
• Tricuspid valve replacement. If the existing valve can't be repaired, it may be replaced by removing the deformed valve and inserting either a mechanical valve or a specially treated biological tissue (bioprosthetic) valve. If a mechanical valve is used, you'll need to take a blood-thinning medication for the rest of your life.
  
• Closure of the atrial septal defect (ASD). If an ASD is present, your surgeon can close the hole during surgery to repair or replace the defective valve.
  
• Maze procedure. Another procedure that doctors may perform during valve repair or replacement surgery is called a maze procedure. It's used to help correct fast heart rhythms in the atrium (atrial tachyarrhythmias). To do the procedure, your surgeon makes a series of incisions in the right atrium with a scalpel or a device that destroys tissue by freezing it. When these incisions heal, the scars create a barrier of tissue in your heart that causes it to beat at a normal rate. The Maze procedure is an open-heart surgery.

Radiofrequency catheter ablation
Radiofrequency catheter ablation is another procedure that can help treat a fast heartbeat or WPW syndrome. In this procedure, one or more catheters are threaded through your blood vessels to your inner heart, where the electrical impulses that cause your heart to beat are generated. Electrodes at the catheter tips are heated with radiofrequency energy. This destroys (ablates) a small spot of heart tissue and creates an electrical block along the pathway that's causing your arrhythmia. Usually, this stops your arrhythmia. However, this procedure may be less effective for treating people with Ebstein's anomaly than for those with other heart problems. Repeat procedures may be necessary.

Heart transplantation
If you have severe Ebstein's anomaly and poor heart function, a heart transplant may be necessary.

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Ebola virus and Marburg virus

Ebola virus and Marburg virus

Definition:

Ebola virus and Marburg virus are related viruses that cause hemorrhagic fevers — illnesses marked by severe bleeding (hemorrhage), organ failure and, in many cases, death. Both Ebola virus and Marburg virus are native to Africa, where sporadic outbreaks have occurred for decades.

Ebola virus and Marburg virus live in animal hosts, and humans can contract the viruses from infected animals. After the initial transmission, the viruses can spread from person to person through contact with body fluids or contaminated needles.

No drug has been approved to treat Ebola virus or Marburg virus. People diagnosed with Ebola or Marburg virus receive supportive care and treatment for complications. Scientists are coming closer to developing vaccines for these deadly diseases.

Symptoms:


In Ebola virus and Marburg virus, signs and symptoms typically begin abruptly within five to 10 days of infection. Early signs and symptoms include:

• Fever
• Severe headache
• Joint and muscle aches
• Chills
• Sore throat
• Weakness

Over time, symptoms become increasingly severe and may include:

• Nausea and vomiting
• Diarrhea (may be bloody)
• Red eyes
• Raised rash
• Chest pain and cough
• Stomach pain
• Severe weight loss
• Bleeding from the nose, mouth, rectum, eyes and ears

Causes:

Ebola virus has been found in African monkeys, chimps and other nonhuman primates. A milder strain of Ebola has been discovered in monkeys and pigs in the Philippines. Marburg virus has been found in monkeys, chimps and fruit bats in Africa.

Transmission from animals to humans
The virus can be transmitted to humans by exposure to an infected animal's bodily fluids. Examples include:

• Blood. Butchering or eating infected animals can spread the viruses. Scientists who have operated on infected animals as part of their research have also contracted the virus.
• Waste products. Tourists in certain African caves and some underground mine workers have been infected with the Marburg virus, possibly through contact with the feces or urine of infected bats.

Transmission from person to person
Infected people typically don't become contagious until they develop symptoms. Family members are often infected as they care for sick relatives or prepare the dead for burial.

Medical personnel can be infected if they don't use protective gear such as surgical masks and latex gloves. Medical centers in Africa are often so poor that they must reuse needles and syringes. Some of the worst Ebola epidemics have occurred because contaminated injection equipment wasn't sterilized between uses.

There's no evidence that Ebola virus or Marburg virus can be spread via insect bites.

Complications:


Both Ebola and Marburg hemorrhagic fevers lead to death for a high percentage of people who are affected. As the illness progresses, it can cause:

• Multiple organ failure
• Severe bleeding
• Jaundice
• Delirium
• Seizures
• Coma
• Shock

One reason the viruses are so deadly is that they interfere with the immune system's ability to mount a defense. But scientists don't understand why some people recover from Ebola and Marburg and others don't.

For people who survive, recovery is slow. It may take months to regain weight and strength, and the viruses remain in the body for many weeks. People may experience:

• Hair loss
• Sensory changes
• Liver inflammation (hepatitis)
• Weakness
• Fatigue
• Headaches
• Eye inflammation
• Testicular inflammation

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Earwax blockage

Earwax blockage

Definition:

Earwax blockage occurs when earwax (cerumen) accumulates in your ear or becomes too hard to wash away naturally.

Earwax is a helpful and natural part of your body's defenses. It protects your ear canal by trapping dirt and slowing the growth of bacteria. It's not known why some people experience earwax blockage or why earwax blockage often occurs in only one ear.
If earwax blockage becomes a problem, you or your doctor can take simple steps to remove the wax safely.

Symptoms:

Signs and symptoms of earwax blockage may include:

• Earache
• Feeling of fullness in the affected ear
• Ear noise (tinnitus)
• Decreased hearing in the affected ear

When to see a doctor
If you're experiencing the signs and symptoms of earwax blockage, talk to your doctor.

Signs and symptoms could indicate another condition. You may think you can deal with earwax on your own, but there's no way to know if you have excessive earwax without having someone, usually your doctor, look into your ears. Having signs and symptoms, such as earache or decreased hearing, doesn't necessarily mean you have wax buildup. Even if you've had a past problem with earwax, you can't be sure that wax buildup is the cause of your current symptoms. It's possible you have another medical condition involving your ears that may need attention.

Wax removal is most safely done by doctor. Asking your doctor to remove earwax may seem unnecessary, but your ear canal and eardrum are delicate and can be damaged easily by excess earwax. Don't try to remove earwax yourself with any device placed into your ear canal, especially if you've had ear surgery, have a hole (perforation) in your eardrum, or are having ear pain or drainage.
Children usually have their ears checked as part of any medical examination. If necessary, a doctor can remove excess earwax from your child's ear during an office visit.


Causes:

In most people, a small amount of earwax regularly makes its way to the opening of the ear, where it's washed away or falls out as new wax is secreted to replace it. If you secrete an excessive amount of wax or if earwax isn't cleared effectively, it may build up and block your ear canal.
Additionally, earwax blockages commonly occur when people try to clean their ears on their own by placing cotton swabs or other items in their ears. This often just pushes wax deeper into the ear, rather than removing it.

The wax in your ears is secreted by glands in the skin that lines the outer half of your ear canals. The wax and tiny hairs in these passages trap dust and other foreign particles that could damage deeper structures, such as your eardrum.

Treatments and drugs:

Your doctor can remove excess wax using a small, curved instrument called a curette or by using suction while inspecting the ear. Your doctor can also flush out the wax using a water pick or a rubber-bulb syringe filled with warm water.

If earwax buildup is a recurring problem, your doctor may recommend that you use a wax-removal medication, such as carbamide peroxide (Debrox, Murine Earwax Removal Drops), every four to eight weeks as a preventive measure. Because these drops can irritate the delicate skin of the eardrum and ear canal, use them sparingly and only on the advice of your physician.

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Ear infection (middle ear)

Ear infection (middle ear)

Definition:

An ear infection (acute otitis media) is most often a bacterial or viral infection that affects the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. Children are more likely than adults to get ear infections.

Ear infections are often painful because of inflammation and buildup of fluids in the middle ear.
Because ear infections often clear up on their own, treatment often begins with managing pain and monitoring the problem. Ear infection in infants and severe cases in general require antibiotic medications. Long-term problems related to ear infections — persistent fluids in the middle ear, persistent infections or frequent infections — can cause hearing problems and other serious complications.

Symptoms:


The onset of signs and symptoms of ear infection is usually rapid.
Children
Signs and symptoms common in children include:

• Ear pain, especially when lying down
• Tugging or pulling at an ear
• Difficulty sleeping
• Crying more than usual
• Acting more irritable than usual
• Difficulty hearing or responding to sounds
• Loss of balance
• Headache
• Fever of 100 F (38 C) or higher
• Drainage of fluid from the ear
• Loss of appetite
• Vomiting
• Diarrhea

Adults
Common signs and symptoms in adults include:

• Ear pain
• Drainage of fluid from the ear
• Diminished hearing
• Sore throat

When to see a doctor
Signs and symptoms of an ear infection can indicate a number of different conditions. It's important to get an accurate diagnosis and prompt treatment. Call your child's doctor if:

• Symptoms last for more than a day
• Ear pain is severe
• Your infant or toddler is sleepless or irritable after a cold or other upper respiratory infection
• You observe a discharge of fluid, pus or bloody discharge from the ear

An adult with ear pain or discharge should see a doctor as soon as possible.


Causes:

An ear infection is caused by a bacterium or virus in the middle ear. This infection often results from another illness — cold, flu or allergy — that causes congestion and swelling of the nasal passages, throat and eustachian tubes.

Role of eustachian tubes
The eustachian tubes are a pair of narrow tubes than run from each middle ear to high in the back of the throat, behind the nasal passages. The throat end of the tubes open and close to:

• Regulate air pressure in the middle ear
• Refresh air in the ear
• Drain normal secretions from the middle ear

Swelling, inflammation and mucus in the eustachian tubes from an upper respiratory infection or allergy can block them, causing the accumulation of fluids in the middle ear. A bacterial or viral infection of this fluid is usually what produces the symptoms of an ear infection.
Ear infections are more common in children, in part, because their eustachian tubes are narrower and more horizontal — factors that make them more difficult to drain and more likely to get clogged.

Role of adenoids
Adenoids are two small pads of tissues high in the back of the throat believed to play a role in immune system activity. This function may make them particularly vulnerable to infection and inflammation.
Because adenoids are located near the opening of the eustachian tubes, inflammation or enlargement of the adenoids may block the tubes, thereby contributing to middle ear infection. Inflammation of adenoids is more likely to play a role in ear infections in children because children have more active and relatively larger adenoids.

Related conditions
Conditions of the middle ear that may be related to an ear infection or result in similar middle ear problems include the following:

• Otitis media with effusion is inflammation and fluid buildup (effusion) in the middle ear without bacterial or viral infection. This may occur because the fluid buildup persists even after an ear infection has resolved. It may also occur because of some dysfunction or noninfectious blockage of the eustachian tubes.
  
• Chronic suppurative otitis media is a persistent ear infection that results in tearing or perforation of the eardrum.

Complications:

Most ear infections don't cause long-term complications. Frequent or persistent infections and persistent fluid buildup can result in some serious complications:

• Impaired hearing. Mild hearing loss that comes and goes is fairly common with an ear infection, but it usually returns to normal after the infection clears. Persistent infection or persistent fluids in the middle ear may result in more significant hearing loss. If there is some permanent damage to the eardrum or other middle ear structures, permanent hearing loss may occur.
  
• Speech or developmental delays. If hearing is temporarily or permanently impaired in infants and toddlers, they may experience delays in speech, social and developmental skills.
  
• Spread of infection. Untreated infections or infections that don't respond well to treatment can spread to nearby tissues. Infection of the mastoid, the bony protrusion behind the ear, is called mastoiditis. This infection can result in damage to the bone and the formation of pus-filled cysts. Rarely, serious middle ear infections spread to other tissues in the skull, including the brain.

Treatments and drugs:


Most ear infections don't need treatment with antibiotics. What's best for your child depends on many factors, including your child's age and the severity of symptoms.

A wait-and-see approach
Symptoms of ear infections usually improve with the first couple of days, and most infections clear up on their own within one to two weeks without any treatment. The American Academy of Pediatrics and the American Academy of Family Physicians recommend a wait-and-see approach for the first 48 to 72 hours for anyone who is otherwise healthy and who is:

• Six months to 2 years of age with mild symptoms and an uncertain diagnosis
• More than 2 years old with mild symptoms or an uncertain diagnosis

Treating pain
Your doctor will advise you on treatments to lessen pain from an ear infection. These may include the following:

• A warm compress. Placing a warm, moist washcloth over the affected ear may lessen pain.
  
• Pain medication. Your doctor may advise the use of over-the-counter acetaminophen (Tylenol, others) or ibuprofen (Motrin, Advil, others) to relieve pain. Use the drugs as directed on the label. Because aspirin has been linked with Reye's syndrome, use caution when giving aspirin to children or teenagers. Although aspirin is approved for use in children older than age 2, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. Talk to your doctor if you have concerns.
  
• Eardrops. Prescription eardrops such as antipyrine-benzocaine (Aurodex) may provide additional pain relief. To administer drops to your child, warm the bottle by placing it in warm water. Put the recommended dose in your child's ear while he or she lies on a flat surface with the infected ear facing up. Benzocaine has been linked to a rare but serious, sometimes deadly, condition that decreases the amount of oxygen that the blood can carry. Don't use benzocaine in children younger than age 2 without supervision from a health care professional, as this age group has been the most affected. If you're an adult, never use more than the recommended dose of benzocaine and consider talking with your doctor.

Antibiotic therapy
Your doctor may recommend antibiotic treatment for an ear infection in the following situations:

• Children under 6 months old with a probable diagnosis of ear infection
• Children 6 months to 2 years old with a certain diagnosis of ear infection
• Anyone with a probable ear infection and moderate to severe ear pain
• Anyone with a probable ear infection and a fever over 102.2 F (39 C) or higher

Even after symptoms have improved, be sure to use all of the antibiotic pills as directed. Failing to do so can result in recurring infection and resistance of bacteria to antibiotic medications. Talk to your doctor or pharmacist about what to do if you accidentally skip a dose.

Ear tubes
If your child has otitis media with effusion — persistent fluid buildup in the ear after an infection has cleared up or in the absence of any infection — your doctor may recommend a procedure to drain fluid from the middle ear.

During an outpatient surgical procedure called a myringotomy, a surgeon creates a tiny hole in the eardrum that enables him or her to suction fluids out of the middle ear. A tiny tube is placed in the opening to help ventilate the middle ear and prevent the accumulation of more fluids. Some tubes are intended to stay in place for six months to a year and then fall out on their own. Other tubes are designed to stay in longer and may need to be surgically removed.
The eardrum closes up again after the tube falls out or is removed.

Treatment for chronic suppurative otitis media
Chronic infection that results in perforation of the eardrum — chronic suppurative otitis media — is difficult to treat. It's often treated with antibiotics administered as drops. You'll receive instructions on how to suction fluids out through the ear canal before administering drops.

Monitoring
Children with frequent or persistent infections or with persistent fluid in the middle ear will need to be monitored closely. Talk to your doctor about how often you should schedule follow-up appointments. Your doctor may recommend regular hearing and language tests.

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E. coli

E. coli

Definition:

Escherichia coli (E. coli) bacteria normally live in the intestines of healthy people and animals. Most varieties of E. coli are harmless or cause relatively brief diarrhea. But a few particularly nasty strains, such as E. coli O157:H7, can cause severe abdominal cramps, bloody diarrhea and vomiting.

You may be exposed to E. coli from contaminated water or food — especially raw vegetables and undercooked ground beef. Healthy adults usually recover from infection with E. coli O157:H7 within a week, but young children and older adults can develop a life-threatening form of kidney failure called hemolytic uremic syndrome (HUS).

Symptoms:


Signs and symptoms of E. coli O157:H7 infections typically begin three or four days after exposure to the bacteria, though you may become ill as soon as one day afterward to more than a week later. Signs and symptoms include:

• Diarrhea, which may range from mild and watery to severe and bloody
• Abdominal cramping, pain or tenderness
• Nausea and vomiting, in some people

When to see a doctor
Contact your doctor if your diarrhea is persistent, severe or bloody.

Causes:

Among the many strains of E. coli, only a few trigger diarrhea. One group of E. coli — which includes O157:H7 — produces a powerful toxin that damages the lining of the small intestine, which can cause bloody diarrhea. You develop an E. coli infection when you ingest this strain of bacteria. Potential sources of exposure include contaminated food or water, and person-to-person contact.

Contaminated food
The most common way to acquire an E. coli infection is by eating contaminated food, such as:

• Ground beef. When cattle are slaughtered and processed, E. coli bacteria in their intestines can get on the meat. Ground beef combines meat from many different animals, increasing the risk of contamination.
• Unpasteurized milk. E. coli bacteria on a cow's udder or on milking equipment can get into raw milk.
• Fresh produce. Runoff from cattle farms can contaminate fields where fresh produce is grown. Vegetables such as spinach and lettuce are particularly vulnerable to this type of contamination.
• Restaurant meals. Cooks or servers who don't wash their hands after using the bathroom can transmit E. coli bacteria to food.

Contaminated water
Human and animal feces may pollute ground and surface water, including streams, rivers, lakes and water used to irrigate crops. Although public water systems use chlorine, ultraviolet light or ozone to kill E. coli, some outbreaks have been linked to contaminated municipal water supplies. Private wells are a greater cause for concern. Some people also have been infected after swimming in pools or lakes contaminated with feces.

Personal contact
E. coli bacteria can easily travel from person to person, especially when infected adults and children don't wash their hands properly. Family members of young children with E. coli infection are especially likely to acquire it themselves. Outbreaks have also occurred among children visiting petting zoos and in animal barns at county fairs.

Complications:

 Most healthy adults recover from E. coli illness within a week. But some people — particularly young children and older adults — may develop a life-threatening form of kidney failure called hemolytic uremic syndrome (HUS)

Treatments and drugs:

 For illness caused by E. coli O157:H7, no current treatments can cure the infection, relieve symptoms or prevent complications. For most people, the best option is to rest and drink plenty of fluids to help with dehydration and fatigue. Avoid taking an anti-diarrheal medication — this slows your digestive system down, preventing your body from getting rid of the toxins.

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