Teen suffers kidney failure after eating McDonald's Quarter Pounder. What is hemolytic uremic syndrome, a rare E.coli complication?

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A 15-year-old girl has been hospitalized for kidney failure due to complications from E. coli poisoning. Kamberlyn Bowler of Grand Junction, Colo. is one of the reported 75 people who became ill after eating contaminated food from McDonald's in the United States. According to the U.S. Centres for Disease Control and Prevention (CDC), one person has died and 22 people have been hospitalized for E.coli poisoning.

In an interview with NBC News, Bowler said she became ill after eating a Quarter Pounder meal with cheese from the fast-food chain. Bowler says she and her mother initially thought she just had a “stomach bug" but her symptoms escalated quickly.

“But then I started throwing up, having diarrhea, and it was bloody, so it scared me,” Bowler said.

Bowler visited her doctor and received scans at the emergency room. Her mother, Brittany Randall, said her symptoms declined and by say six, Bowler asked to go back to the hospital. Tests revealed Bowler was in renal failure due to a severe E.coli infection.

Bowler was airlifted to Children’s Hospital Colorado where she was diagnosed with enterohemorrhagic Escherichia coli-associated hemolytic uremic syndrome (HUS) and required multiple rounds of dialysis. Although there are “some signs” of kidney function, the family doesn’t know the extent of the damage to her kidneys.

“We’re not really sure what it’s going to look like for her moving forward,” Randall said. “She’ll probably have to do another round of dialysis. We’re hoping that that’s the last one, but we also don’t know, and we don’t know if there’s going to be future issues.”

It's believed that the slivered onions used in the Quarter Pounder Bowler consumed were contaminated with E.coli. On Oct. 25, McDonalds announced it was no longer sourcing onions from Taylor Farms, a California-based produce company.

At present, the outbreak is only in the United States. McDonald's Canada has said its operations aren't affected by the incident, and that it uses none of the affected products or ingredients.

Read on for everything you need to know about the bacteria and the HUS illness.

What is hemolytic uremic syndrome?

According to Mayo Clinic, HUS is a condition that can occur when the small blood vessels in your kidneys become damaged and inflamed.

"This damage can cause clots to form in the vessels. The clots clog the filtering system in the kidneys and lead to kidney failure, which could be life-threatening," the clinic stated.

The most common cause of HUS is infection with certain strains of E. coli, and it's most common among young children.

The Mayo Clinic listed the following changes in symptoms for HUS:

• Loss of colour in the skin

• Extreme tiredness

• Easy bruising

• Unusual bleeding, including from the nose and mouth

• Decreased urination or blood in urine

• Swelling of the legs, feet or ankles, or less commonly, other parts of the body

• Confusion, seizures or stroke

• High blood pressure

What is Shiga toxin-producing E. coli?

According to the World Health Organization, E. coli are bacteria that normally live harmlessly in the guts of humans and animals, but there are strains of E. coli that can cause illness in people.

One of those strains is the Shiga toxin-producing E. coli, which can cause severe food poisoning.

"The farming conditions can sometimes lead to one infected animal excreting (E. coli) out through its intestines into feces, which then contaminates the food or the water or is directly eaten by other animals," said Dr.Donald Vinh in a previous interview with Yahoo Canada.

The McGill University Health Centre infectious diseases specialist said eating undercooked or raw meat can lead to illness, but it's not the only source where people can come into contact with E. coli.

It can also be caused by:

• drinking contaminated or untreated water

• eating contaminated raw fruits or vegetables

• drinking raw or unpasteurized milk

• improper food handling

• surface contamination

What are the symptoms of E. coli contamination?

Shiga toxin-producing E. coli can cause bloody diarrhea or kidney damage, and while these complications may occur more frequently in kids than adults, Vinh said it's not rare in adults.

"I don't want people to think that this is only a kid's disease because it definitely isn't," he added.

Symptoms appear within one to 10 days after exposure to E. coli bacteria, according to the agency, and most symptoms end within five to 10 days.

But some people may experience a more serious illness that will require hospital care, claimed Vinh, especially if the person is suffering from bloody diarrhea.

"The Shiga toxin-producing E. coli can go out into the bloodstream and it can cause a lot more damage, including damage to the kidneys. It can damage the red blood cells and the platelets," said Vinh.

This can lead to the development of hemolytic uremic syndrome (HUS).

How do you treat E. coli infection?

There is no medical treatment for E. coli infections, Vinh said.

The majority of people who get infected generally get better on their own, though some may develop complications.

"All we do is recommend that people become vigilant," said Vinh. "So people who may get dehydrated, they'll have to drink plenty of fluids with electrolytes or they need to get intravenous fluids."

Those who require hospitalization end up getting other types of treatments, especially if the toxin begins to cause damage to the kidneys.

Treatment for HUS, according to Mayo Clinic, involves "replacing lost fluids and minerals to make up for the kidneys not removing fluids and waste as well as usual. It also might involve getting nutrition through a vein."

Patients may also receive a blood transfusion while in hospital and be placed on medication to lower blood pressure and prevent or slow down further kidney damage, Mayo Clinic explained. Worse cases might see treatment include a kidney dialysis, a plasma exchange or even a kidney transplant if damage from HUS is too severe.

How to protect yourself and your children from E. coli infection?

Vinh explained since E. coli lives in the intestines of animals, and can even be found in fruits and vegetables, it's important people make sure they're washing and cooking their food properly.

"The reality is that fruits and vegetables can be easily contaminated by soil or by manure or by feces of an infected animal. So if it sits in your fruits and vegetables, you could eat that bacteria and then you can get sick," said Vinh.

Meat must also be properly cooked, especially ground meats that include things like intestines that may have been contaminated.

"If it's not adequately cooked, the bacteria can thrive in there," said Vinh. "Inadequately cooked burgers is one of the most common ways that you can get Shiga toxin-producing E. coli."

According to Canada Health, ground beef and pork should be cooked at a temperature of 71 degrees Celsius while poultry is recommended to be cooked at 74 degrees Celsius.

Vinh also recommended people leave their fruits, vegetables or meats in a cool place because E. coli thrives in hot temperatures. If people go on picnics, for example, they must not put all of their food in one basket under the sun.

"Those temperatures, as well as closed spaces, allow for contamination between different foods," said Vinh. "And the warm temperatures actually favors the bacteria to grow even faster."

He also said proper hygiene is key in preventing the spread of E. coli and that parents need to teach their children to always wash their hands before eating.

"Soap and water is really the ideal situation… Clean cutlery, clean tables, all of that is gonna be very important to prevent this from happening."

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