An estimated 73,000 cases of E. coli infection occur in the United States each year. The Centers for Disease Control and Prevention (CDC) recognizes E. coli as an emerging food-borne illness. Infection often leads to bloody diarrhea.

• Person-to-person contact in families and in child-care and other institutional-care centers can also be places where the transmission of the bacteria can occur.
  
  
• Bacteria present on a cow's udders, or on equipment, may get into raw milk causing the infection.
  
  
• Infection may also occur after swimming in or drinking sewage-contaminated water.
  
  
• It has been confirmed that unpasteurized juices, such as apple cider, may also cause the infection.

Bacteria in diarrhea stools of infected persons can be passed from one person to another if hygiene or handwashing habits are inadequate. This is particularly likely among toddlers who are not toilet trained. Family members and playmates of these children are at high risk of becoming infected.

Young children typically shed the organism in their feces for a week or two after their illness resolves.

• Cook all ground beef or hamburger thoroughly. Make sure that the cooked meat is gray or brown throughout (not pink), any juices run clear, and the inside is hot.

• Using a digital instant-read meat thermometer, the temperature of the meat should reach a minimum of 160° F.

• If you are served an undercooked hamburger in a restaurant, send it back.

• Consume only pasteurized milk and milk products. Avoid raw milk.

• Consume only pasteurized juices and ciders.

• Make sure that infected persons, especially children, wash their hands carefully and frequently with soap to reduce the risk of spreading the infection.

• Drink municipal water that has been treated with adequate levels of chlorine, or other effective disinfectants.

• Avoid swallowing lake or pool water while swimming.

• Wash hands thoroughly after using the toilet.

• People with diarrhea should not:
  
  
  • swim in public pools or lakes
  • bathe with others
  • prepare food for others

However, in some persons the diarrhea may be so severe that the patient needs to be hospitalized. In those patients, the salmonella infection may spread from the intestines to the blood stream and then to other body sites and can cause death unless the person is treated promptly with antibiotics. Infants and those with impaired immune systems are more likely to have a sever illness.

• eating raw foods contaminated with animal feces.
  Contaminated foods usually look and smell normal. Contaminated foods are often of animal origin, such as beef, poultry, milk, or eggs, but all foods, including vegetables, may become contaminated. Many raw foods of animal origin are frequently contaminated, but fortunately, thorough cooking kills Salmonella.
  
  
• handling reptiles. Reptiles (such as iguanas and turtles) are particularly likely to harbor Salmonella and people should always wash their hands immediately after handling a reptile, even if the reptile is healthy. Adults should also be careful that children wash their hands after handling a reptile.

• Make sure poultry and meat, including hamburgers, are well-cooked, not pink in the middle.
  
  
• Do not consume raw or unpasteurized milk or other dairy products.
  
  
• Thoroughly wash produce before eating it.
  
  
• Avoid cross-contamination of foods. Uncooked meats should be kept separate from produce, cooked foods, and ready-to-eat foods.
  
  
• All utensils, including cutting boards, knives, counters, etc., should be thoroughly washed after handling uncooked foods.
  
  
• Thoroughly wash hands before handling foods and between handling different food items.
  
  
• Thoroughly wash hands after contact with feces.
  
  
• Thoroughly wash hands after handling any reptiles, since reptiles are particularly likely to have Salmonella.

In the United States, the disease occurs most often in the winter, with annual epidemics occurring from November to April. The highest rates of illness occur among infants and young children, and most children in the United States are infected by two years of age. Adults can also be infected, though disease tends to be mild.

The incubation period for rotavirus disease is approximately two days. The disease is characterized by vomiting and watery diarrhea for three to eight days, and fever and abdominal pain occur frequently. Immunity after infection is incomplete, but repeat infections tend to be less severe than the original infection.

• through accidentally swallowing the virus picked up from surfaces contaminated with stool from an infected person, such as toys, bathroom fixtures, changing tables, and diaper pails.
  
  
• through ingestion of contaminated food, or contaminated water, such as the type of water found in a public swimming pool.

Handwashing is a very important means of preventing the spread of rotavirus. Careful and frequent handwashing can prevent the spread of infection to other people.

The Centers for Disease Control and Prevention (CDC) recommends:

• Adults should wash their hands after using the toilet, after helping a child use the toilet, after diapering a child, and before preparing, serving, or eating food.
  
  
• Children should wash their hands after using the toilet, after having their diapers changed (an adult should wash infant's or small child's hands), and before eating snacks or meals.
  
  
• Toys, bathrooms, and food preparation surfaces are disinfected frequently, especially if a sick child has been in the home.
  
  
• Use diapers with waterproof outer covers that can contain liquid stool or urine, or use plastic pants.
  
  
• Make sure that children wear clothes over diapers.

Diaper-aged children who attend day care centers, international travelers, hikers, campers, and others who drink untreated water from contaminated sources, are most at risk for developing infection with Giardia. Several community-wide outbreaks of infection have been linked to drinking municipal water contaminated with Giardia.

Some of the ways people can become infected with Giardia include:

• eating uncooked food contaminated with Giardia.
  
  
• swallowing water from swimming pools, lakes, rivers, springs, ponds, or streams contaminated with sewage or feces from humans or animals.
  
  
• accidentally swallowing the parasite picked up from surfaces contaminated with stool from an infected person, such as toys, bathroom fixtures, changing tables, diaper pails.

• washing hands with soap and water after using the toilet, changing diapers, and before handling food.
  
  
• washing and peeling all raw vegetables and fruits before eating.
  
  
• avoiding drinking water from lakes, rivers, springs, ponds, or streams unless it has been filtered and chemically treated.
  
  
• boiling drinking water for one minute to kill the Giardia parasite. This will ensure safe drinking water during community-wide outbreaks caused by contaminated drinking water.
  
  
• when camping or traveling in countries where the water supply may be unsafe, avoid drinking unboiled tap water and avoid uncooked foods washed with unboiled tap water. Bottled or canned carbonated beverages, seltzers, pasteurized fruit drinks, and steaming hot coffee and tea, are safe to drink.

If your child has Giardia, avoid swimming in pools for two weeks after the diarrhea or loose stools have cleared. Giardia is fairly chlorine resistant and is passed in the stools of infected people for several weeks after they no longer have symptoms.

• accidentally swallowing anything that has come in contact with the stool of a person or animal
  
  
• swallowing contaminated water from swimming pools, hot tubs, lakes, rivers, springs, ponds, or streams contaminated with sewage or feces from humans or animals.
  
  
• eating uncooked contaminated food.
  
  
• picking cryptosporidium up from surfaces contaminated with stool from an infected person (such as toys, bathroom fixtures, changing tables, and diaper pails).

• The Centers for Disease Control and Prevention (CDC) recommends:
  
  
• your child should wash their hands with soap and water after using the toilet, changing diapers, and before eating or helping prepare food.
  
  
• avoid water or food that may be contaminated.
  
  
• washing and/or peeling all raw vegetables and fruits before giving them to your child to eat.
  
  
• avoiding drinking water from lakes, rivers, springs, ponds, or streams unless it has been filtered and chemically treated.
  
  
• boiling drinking water for one minute to kill the Giardia parasite. This will ensure safe drinking water during community-wide outbreaks caused by contaminated drinking water.
  
  
• when camping or traveling in countries where the water supply may be unsafe, avoid drinking unboiled tap water and avoid uncooked foods washed with unboiled tap water.
  
  
• avoiding swimming in pools if your child has had cryptosporidium and for at least two weeks after diarrhea stops. Crypto can be passed in the stool and contaminate water for several weeks after your child no longer has symptoms. This has resulted in several outbreaks of cryptosporidium among pool users. Crypto can survive in chlorinated pools for several days.