Escherichia coli - diseases, routes of transmission, symptoms of intestinal infections and diseases of the genitourinary tract (in women, men, children), treatment methods. Detection of bacteria in urine tests and vaginal smears

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Escherichia coli in Latin it's called Escherichia coli (E. coli) and is a type bacteria, which includes pathogenic and non-pathogenic varieties. Pathogenic varieties of Escherichia coli cause infectious and inflammatory diseases of the digestive tract, urinary and reproductive systems in men and women. And non-pathogenic species of bacteria live in the human intestine as representatives of normal microflora.

Brief characteristics and types of E. coli

Bacteria of the E. coli type are heterogeneous, since they include about 100 species, most of which are non-pathogenic and constitute the normal intestinal microflora of humans and some mammals. Pathogenic varieties (strains) cause infectious and inflammatory diseases of the organs into which they enter. And since pathogenic E. coli most often enter the gastrointestinal tract and genitourinary system, they usually cause inflammatory diseases of these organs. However, when newborn children or women in labor are infected, pathogenic E. coli can enter the blood and travel through the blood into the brain, causing meningitis or sepsis (blood poisoning).

All varieties of E. coli are resistant to environmental factors, and therefore can remain viable for a long time in water, soil and fecal matter. At the same time, E. coli are killed by boiling and exposure to formaldehyde, bleach, phenol, sublimate, sodium hydroxide and 1% carbolic acid solution.

Bacteria multiply quickly and well in food, especially in milk, and therefore eating contaminated and contaminated food with E. coli causes infection with the subsequent development of an infectious-inflammatory disease.

Non-pathogenic varieties of Escherichia coli (Escherichia coli) are part of the normal microflora of the human intestine. They appear in the human intestine in the first days after birth during the process of its colonization with normal microflora, and persist throughout life. Normally, the contents of the human large intestine should contain 10 6 -10 8 CFU/g of E. coli, and in feces - 10 7 -10 8 CFU/g of typical E. coli and no more than 10 5 CFU/g of its lactose-negative varieties. In addition, hemolytic E. coli should be normally absent in both the contents of the colon and feces. If the bacteria content is higher or lower than the specified standards, then this indicates dysbacteriosis.

Although the share of E. coli among all other representatives of microflora is only 1%, the role of these bacteria is very important for the normal functioning of the digestive tract. Firstly, Escherichia coli, colonizing the intestines, competes with other pathogenic and opportunistic microorganisms, preventing their settlement in the lumen of the colon, thereby preventing various infectious and inflammatory intestinal diseases.

Secondly, E. coli utilize oxygen, which is destructive and harmful to lactobacilli and bifidobacteria, which make up the rest of the intestinal microflora. That is, thanks to E. coli, the survival of lactobacilli and bifidobacteria is ensured, which, in turn, are vital for the functioning of the intestines and the digestion of food. After all, if there are no lactobacilli and bifidobacteria, the food will not be completely digested and will begin to rot and ferment in the intestinal lumen, which will lead to severe illness, exhaustion and, ultimately, death.

Thirdly, E. coli, as a result of their vital activity, produce substances vital for the body, such as B vitamins (B 1, B 2, B 3, B 5, B 6, B 9, B 12), vitamin K and biotin , as well as acetic, formic, lactic and succinic acid. The production of vitamins allows us to provide most of the body’s daily need for them, as a result of which all cells and organs function normally and as efficiently as possible. Acetic, formic, lactic and succinic acids, on the one hand, provide the acidity of the environment necessary for the life of bifidobacteria and lactobacilli, and on the other hand, they are utilized in metabolic processes. In addition, E. coli are involved in the metabolism of cholesterol, bilirubin, choline, bile acids and promote the absorption of iron and calcium.

Unfortunately, among the varieties of E. coli there are also pathogenic ones, which, when they enter the intestines, cause infectious and inflammatory diseases.

Escherichia coli under a microscope - video

Pathogenic species of bacteria

Currently, there are four main groups of pathogenic E. coli:

• Enteropathogenic Escherichia coli (EPEC or ETEC);
• Enterotoxigenic Escherichia coli (ETC);
• Enteroinvasive Escherichia coli (EIEC);
• Enterohemorrhagic (hemolytic) Escherichia coli (EHEC or EHEC).

Enteropathogenic Escherichia coli most often cause infectious and inflammatory diseases of the small intestine in infants under one year of age, as well as “travelers' diarrhea” in adults and children over one year of age.

“Travellers' diarrhea” is manifested by watery, loose stools and most often develops in people who find themselves in developing countries where there are no normal sanitary standards for storing and preparing food. This intestinal infection after a few days it goes away on its own and does not require treatment, since the human body’s immune system successfully destroys pathogenic E. coli.

Enterohemorrhagic (hemolytic, hemolyzing) Escherichia coli causes hemorrhagic colitis in children and adults or hemolytic uremic syndrome (HUS). Both diseases require treatment.

Escherichia coli: features of the genome, causes of outbreaks of intestinal diseases, how bacteria acquire pathogenic properties - video

What diseases does E. coli cause?

The set of infectious and inflammatory diseases caused by Escherichia coli in various organs and systems is called Escherichiosis or coli infections(from the Latin name of the bacterium - Escherichia coli). Escherichiosis has a different course and localization, depending on which organ the E. coli entered.

Pathogenic varieties of Escherichia coli, when they enter the gastrointestinal tract, cause intestinal infections and hemolytic-uremic syndrome in children and adults. Intestinal infections can occur as hemorrhagic colitis, enteritis, food poisoning or traveler's diarrhea.

Wherein enteropathogenic Escherichia coli (EPEC) cause predominantly enterocolitis (intestinal infections) in children of the first year of life, and the infection, as a rule, occurs in the form of an outbreak in preschool institutions, maternity hospitals and hospitals. Pathogenic strains of Escherichia coli are transmitted to children through contact and household contact through the hands of women who have given birth and medical personnel, as well as with non-sterile instruments (spatulas, thermometers, etc.). Also, enteropathogenic varieties of Escherichia coli can cause food poisoning in children of the first year of life who are bottle-fed if they get into infant formula prepared with non-compliance with sanitary standards and hygiene rules.

Enteroinvasive Escherichia coli (EIEC) cause intestinal infections in children over one year of age and adults, which occur as dysentery. Transmission usually occurs through contaminated water and food. Most often, such dysentery-like infections occur in the warm season, when the frequency of consumption or accidental ingestion of dirty, unboiled water and food prepared and stored in violation of sanitary standards increases.

They cause intestinal infections in children over 2 years of age and adults, occurring like cholera. As a rule, these infections are widespread in countries with hot climates and poor sanitary living conditions of the population. In the countries of the former USSR, such infections are usually imported; they are “brought” by people returning from vacation or work trips to hot areas. Typically, infection with these intestinal infections occurs through the consumption of contaminated water and food.

Enteropathogenic, enteroinvasive and enterotoxigenic E. coli, when the intestinal infections they cause are severe, can lead to the development of complications such as otitis media, cystitis, pyelonephritis, meningitis and sepsis. As a rule, such complications occur in children in the first year of life or in older people, whose immune system does not effectively destroy pathogenic microbes.

Enterohemorrhagic (hemolytic) Escherichia coli cause severe intestinal infections in children over one year of age and adults, which occur as hemorrhagic colitis. In severe cases of hemorrhagic colitis, a complication may develop - hemolytic-uremic syndrome (HUS), which is characterized by a triad - hemolytic anemia, renal failure and a critical decrease in the number of platelets in the blood. HUS usually develops 7–10 days after an intestinal infection.

In addition, hemolytic E. coli can lead to the development of neuritis and kidney disease in children and adults if it enters the urinary tract or bloodstream. Infection occurs through water and food.

In addition to intestinal infections, E. coli can cause diseases of the urinary and reproductive systems in men and women, provided that they go to the appropriate authorities. Moreover, diseases of the genitourinary system in men and women can be caused not only by pathogenic, but also by non-pathogenic varieties of Escherichia coli. As a rule, E. coli enters the genital and urinary organs due to non-compliance with personal hygiene rules, wearing tight underwear or anal intercourse.

When E. coli enters the urinary tract of both men and women, inflammatory diseases of the urethra, bladder and kidneys develop, such as urethritis, cystitis and pyelonephritis.

The entry of E. coli into the male urethra leads to the development of inflammatory diseases not only of the urinary organs, but also of the reproductive system, since microbes can ascend through the urethra to the kidneys, testicles and prostate gland. Accordingly, infection of the male urethra with E. coli in the future can lead to chronic prostatitis, orchitis (inflammation of the testicles) and epididymitis (inflammation of the epididymis).

The entry of E. coli into the vagina of women causes inflammatory diseases of the internal genital organs. Moreover, first of all, E. coli causes colpitis or vulvovaginitis. In the future, if E. coli is not destroyed and removed from the vagina, the bacteria can rise into the uterus, from where they travel through the fallopian tubes to the ovaries. If E. coli enters the uterus, the woman will develop endometritis; if it enters the ovaries, adnexitis. If E. coli enters the abdominal cavity from the fallopian tubes large quantities, then this can lead to the development of peritonitis.

Diseases of the urinary and genital organs caused by E. coli can last for years and are difficult to treat.

Routes of transmission

E. coli is transmitted mainly through the oral-fecal route or, less commonly, through household contact. With the oral-fecal route transmission, E. coli gets into the water or soil with feces, as well as onto agricultural plants. Further infection can occur in various ways, for example, when swallowing dirty water, bacteria enter the body and lead to the development of intestinal infections. In other cases, a person touches contaminated plants or soil with their hands and transfers E. coli to food or directly into the body by eating or licking their own hands without first washing them.

Contact and household path the spread of E. coli is less common and plays the greatest role in the development of outbreaks of escherichiosis in groups, for example, in hospitals, maternity hospitals, kindergartens, schools, families, etc. Through contact and household contact, E. coli can be transmitted from mother to newborn baby when the latter passes through the birth canal contaminated with bacteria. In addition, bacteria can be transferred to various objects (for example, dishes, spatulas, etc.) by unwashed hands, the use of which leads to infection of children and adults.

Escherichia coli in women

When pathological varieties of E. coli enter the digestive tract of women, they develop intestinal infections, which, as a rule, have a benign course and go away on their own within 2 to 10 days. These intestinal infections are the most common diseases caused by E. coli in women. However, intestinal infections, as a rule, do not cause complications and do not cause long-term chronic diseases, so their importance for women is not too great.

Important for women are genitourinary infections, also caused by E. coli, since they are long-lasting, painful and difficult to treat. That is, in addition to intestinal infections, pathological and non-pathological E. coli can cause severe, long-term chronic diseases of the urinary and genital organs in women, as well as blood poisoning or meningitis, provided that they enter the urethra, vagina or bloodstream. E. coli can penetrate the genitourinary organs from feces, which normally contain them in fairly large quantities.

E. coli can enter the urethra and vagina in the following ways:

• Lack of hygiene (the woman does not wash herself regularly, fecal residues accumulate on the skin of the perineum, anus and genitals after bowel movements, etc.);
• Wearing underwear that is too tight (in this case, the skin of the perineum sweats and particles of feces remaining on the skin of the anus after defecation move towards the entrance to the vagina, ultimately ending up in it);
• Incorrect washing technique (the woman first washes the anal area, and then washes the external genitalia with the same dirty hand);
• A specific technique of sexual intercourse in which penetration occurs first into the rectum and then into the vagina (in this case, fecal particles with E. coli remain on the penis or sexual toys after penetration into the rectum, which are carried into the vagina);
• Normal vaginal intercourse with ejaculation into the vagina with a man suffering from chronic prostatitis, orchitis or epididymitis caused by E. coli (in this case, E. coli, carried by her sexual partner, enters the woman’s vagina with sperm).

After penetration into the vagina and urethra, E. coli provokes acute colpitis and urethritis, respectively. If these infectious and inflammatory diseases are not cured, then E. coli will remain in the genital tract or urethra, since the bacterium is able to attach to the mucous membrane, and therefore is not washed out by a stream of urine or vaginal discharge. And remaining in the urethra or vagina, E. coli can rise to the overlying organs of the urinary and reproductive systems - the bladder, kidneys, uterus, fallopian tubes, ovaries, and cause inflammatory diseases in them (cystitis, pyelonephritis, endometritis, salpingitis, adnexitis). According to statistics, approximately 80% of all cystitis in women is caused by E. coli, and the cause of almost all cases of pyelonephritis or bacteriuria (bacteria in the urine) in pregnant women is also E. coli.

Inflammatory diseases of the genitourinary organs in women, provoked by E. coli, take a long time, are prone to chronicity and are difficult to treat. Often a subacute inflammatory process occurs in the body, in which there are no clear and noticeable symptoms, as a result of which the woman considers herself healthy, although in fact she is a carrier of a chronic infection. With such a subacute, erased course of the infection, any slightest hypothermia of the body, stress or other sudden impact leading to a decrease in immunity will be the impetus for the inflammation to transition into an active and noticeable form. It is the carriage of E. coli that explains chronic recurrent cystitis, pyelonephritis, colpitis and endometritis, which worsen in women with the slightest cold and do not go away for many years, despite the therapy.

Escherichia coli in men

In men, as in women, E. coli can cause intestinal infections and inflammatory diseases of the genital organs. In this case, intestinal infections are caused only by pathogenic varieties of bacteria, proceed relatively favorably and, as a rule, go away on their own within 3 to 10 days. In principle, every man experiences intestinal infections caused by Escherichia coli several times during his life, and these diseases are not of great importance, they are not dangerous and do not leave consequences.

And here inflammatory diseases of the genitourinary organs caused by E. coli play a much greater role in a man’s life, since they negatively affect the quality of life and cause a progressive deterioration in sexual and urinary function. Unfortunately, these diseases are almost always chronic, sluggish and very difficult to treat.

Inflammatory diseases of the genitourinary organs in men are caused by E. coli if it manages to penetrate the urethra (urethra) of a man's penis. Typically, this occurs during anal sex without a condom or vaginal intercourse with a woman whose vagina is contaminated with E. coli.

After penetration into the urethra, E. coli provokes acute urethritis, which subsides without treatment within a few days, but this does not happen because self-healing occurs, but because the infection becomes chronic and the severity of symptoms simply decreases. That is, if acute urethritis caused by E. coli in a man is not cured, then the infection will become chronic, and the bacteria will not just remain in the urethra, but will spread to other organs of the reproductive and urinary systems.

It is necessary to understand that E. coli cannot be removed from the urethra without treatment only by regular urination, since the bacterium is able to tightly attach to the mucous membrane and not be washed away by a stream of urine. Over time, E. coli from the urethra rises to the overlying organs of the man, such as the bladder, kidneys, prostate gland, testicles and epididymis, and causes a chronic inflammatory process in them.

In men, E. coli from the urethra more often penetrates the genital organs, rather than the urinary organs. As a result, they are much less likely than women to suffer from cystitis and pyelonephritis caused by E. coli. But men very often suffer from chronic, long-term and difficult-to-treat prostatitis, orchitis and epididymitis, which are also caused by the fact that E. coli has penetrated into these organs from the urethra and periodically causes exacerbations. Suffice it to say that at least 2/3 of chronic prostatitis in men over 35 years of age are caused by E. coli.

If E. coli is present in the genitals of a man, it, just like in women, will be activated after the slightest episode of hypothermia or stress, causing an exacerbation of prostatitis, orchitis or epididymitis. Such inflammatory diseases are difficult to treat, and the man is their constant carrier, experiencing episodic painful exacerbations that stubbornly do not go away, despite the therapy.

A man who has become a carrier of chronic coli infection of the genital organs is also a source of infection and the cause of frequent cystitis, pyelonephritis and colpitis in his sexual partners. The fact is that with chronic prostatitis caused by E. coli, the latter always ends up in the sperm along with other components produced by the prostate gland. And as a result of ejaculation of such infected sperm into a woman’s vagina, E. coli is introduced into her genital tract. Next, E. coli enter the urethra or remain in the vagina and cause cystitis or colpitis, respectively. Moreover, episodes of cystitis or colpitis appear after almost every sexual intercourse with a male partner whose sperm is contaminated with E. coli.

Statistics from the past 30–40 years indicate that 90–95% of all defloration cystitis that occurs after a girl’s first sexual intercourse in her life is caused by E. coli. This means that a virgin girl, having her first sexual intercourse, becomes infected with E. coli from the sperm of a man who is its carrier, as a result of which she develops cystitis, since the bladder is the organ where bacteria can most easily enter.

Escherichia coli during pregnancy

In pregnant women, E. coli is often detected in vaginal smears and urine. Moreover, many women say that before pregnancy the bacterium was never found in tests. This does not mean that the woman became infected during pregnancy. On the contrary, the detection of Escherichia coli indicates that a woman has long been a carrier of E. coli, but during pregnancy her immune system can no longer suppress the activity of this microbe, as a result of which it has multiplied so much that it could be detected in tests.

The appearance of bacteria does not mean that a woman is necessarily sick, but indicates that her genital tract or urinary system is contaminated with E. coli, which can provoke an inflammatory process at any time. Therefore, even in the absence of symptoms of the disease, gynecologists managing pregnancy prescribe antibiotics to destroy the bacteria. After all, if E. coli remains in the urine, sooner or later this will lead to pyelonephritis or cystitis in a pregnant woman. If E. coli remains in the vagina, this can lead to colpitis, which, as is known, can provoke premature rupture of amniotic fluid. In addition, the presence of E. coli in the vagina before birth poses a danger to the fetus, since the baby can become infected with the microbe while passing through the mother's birth canal. And such an infection of the baby can lead to the development of serious diseases, such as sepsis, meningitis, otitis media or intestinal infection, which are deadly for the newborn.

Thus, it is obvious that the detection of E. coli in a vaginal smear or in the urine of a pregnant woman requires mandatory treatment, even if there are no symptoms of an inflammatory process in the kidneys, bladder, urethra or vagina. During pregnancy, the following antibiotics can be used to kill E. coli:

• Amoxiclav - can be used throughout pregnancy;
• Cefotaxime - can only be used from the 27th week of pregnancy until delivery;
• Cefepime - can only be used from the 13th week of pregnancy until delivery;
• Ceftriaxone - can only be used from the 13th week of pregnancy until birth;
• Furagin - can be used until the 38th week of pregnancy, but from 38 to childbirth - cannot be used;
• All antibiotics of the penicillin group.

Antibiotics are taken for 3 to 10 days, after which a urine test is taken. 1 - 2 months after the end of treatment, a bacterial urine culture is taken, and if it is negative, then the therapy is considered completed, since Escherichia coli is not detected. But if E. coli is detected in the bacterial culture of urine, then treatment is carried out again, changing the antibiotic.

Escherichia coli in infants

When testing for dysbacteriosis or coprogram (scatology), two types of E. coli are often found in the stool of infants: hemolytic and lactose-negative. In principle, hemolytic Escherichia coli should not be present in the feces of either an infant or an adult, since it is a purely pathogenic microbe and causes intestinal infections that occur as hemorrhagic colitis.

However, if hemolytic E. coli is detected in an infant, you should not rush to start treatment with antibiotics. To understand whether your baby needs to be treated, you should objectively assess his condition. So, if a child gains weight normally, develops, eats well and does not suffer from watery yellow stools that literally stream out of the child’s anus, then there is no need to treat the baby, since therapy is only necessary if there are symptoms, and not numbers in the tests. If a child loses or does not gain weight, or suffers from watery, yellow, foul-smelling stool that comes out in a stream, then this indicates an intestinal infection, and in this case, the E. coli detected in the tests must be treated.

Lactose-negative Escherichia coli may well be present in the feces of a baby, since it is a component of normal microflora, and normally can account for up to 5% of the total amount of all Escherichia coli present in the intestines. Therefore, the detection of lactose-negative Escherichia coli in the stool of a baby is not dangerous, even if its quantity exceeds the norms indicated by the laboratory, provided that the child is gaining weight and developing normally. Accordingly, there is no need to treat lactose-negative Escherichia coli detected in tests on an infant if it is growing and developing. If the baby does not gain or loses weight, then lactose-negative E. coli needs to be treated.

Symptoms of infection

E. coli can cause various intestinal infections and diseases of the genitourinary tract. Infectious and inflammatory diseases of the genitourinary organs develop, as a rule, in adult men and women, and their symptoms are quite typical, the same as when infected with other pathogenic microbes. Clinical manifestations of cystitis, urethritis, vaginitis, adnexitis, pyelonephritis, prostatitis, orchitis and epididymitis caused by Escherichia coli are quite standard, so we will describe them briefly.

And intestinal infections caused by pathogenic varieties of Escherichia coli can occur in different ways, so we will describe their symptoms in detail. Moreover, in this section we will describe the symptoms that occur in adults and children over three years of age, since it is from this age that intestinal infections in children proceed in the same way as in adults. Separately, in the following sections we will describe the symptoms of intestinal infections caused by pathogenic varieties of Escherichia coli in children under 3 years of age, since they do not proceed the same way as in adults.

So, colpitis, provoked by E. coli, proceeds quite typically - a woman experiences copious foul-smelling vaginal discharge, pain during sexual intercourse and an unpleasant sensation when urinating.

Cystitis both men and women also have a typical course - pain and pain appear when trying to urinate and there is a frequent urge to urinate. When going to the toilet, a small amount of urine is released, sometimes mixed with blood.

Pyelonephritis It occurs more often in women and occurs with pain in the kidney area and discomfort during urination.

Urethritis both men and women also have a typical course - itching appears in the urethra, the skin around it turns red, and a sharp pain and burning sensation is felt during urination.

Prostatitis in men it is characterized by pain in the prostate area, difficulty urinating and deterioration of sexual function.

Intestinal infections caused by different types of pathogenic E. coli occur with different symptoms, so we will consider them separately.

So, intestinal infections caused by enteropathogenic Escherichia coli, in adults and children over 3 years of age, they occur according to the type of salmonellosis. That is, the disease begins acutely, nausea, vomiting, abdominal pain appear, and body temperature rises moderately or slightly. The stool becomes thin, watery and profuse, and the patient goes to the toilet 2–6 times a day. When defecating, stool literally splashes out. The infection lasts on average for 3 to 6 days, after which recovery occurs.

Enterotoxigenic Escherichia coli cause intestinal infections called "traveler's diarrhea", and occurring like salmonellosis or a mild form of cholera. A person first develops signs of intoxication (fever, headache, general weakness and lethargy), expressed moderately, and within a short period of time they are accompanied by abdominal pain in the stomach and navel, nausea, vomiting and profuse loose stools appear. The stools are watery, without any admixture of blood or mucus, copious, coming out of the intestines in a stream. If the infection occurred in countries with a tropical climate, then the person may experience fever, chills, muscle and joint pain. An intestinal infection lasts on average 1–5 days, after which recovery occurs.

Enteroinvasive Escherichia coli provoke intestinal infections similar in course to dysentery. A person's body temperature rises moderately, headache and weakness appear, appetite disappears, and severe pain develops in the left lower abdomen, which is accompanied by copious watery stools mixed with blood. Unlike dysentery, the stool is copious, not scanty, with mucus and blood. The infection lasts 7–10 days, after which recovery occurs.

They cause intestinal infections that occur as hemorrhagic colitis and are found mainly in children. The infection begins with a moderate increase in body temperature and intoxication (headache, weakness, loss of appetite), followed by nausea, vomiting and watery stools. In severe cases, on the 3rd – 4th day of the disease, abdominal pain develops, the stool remains liquid, but happens much more often, and streaks of blood appear in the stool. Sometimes the stool consists entirely of pus and blood without fecal matter. Typically, the infection lasts for a week, after which self-recovery occurs. But in severe cases, hemolytic-uremic syndrome may develop 7–10 days after the diarrhea stops.

Hemolytic-uremic syndrome (HUS) manifested by anemia, the platelet count decreases to critical levels and acute renal failure appears. HUS is a serious complication of intestinal infection, because in addition to anemia, kidney failure and a decrease in the number of platelets, a person may develop leg and arm cramps, muscle stiffness, paresis, stupor and coma.

Complications of intestinal infections caused by pathogenic Escherichia coli in adults and children over 3 years of age occur very rarely. Moreover, in most cases, complications arise from infection with enterohemorrhagic Escherichia coli, and occur in approximately 5% of cases. Complications of intestinal infections caused by E. coli include kidney disease, hemorrhagic purpura, cramps, paresis and muscle stiffness.

Escherichia coli - symptoms in children

Since children practically do not have inflammatory diseases of the genitourinary organs caused by E. coli, children for the most part suffer from intestinal infections provoked by pathogenic varieties of Escherichia coli. Therefore, in this section we will look at the symptoms of intestinal infections in children under 3 years of age caused by pathogenic E. coli.

Enteropathogenic and enterotoxigenic Escherichia coli are the cause of intestinal infections in young children located in groups, for example, in hospitals, maternity hospitals, etc. The infection caused by these types of E. coli is characterized by a gradual deterioration of the condition and an increase in severity by 4–5 days. The baby's body temperature first rises moderately (not higher than 37.5 o C) or remains normal, then frequent regurgitation and vomiting appear. Stools become frequent, yellow feces mixed with mucus or particles of undigested food. With each new bowel movement, the stool becomes more liquid and the amount of water in it increases. Feces may come out in a strong stream. The child is restless, his stomach is swollen.

With a mild infection, vomiting occurs 1-2 times a day, and stools 3-6 times, and body temperature does not rise above 38 o C. With a moderate infection, vomiting more than 3 times a day, stools up to 12 times a day day, and the temperature can rise to 39 o C. In severe cases of the disease, stool occurs up to 20 times a day, and the temperature rises to 38 - 39 o C.

If a child who has such an intestinal infection does not receive enough fluid to replenish its losses with diarrhea, then as a complication he may develop DIC syndrome (disseminated intravascular coagulation syndrome) or hypovolemic shock with myocardial insufficiency and intestinal paresis.

In addition, in children with a weakened immune system, E. coli, due to damage to the intestinal wall, can enter the bloodstream and spread to other organs, causing pyelonephritis, purulent otitis, meningitis or sepsis.

Infection caused by enteropathogenic and enterotoxigenic E. coli is most severe in children 3 to 5 months old. Moreover, an infection caused by enterotoxigenic E. coli in children of the first year of life, as a rule, goes away within 1 - 2 weeks, after which complete recovery occurs. And the disease caused by enteropathogenic bacilli in children of the first year of life lasts a long time, since after recovery it can recur within 1 to 2 weeks. In total, the infection can last from 1 to 3 months, when periods of recovery alternate with exacerbations. In children 1–3 years old, infections caused by both enteropathogenic and enterotoxigenic Escherichia coli last for 4–7 days, after which self-recovery occurs.

Infection caused by enteroinvasive Escherichia coli, in children under 3 years of age, it begins with symptoms of moderate intoxication (fever, headache, weakness, loss of appetite), which is accompanied by diarrhea. The feces are liquid, similar in consistency to sour cream, and contain impurities of mucus and sometimes blood. Before the urge to defecate, abdominal pain appears. The disease usually lasts for 5 to 10 days, after which self-recovery occurs.

Enterohemorrhagic Escherichia coli cause intestinal infections that occur equally in children of any age. At the onset of the disease, body temperature rises moderately and symptoms of intoxication appear (headache, weakness, loss of appetite), then nausea, vomiting and loose stools appear. The feces are watery, very liquid, spraying out in a stream. If the infection is severe, then by 3–4 days abdominal pain appears, stool becomes more frequent, and blood is found in the feces. In some cases, feces completely disappear from the stool, and the stool consists entirely of blood and pus.

In mild cases, the infection lasts 7–10 days, after which self-recovery occurs. And in severe cases, in about 5% of cases, a complication develops - hemolytic-uremic syndrome (HUS). HUS is manifested by renal failure, anemia and a sharp decrease in the number of platelets in the blood. Sometimes with HUS, cramps, stiffness and muscle paresis also appear, and stupor or coma develops.

What does the detection of E. coli in various tests mean?

E. coli in urine or bladder

The detection of E. coli in the urine is an alarming signal, indicating that the urinary organs are infected with this microbe, and they have a sluggish inflammatory process that does not manifest clinical symptoms. If E. coli is found in the bladder, then this indicates that only this organ is infected and that there is also an inflammatory process in it, which is sluggish and subacute, without clinical symptoms. Activation of E. coli and the development of inflammation with clinical symptoms in any organ of the urinary system or specifically in the bladder in such a situation is only a matter of time. Inflammation can become acute and manifest symptoms, for example, during hypothermia or stress, when the immune system weakens, as a result of which E. coli multiplies and provokes disease.

Therefore, the detection of E. coli in the urine or bladder is a signal to begin antibacterial therapy with antibiotics in order to destroy the pathogenic microbe and eliminate the risk of developing an acute inflammatory disease of the genitourinary organs. For treatment to be effective, you must first take a urine test for bacterial culture in order to identify which antibiotics the E. coli living in the genitourinary tract of a given person is sensitive to. Based on the results of bacteriological urine culture, an effective antibiotic is selected and a course of therapy is carried out. After 1 - 2 months, urine is again submitted for bacteriological culture, and if the results do not reveal E. coli, then the treatment is considered successful. If, according to the results of a control urine culture, E. coli is again detected, then a course of another antibiotic is taken again, to which the bacterium is also sensitive.

E. coli in a smear (in the vagina)

The detection of E. coli in the vagina is an alarm for a woman, since this bacterium should not be in the genital tract. And if it is in the vagina, E. coli will sooner or later cause an infectious and inflammatory disease of any female genital organ. In the best case, E. coli will provoke colpitis, and in the worst case, it will penetrate from the vagina into the uterus and further into the ovaries, causing endometritis or adnexitis. In addition, bacteria from the vagina can enter the bladder and cause cystitis.

Therefore, if E. coli is detected in a vaginal smear, it is necessary to undergo a course of antibiotic treatment in order to destroy this bacterium in the genital tract. For therapy to be effective, it is necessary to first submit vaginal discharge for bacteriological culture in order to identify which antibiotics the E. coli found in the vagina of a particular woman is sensitive to. Only after sensitivity is identified, an antibiotic that will be effective is selected and its administration begins. 1 – 2 months after treatment, a control bacterial culture is taken, and if, according to its results, E. coli is absent, then the therapy was successful. If E. coli is again detected in the culture, then you will have to undergo a new course of antibiotic therapy, but with a different one.

E. coli in the sea

If, according to epidemiological studies, E. coli is found in the sea, then it is better not to swim in such water, since accidental ingestion may lead to infection with the development of an intestinal infection. If, despite the presence of E. coli, you decide to swim in the sea, you should do so with caution, trying not to swallow the water, so as not to contract an intestinal infection.

E. coli in the Black Sea: in 2016, the number of infections with intestinal infection breaks records - video

Escherichia coli test

To detect E. coli in various organs, the following tests are currently performed:

• Bacteriological culture of feces, urine, vomit, genital secretions. During the analysis, biological fluids are sown on a nutrient medium, the composition of which is adapted for the growth of E. coli. If colonies of E. coli grow on the medium, then the test result is considered positive and means that the organ from which the biological secretions were taken contains E. coli.
• Coprogram or stool analysis for dysbacteriosis. These tests reveal which microorganisms are contained in feces and in what quantities. If, according to the results of a coprogram or analysis for dysbacteriosis, pathogenic E. coli are detected, this means that the person has an intestinal infection. If the test results reveal non-pathogenic E. coli, but in abnormal quantities, then this indicates dysbacteriosis.

E. coli normal

In human feces, the total number of typical E. coli should be 10 7 -10 8 CFU/g. The number of lactose-negative Escherichia coli should be no more than 10 5 CFU/g. Hemolytic E. coli should be absent in the feces of any person, both adults and children.

Treatment

Treatment of diseases of the genitourinary tract in men and women caused by E. coli is carried out with the help of antibiotics. In this case, a bacteriological culture is first performed to determine sensitivity to antibiotics in order to determine which drug will be most effective in this particular case. Next, choose one of the antibiotics to which E. coli is sensitive, and prescribe it for a course of 3–14 days. 1–2 months after the end of the course of antibiotic use, a control bacteriological culture is carried out. If the results do not reveal E. coli, then the treatment was successful and the person is completely cured, but if the bacteria are detected, then you should again take some other antibiotic to which the microbe is sensitive.

The following antibiotics are most effective for treating genitourinary tract infections caused by E. coli:

• Cefotaxime;
• Ceftazidime;
• Cefepime;
• Imipenem;
• Meropenem;
• Levofloxacin;

Treatment of intestinal infections caused by Escherichia coli, in children and adults they perform according to the same rules. The only difference in approaches to therapy is that children under one year of age must be hospitalized in an infectious diseases hospital, while adults and children over one year old with moderate and mild infection can be treated at home.

So, for intestinal infections, children and adults are prescribed a gentle diet consisting of mucous soups, water-based porridges, stale white bread, bagels, crackers, boiled vegetables, lean boiled fish or meat. Spices, smoked, fatty, fried, salted, pickled, canned food, milk, rich soups, fatty fish and meats, and fresh fruits are excluded from the diet.

From the moment diarrhea and vomiting appear until they completely stop, be sure to drink rehydration solutions that replenish the loss of fluid and salts. You need to drink 300–500 ml for each episode of diarrhea or vomiting. Rehydration solutions are prepared either from pharmaceutical powders (Regidron, Trisol, Glucosolan, etc.), or from ordinary salt, sugar, baking soda and clean water. Pharmaceutical preparations are simply diluted with clean water in the amount specified in the instructions. A homemade rehydration solution is prepared as follows: a tablespoon of sugar and one teaspoon each of salt and baking soda are dissolved in 1 liter of clean water. If for some reason it is impossible to buy or prepare rehydration solutions yourself, then you need to drink any drinks available in the house, such as tea with sugar, compote, fruit juice, etc. Remember that during diarrhea and vomiting it is better to drink at least something than nothing, since it is necessary to replenish the loss of fluid and salts.
Furazolidone, which is prescribed to both adults and children. Among the antibiotics, Ciprofloxacin, Levofloxacin or Amoxicillin are most often prescribed for the treatment of E. coli. Antibiotics and Furazolidone are prescribed for 5 to 7 days.

In addition to antibiotics, currently, bacteriophages can be used to destroy E. coli from the first days of the disease - coli bacteriophage liquid, intestibacteriophage, coliproteus bacteriophage, pyobacteriophage combined liquid, pyobacteriophage polyvalent combined liquid, etc. Bacteriophages, unlike antibiotics, act only on pathogenic intestinal bacillus and do not destroy bifidobacteria and lactobacilli of normal microflora. Therefore, they can be taken from the first days of the disease.

After recovery from an intestinal infection, it is recommended to take probiotics (Bifikol, Bifidumbacterin) for 2–3 weeks

Dysbacteriosis. Symptoms, signs, diagnosis and treatment

Intestinal colic in adults and newborns - the essence of the phenomenon, symptoms, treatment, remedies for colic, massage, diet (foods that cause colic). What intestinal diseases cause colic?

A Russian tourist appealed to Vladimir Putin with a request to take control of the situation at the Black Sea resorts of the Russian Federation due to the increasing number of cases of intestinal infection after swimming in the sea.

Even a resident of Norilsk (the most polluted city on the planet) called the sanitary situation in the Black Sea resorts “catastrophic.” Larisa Yangol, the author of the petition, writes that “having been in Adler with a small child for only two days and having swam in the sea, she and her child ended up in an “infectious disease” crowded with vacationers with small children.

As Kommersant reports, since mid-August, numerous vacationers have been publishing messages on social networks about cases of intestinal infection and rotavirus in Sochi and Anapa, as well as their reports on visits to overcrowded hospitals. At the same time, the Ministry of Health Krasnodar region and Rospotrebnadzor deny massive outbreaks of infection. The regional prosecutor's office announced the closure of the beach in Novorossiysk due to the dangerous proximity to the sewerage system.

The last weeks of the school holidays were overshadowed by numerous reports of outbreaks of intestinal infection and rotavirus at resorts on the Black Sea coast of the Krasnodar Territory. Messages are published on social networks by vacationers themselves, as a result of which some users who booked tickets and vacations on the Black Sea for the last days of August or the velvet season abandon their plans.

Petition “Stop intestinal infection in the Black Sea!” on change.org, by Monday, August 29, it had collected more than 700 signatures. The initiator of the appeal to the President of Russia, Larisa Yangol from Norilsk, described the sanitary situation on the Black Sea coast as catastrophic: “Having been in Adler with a small child for only two days and having swam in the sea, instead of resting, we got an intestinal infection and a trip to the infectious diseases hospital, which turned out to be overcrowded with vacationers, sick The kids are even lying in the corridors, there’s not enough space!” - writes Larisa Yangol.

The BlogSochi resource published a message from Angela Alekseenko, who complained that her child in Adler contracted an intestinal infection just by sitting on the beach. “60 children a night are admitted to the hospital with one diagnosis - “intestinal infection”, all the children are in the arms of their parents, they are constantly vomiting, they are exhausted and cannot stand on their feet,” the woman writes. “Poor doctors who do nothing they have time, the hospitals are overcrowded.” Users of social networks from different cities of Russia in their comments to these messages confirm that cases of intestinal diseases, especially in children, are not uncommon on the Black Sea coast.

The editor-in-chief of the BlogSochi resource, Alexander Valov, believes that the sanitary and epidemiological situation in Sochi may worsen due to shortcomings in the commissioning of Olympic infrastructure facilities (sewage treatment plants are not operating at full capacity), as well as due to the massive construction of mini-hotels and housing that is connected to the sewer system with violations or is not connected at all. In this regard, garbage and sewage end up in streams and rivers, and then into the sea, notes Mr. Valov.

According to the Ministry of Resorts of the Krasnodar Territory, the congestion of Black Sea beaches in high season In 2016, it exceeded 100%, but the controlling structures deny widespread cases of violation of sanitary standards in recreation areas. The regional administration of Rospotrebnadzor reported to Kommersant that cases of group and outbreak morbidity associated with the water factor of infection transmission (swimming in the sea, rivers, use of recreational areas) have not been registered in the region.

This information was confirmed to Kommersant by the Ministry of Health of the Krasnodar Territory. As for the state of sea water, according to Rospotrebnadzor research, the proportion of water samples that do not meet hygienic standards for microbiological indicators was 0.8%; according to sanitary and chemical indicators - 0.4%.

All samples taken for parasitological indicators comply with hygienic standards. The representative of the department characterized the sanitary and epidemiological situation on the coast as normal; the Ministry of Health associates the increase in visits to hospitals with the seasonal factor - a large influx of vacationers during the high season.

Oh sea, sea, who polluted you with dinoflagellate?

I went out to the sea beach - breathed in the fresh breeze... - lost my memory. Or respiratory paralysis may suffice or uncontrollable salivation may begin. The danger of catching such exotic diseases may lie in wait for vacationers on some tropical beaches. Their source is toxic microalgae that produce terrible, sometimes fatal toxins for humans. Dinoflagellates, diatoms... These single-celled organisms make up up to a quarter of all organic matter on the planet, but few people know about them, since they are truly invisible. Just a few years ago, only narrow specialists and coastal residents of the Southern Hemisphere knew about these representatives of the coastal zone. Now this scourge has spread much wider and even moved to our Black Sea and the Baltic. About this, as well as about what else our native resorts can surprise or sadden us in, in the material of the MK correspondent, who talked with a great connoisseur of seaweed, Doctor of Biological Sciences, leading researcher at Moscow State University. Lomonosov, a member of the ancient Moscow Society of Natural Scientists Alexander KAMNEV.

The sea is the sea. Even in the best of times, when there was no such tourist boom, it required a respectful and careful attitude: do not swim in wild beaches, do not swim behind the buoys, do not overheat in the sun. Now, when up to several million vacationers are expected in Anapa during the summer season (with the norm being 150–200 thousand, the waste of which, in principle, can be handled by the existing infrastructure), draw your own conclusions...

Toxic Aleksandrium has settled in the Black Sea

Experts advise treating an overpopulated sea coast in much the same way as we treat a polluted city: to compensate as much as possible for its possible negative impact. In the metropolis, doctors recommend using a shower, walks in parks, going out of town and a balanced diet, and on the coast you should try to walk more, be attentive to what you put in your mouth, even more carefully than before, control the time you spend near the water, be sure to use sunscreen and hats. Using a shower after swimming in sea water is also advisable - in the shower you wash off not only the salt, but also pollutants, which, alas, are now almost everywhere. But maybe there is still an opportunity to choose a cleaner place in advance?

“Recently, a lot of untreated sewage has been entering the Black Sea,” answers Kamnev. - Because best advice: choose places away from towns and cities. It is better to relax on organized beaches, avoid wild, untested ones.

- And if you compare the conditions in Crimea and the North Caucasus?

Still, the climatic conditions in Crimea differ from North Caucasus: the humidity is different, the water in Crimea is different, more flowing due to the ruggedness of the coastal zone. The Black Sea has several currents: surface and internal. One comes from Turkey, and the other, on the contrary, to Turkey. These currents actively wash our Russian shores.

- Sometimes the water near the shore is brown. How to determine why?

Many banks have a clayey base. And therefore, after a storm or rain, part of this clay, as well as coastal runoff, ends up in the sea, and the water becomes brown. Sometimes, due to flowering in the coastal zone, the water acquires a greenish tint.

But there is a more serious reason that can affect the color of the water. Sometimes it changes color a little when microalgae (diatoms) begin to multiply in it. Some of them release toxins into the air, causing serious illnesses in vacationers - from stomach disorders to amnesia. Mostly they live in the Atlantic, Indian, Pacific oceans, in the seas South-East Asia, in the Mediterranean Sea, but recently they have moved to our shores.

- Can you tell us more about them?

The ancient Indians who lived on the sea coast knew about the presence of a toxic “substance” in water that kills fish and brings health problems to humans. The group of toxic algal exometabolites includes substances with very different chemical structures and mechanisms of action. For example, amnesic toxins, based on domoic acid and its derivatives, are produced by diatoms of the genus Nitzschia. I breathed in such a breeze and got amnesia - a memory disorder.

Some dinoflagellates, such as Gymnodinium breve, are particularly dangerous when in bloom. Brevetoxin, which is a powerful neurotoxin, is released into the atmosphere. In this case, damage occurs when inhaling air in the coastal zone. Brevetoxin in excessive quantities causes drooling, severe runny nose, spontaneous bowel movements and muscle paralysis. Death as a result of receiving a large dose of a toxic substance occurs as a result of respiratory arrest...

- What a horror! Interesting, travel companies Do they warn tourists about this?

Unfortunately, no one here is seriously addressing this issue. There are cases of poisoning, but do people attribute them to algae? Most often they are blamed on some exotic viruses or insects. Many, on the contrary, strive to the southern coast of the United States, to Florida. In our country this is considered prestigious, despite the fact that the ocean there is sometimes teeming with dinoflagellates. So-called red tides, when people don't swim or fish, are common there.

- Do microalgae make them red?

Yes. But depending on the species, the tides can be either brown or yellowish. They are typical for South America, Japan, New Zealand, Australia. Fishermen suffer greatly from such tides. Back in the early 90s, one-time losses to individual fishing companies amounted to up to $500 million due to invisible plankton. It has been observed, for example, that threads of the diatoms Chaetoceros convolutes and C. coucavicornis clog the gills of fish, leading to mass mortality in fish farms. Some dinoflagellates, such as Prymnesium parvum, P. patelliferum, Gymnodinium mikimotoi, etc., secrete hemolysins. In fish, they damage the gill epithelium, causing hemolysis (destruction of red blood cells - N.V.). But the saddest thing is that recently we have begun to notice some dinoflagellates off our shores in the Black Sea and the Baltic. The genus Alexandrium, which secretes paralytic toxins, the main chemical component of which is saxitoxin, a sodium channel blocker, has moved here, apparently from the Mediterranean Sea. It causes respiratory paralysis (muscle weakness) and in acute cases is fatal.

- What prompted them to move to us?

Most likely, they are carried along by currents, but a favorable environment is created due to changes in the temperature regime of our seas, they become warmer. In addition, the level of organic compounds in them increases every year due to sewage discharged directly into the sea. We also cannot exclude the possible appearance of new bacteria in our seas. It’s sad that these microalgae travel through trophic (food) chains into shellfish, and people can become seriously poisoned after tasting seafood in a seaside restaurant. Of course, toxins are not always released by microalgae, but only during certain periods. But it is imperative to study them and classify them. In most countries of the world, especially in those where mariculture is developed, the legislative framework on hydrobiont toxins. Maximum concentration limits have been determined, and the content of these substances is constantly monitored. Alas, there is nothing like this in Russia yet. But some types of plankton threaten humans with more than just one-time poisoning. For example, algae of the genus Dinophysis and Prorocentrum, even in small quantities (about tens of thousands of cells per liter), are a tumor promoter, producing okadaic acid. Sometimes it can cause mild digestive upset in a person. A day or two, and it passes, but many do not even suspect a more serious “gift” for a long time. Hepatotoxins from a number of freshwater blue-green algae are also dangerous. In addition to damaging liver tissue, these toxins can cause serious dermatitis.

After all that has been said, the sea somehow no longer attracts. What should those who have already taken trips to the resort do, but are very afraid of catching some kind of toxin there?

There is no need to be afraid. We must live and enjoy life. I myself am going to the same Anapa any day now, where I will swim and scuba dive. In order to protect yourself as much as possible from possible encounters with toxic microalgae, you need to know that most often their number near the coast increases after outbreaks of extreme heat. If possible, it is better to wait a few days after the temperature peaks and only then go into the water. You should also try not to swallow sea water while swimming, and not wash fruits and vegetables in it, so that toxins do not enter the gastrointestinal tract. The second point is compliance with hygiene rules. Many people habitually wash off sea salt in the shower after bathing. This procedure is also necessary to wash away toxins. In addition to taking a shower, I would recommend gargling with drinking water and washing your hands with soap after swimming in the sea. Well, I would like to remind everyone once again that the coastal zone of our seas is not intended to cope with natural needs; there are toilets for this. The cleanliness of our seas largely depends on improving our culture, maintaining prudence and initiatives of city administrations to improve urban wastewater treatment systems. By the way, so far in our coastal zone the situation with diatoms is much better than off the coast of the USA or Japan. Luckily, we don't have red or yellow tides yet. And this is despite the fact that our seas have less antiseptic properties due to their low salinity. If you do not take measures to cleanse them, this advantage can be lost.

It is undesirable to soar from under the water into the sky

Well, thank you, at least you calmed me down a little. Now let me ask you a question as an experienced diver teaching children to scuba dive. At what age can you start scuba diving?

Interesting question. First, I will note that, having decided to go underwater diving, every person should visit an ENT doctor and get confirmation that diving is not contraindicated for him, that is, there are no problems with the ears, in the presence of which it is impossible to dive to depth.

Let's assume that permission has been received from the doctor, then we will determine the age. There are regulatory frameworks that are written for different levels of training, and they have their own age categories. If we go down to our everyday level, it is optimal to start working in the sea with scuba gear from the age of 10. Many American schools adhere to this. But my personal belief is that you can start earlier, from 6–8 years old. Only the depth should be reasonable. For example, at 1.5 meters a child will definitely not get injured. But at the same time, high-class specialists must work with it. Another important tip: if you, while relaxing at sea, decide to sign up for a dive with your child, then keep in mind that this should be done at least a day or two before the plane flight - the body will have to recover after scuba diving.

While we are just learning the culture of handling the sea, for example, the Japanese, due to lack of territory, are already beginning to build sea cities and are gradually going under water. How will they solve the issue of waste disposal? How will they protect their underwater homes from waste from neighboring countries? It is already clear that the future will require all of humanity to reconsider its attitude towards the cradle of life, to radically change its philosophy, to realize that we are all really “cooking” on Earth in a single cauldron called the World Ocean.

The Black Sea is poisoned by a poisonous bacterium. The environmental situation is so catastrophic that hundreds of local residents and tourists turn to doctors every day with complaints of intestinal infection.

On the one hand, everything can be explained by natural causes - dangerous algae began to multiply due to the fact that the water temperature reached an anomalous 29 degrees, and, given the location of the sea, the circulation of water in it is extremely slow, in fact it is a closed reservoir. But experts also name other factors: for example, the excessive activity of officials who, without the necessary base, began to squeeze the maximum out of domestic resorts.

She has few pleasant impressions from her summer holidays: they all fit into a few photographs. 14-year-old Sonya was vacationing on the Black Sea, but this year it was not too kind to her. After just a couple of swims, she came down with an acute infection. According to the girl, the water was warm and dirty, jellyfish and even bottles were floating in it.

Similar situations happen everywhere. Hospitals in resort towns are packed to capacity: there is only one diagnosis - acute intestinal infection. Many of those who decided to spend their long-awaited vacation on the beaches of Adler, Anapa or Gelendzhik literally find themselves in hospital beds on the second day.

“The situation is simply catastrophic: after swimming in the sea, instead of relaxing, we got an intestinal infection and a trip to an infectious diseases hospital, which turned out to be overcrowded with vacationers. Everyone has the same story: we swam in the Adler Black Sea, where sewage is dumped and is infested with E. coli,”- the petition says.

The situation in resort towns really raises concerns, even health officials do not hide: hospital beds are filled exclusively with vacationers.

On the Sochi beach, as always, there is nowhere to lay a towel. The Velvet season is in full swing, and the flow of tourists does not stop. Even these frightening numbers don’t stop holidaymakers: the water temperature is 27 degrees, and two weeks ago it almost reached 30. For the Black Sea, this is an exorbitant figure. However, doctors report: you can swim in such water. And vacationers are happy to follow these recommendations. It’s just that after swimming like this, tourists often have to exchange beach beds for beds in infectious diseases departments.

Another problem typical of coastal towns is the irresponsibility of local residents and businessmen. Numerous hotels, restaurants, shops and residential buildings are simply not connected to the central sewer system. The authorities, of course, are fighting this, but not everyone follows their instructions. In many resort areas, tourists literally swim in their own excrement.

“Very often with my own eyes I see those sewage drains that either flow into the sea with rivers or with storm water. That is, this is due to the fact that there are a lot of mini-hotels, a lot of houses that are rented out, and many simply have their own sewerage system - they simply throw it away,”- says ecologist Vitaly Bezrukov.

And this is a problem that is faced not only in Russia. For example, for the Bulgarians the Black Sea has long turned into a landfill. The bodies of baby dolphins are regularly found on the beaches of the Gold Coast, and no one even tries to disguise the pipes through which waste flows into the sea. In addition, temperatures here are breaking records.

The sea water temperature on the Varna coast is 24 degrees, and this does not have a very good effect on the marine ecosystem. Bacteria multiply very easily in water. In addition, large companies very often break the law by dumping waste into seas around the world, in particular into the Black Sea, near industrial cities.

Now reports of an epidemic of intestinal infection in the Black Sea resorts are coming from almost all countries that have access to it. And if the situation cannot be corrected in the near future, there is a risk of facing an environmental disaster on a regional scale.

Situation in Krasnodar region is rapidly approaching an environmental catastrophe. Russians vacationing there are stating this en masse. Tourists complain that the sea is polluted by sewage and algae, and talk about overcrowded hospitals, federal media write.

On social networks and blogs, tourists talk about intestinal infection epidemics on major resorts Black Sea: Anapa, Sochi, Gelendzhik and others. Hundreds of similar reports have been published about how tourists, after swimming in the sea, suffered from diarrhea and vomiting, waited for hours for an ambulance and spent most of their vacation in the hospital. Mostly parents of young children complained about their ruined vacation.

At the same time, local authorities do not recognize the problem: official comments say that there are no mass cases of disease. And on the Internet they began to collect signatures for a petition: Russians are asking President Vladimir Putin to save the Russian resort from an environmental disaster.

Official response Rospotrebnadzor according to September 3 as follows:

“Over the past 24 hours, 87 cases of infectious diseases were registered on the Azov-Black Sea coast, including those with a preliminary diagnosis: acute intestinal infections of unspecified etiology - 56, ARVI - 31 cases of the disease, the average daily recorded rates of infectious morbidity according to preliminary diagnoses do not exceed the daily average long-term levels".

More than 3.3 million tourists vacationed in Sochi from January to July 2016, according to an official statement on the municipality’s website. At the same time, the beaches were 100% busy.

We decided to find out about the situation on Black Sea coast at our fellow countryman who was there for a month. Let us remind you that Pavel Gedz recently returned from . According to him, there can be no talk of any epidemic:

— The problem is that you don’t have to put everything in your mouth: from the shelves, from the stores. I myself saw how a family came to the beach with half a watermelon. They went for a swim in the sea, came out of the sea and again continued to eat watermelon, without visiting the shower. I will not be surprised that after some time this family ended up in famous place. In this regard, I was more careful, always rinsed myself, and ate in exclusively designated places - cafes and canteens. The latter, by the way, are located right on the coast, and the prices there are normal. Lunch can be taken with first, second, compote and salad for around 200-300 rubles. Just like everyone else, being at sea, every now and then he caught water, now with his mouth, now with his nose. Sometimes I even swallowed it, but no virus took root in me, or it doesn’t exist at all.

Paul advised people to wash their hands often and watch what they eat.

“I have never bought food from hand, from traveling merchants. No churchkhella, no boiled corn, no anything! I do not advise tourists to immediately rush to local food. You come from another region. What is normal and familiar for locals may be sad for visitors; everyone’s body is different. Be healthy!