Battling E. coli, One Girl's Story

Sept. 21, 2006 — -- Alaina Dressman, a 12-year-old, straight-A student in Union, Ky., ate a sandwich on Sept. 5 that changed her life.

"Alaina loves spinach on her sandwiches," said her mother, Donna Dressman.

After stopping for dinner at a small restaurant with her mother, Alaina piled spinach on her sandwich as she normally did. She was returning from dance practice.

For the next 3½ days, it was life as usual.

Then, Alaina complained of a bellyache and diarrhea, and told her mom that she wasn't feeling well.

Alaina never slept that night, going to the bathroom every 20 minutes to 40 minutes.

On the morning of Sept. 10, Alaina noticed blood in her diarrhea.

The pains in her belly had gone from a dull aching to severe cramping. The usually strong Alaina was starting to cry from the pain.

"She was doubled over from cramping," Dressman said. "She was tearing up, and that was unusual for her. That's when I thought, 'This isn't right.'"

The morning of Sept. 11, Alaina's pediatrician advised her and her mother how to manage diarrhea and to keep Alaina well hydrated. The symptoms didn't improve, though.

"Around 3:30 to 4:00 in the afternoon I really started to get concerned."

Dressman called the pediatrician again, who asked for a stool sample.

But the lab said it was closing for the day and would not be able to take the sample until the morning.

Dressman didn't want to wait another day, because her daughter's condition was deteriorating.

She called the pediatrician's office again. This time, the office told the mother and daughter to go to the emergency room at Cincinnati Children's Hospital -- a 40-minute drive from their home.

They arrived in the emergency room at around 9 p.m.

The doctors at Cincinnati Children's ran lab tests, took X-rays, and ran cultures of her diarrhea.

Every test turned up negative. The doctors found none of the problems they were looking for.

Alaina seemed to look and feel better. The emergency room doctor decided to send her home.

"Cincinnati Children's Hospital sees 90,000 children a year, and bloody diarrhea is not uncommon," said Dr. Robert Shapiro, one of the emergency room physicians to see Alaina that night.

"We will send them home if tests are negative and the child is stable."

"This is always based on the child having close follow-up with a pediatrician," Shapiro said.

After Alaina came home at 4 a.m. Sept. 12, she didn't seem stable anymore.

Her symptoms continued with no relief. Dressman made an appointment to see a doctor later that morning.

When the doctor saw Alaina, he thought she looked very ill and told them that she needed to be hospitalized.

She was admitted to Cincinnati Children's Hospital that night.

"She was given some morphine for her pain and was started on IV fluids to keep her hydrated," Dressman said.

Doctors Determine Girl's Condition

On the morning of Sept. 13, the gastroenterology team -- a group of doctors who study the digestive tract -- saw Alaina.

The doctors said they did not know what the problem was. But soon enough, the doctors had a deadly idea.

"At around 4 p.m., they came in again and said they were leaning towards E. coli," Dressman said. "They said they were 90 percent sure it was E. coli and were awaiting the test results."

On Sept. 14, the gastroenterologists confirmed that Alaina had been infected with E. coli -- the same bacteria that is currently responsible for a widespread E. coli outbreak.

Making the Connection to National Outbreak

Alaina's mother didn't make the connection between the national outbreak and her daughter's condition until she heard from a friend.

"Around noon, I received a text message about E. coli and the spinach from a friend who saw it on the news," Dressman said. "Alaina remembered the spinach on the sandwich, but I told her that was too long before she got sick. She would have gotten sick on Tuesday night or Wednesday."

On Sept. 15, however, the gastroenterologists told Alaina and her mother that the spinach sandwich probably had been the source of the E.coli, and that it was not unusual to fall ill so long after eating contaminated food.

Alaina began to recuperate that morning. She was able to eat a couple of pancakes for breakfast and pasta for lunch. Her stool cultures that day came back negative.

Doctors sent Alaina home that night.

Since then, she has been slowly recuperating at home and has been able to eat more and more. Her bowel movements have gotten more regular.

Finally, on Sept. 22, two weeks after that fateful meal, Alaina went back to school for the first time, just for a half day.

"She had really missed school and was anxious to get back," Dressman said. "It has been a very stressful time. I'm glad things are getting back to normal."

Fortunately, Alaina's case was not so complicated.

"Alaina was lucky not to have the severe complications that are seen with this bacteria that lead to kidney failure and occasional deaths, known as HUS [hemolytic uremic syndrome]," said Dr. Kenneth McAllister, an infectious disease specialist at the University of Kentucky. "HUS is becoming more common and is very dangerous."

He went on to say that "they [doctors] seemed to have followed the right course, not giving antibiotics, which increase the risk of the bad complications."

Alaina's experience shows us a little picture of what it's like to be on the inside of an outbreak.

Doctors don't always know exactly what is going on until some time has passed.

That might explain to some people how this current E. coli outbreak could have spread so far.

As for Alaina, she is happy to be home, getting a little better every day, back doing the things she loves, dancing and making straight A's.