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The Scoop on Poop: Why Your Fecal Matter Matters

Posted in Campylobacter,Cyclospora,E. coli,Listeria,Norovirus,Outbreaks & Recalls,Salmonella,Shigella,Staphyloccocous,Vibrio on June 23, 2018

When a tummy ache becomes serious enough that your over-the-counter treatments and home remedies are just not doing the trick, it might be time to see a doctor.  If you find yourself in a doctor’s office or emergency room as a result of foodborne illness, you are not alone.  In fact, foodborne illness, more commonly referred to as food poisoning, affects around 1 in 6 Americans amounting to 48 million illnesses each year.  Poor food handling, temperature control, or cross-contamination may be culprit.  Once it is too serious to treat yourself (out of control diarrhea, vomiting, extreme dehydration, bloody stool, etc.) professional help is necessary.

Consultation

The first step in understanding what you may have and how you may have acquired it starts with a medical consultation.  Your doctor will likely ask you some questions about your symptoms and when they started, your recent eating habits, and if anyone else you know has a similar illness.  Your doctor may begin a broad-spectrum treatment to help you get well sooner but will likely request a stool sample from you to be tested to confirm what you might be infected with.

Why Do You Want My Poop?

If you are experiencing bloody diarrhea or you have diarrhea lasting more than three days, your doctor may request a stool sample, also known as a fecal sample.  Essentially, they want to examine your poop.  More specifically, they want to see what pathogens might be present there.

This sample can be used for a variety of purposes.

  • Expedite treatment: Your poop sample can be used to help expedite your treatment.  Knowing the exact pathogen allows your health care provider to accurately diagnose and treat your illness.
  • Track outbreaks: Your poop sample allows the pathogen that caused your illness to be DNA fingerprinted.  This enables epidemiologist to link your illness with others who are infected with the same pathogenic source.  DNA fingerprinting is a process of looking at the genome of a pathogen.  This distinguishes one bacteria from another within the same species.  This knowledge is useful for identifying and tracking infection trends used in outbreak tracing.

The Life Cycle of a Poop Sample

It’s a bit awkward, but you are assured the process is to help you.  So, you follow doctors orders and go in a cup.  But what happens to the sample once you turn it in.  Believe it or not, many people will likely handle your sample along the way.  Let’s take a look at the life cycle of how your illness is diagnosed with your poop sample.

Day 1: Patient Eats Contaminated Food

From the time you eat contaminated food (many foodborne illnesses are transmitted via fecal-oral route, so your contaminated food is likely contaminated with microscopic amounts of contaminated poop – gross but true) to the time the patient becomes symptomatic is generally somewhere between 1 to 3 days.  It takes a bit of time for the small number of harmful bacteria to build up to quantities to be symptomatic.

Day 4 to Day 8: Patient Becomes Ill Enough to Seek Medical Treatment

Anywhere from 1 to 5 days later you might become ill enough to seek medical treatment.  This little upset stomach is clearly a little something more than a mild bug.  Once at the doctor’s office or emergency room, they ask for a sample.  Yep.  This is where you poop in a cup.  Your sample them makes its way to a laboratory to be screened.  On the low end, you are on day 4 after consuming contaminated food.  On the high end you are somewhere around day 8.

Day 5 to Day 11: Initial Pathogen Diagnosis

Your sample has been handed off to the nurse or doctor who writes up the request according to doctor’s orders.  Some facilities can test this inhouse, while other will send the sample off to a company that performs these tests for the facility.  This can take between 1 and 5 days to return.  On the low end, you are now on day 5 after consuming contaminated food.  On the high end you are somewhere around day 11.

 Day 5 to Day 18: Sample is Shipped to Nearest Public Health Laboratory

At this point, if your sample has been screen tested positive, protocol requests your health care provider or the screen testing laboratory to forward the sample to your local or state Public Health Laboratory for serotyping and DNA fingerprinting.  This trip could take between 0 to 7 days, depending on how far away the Public Health Laboratory is from your doctor’s office or hospital.  On the low end, you are now on day 5 after consuming contaminated food.  On the high end you are somewhere around day 18.

Day 7 to Day 28: Case Confirmed as Part of an Outbreak

Once your sample has made it to the Public Health Laboratory for confirmation and additional testing, it can take anywhere from 2 to 10 days for results to be obtained and reported to your healthcare provider.  Serotyping and DNA fingerprinting is uploaded into a database that investigators can use to help track down people who are infected with exact same strain and type of bacteria that you are.  On the low end, you are now on day 7 after consuming contaminated food.  On the high end you are somewhere around day 28.

Why Should I Get My Poop Tested?

If your symptoms are very severe and result turn-around time is quick, you might be able to find out if you are part of an outbreak in as little as 7 days.  This is generally not the case.  Most people wait quite awhile before seeking medical attention and the process can take somewhere between the middle and high end of processing times.  Ultimately it could mean that it takes almost a month or more to identify a source of illness.  Meanwhile, others could be infected and an outbreak not linked as quickly as it could be.

Oftentimes, the individual has fully recovered before they know they were part of an outbreak.  Sometimes, they may never find out. The sooner your sample can be tested, the faster an outbreak can be identified.  Once an outbreak is identified, investigators can track down a source and hopefully prevent others from becoming ill.  All because you pooped in a cup.

Fecal Matter Matters

Why is testing the stool sample and tracking foodborne illness important?  The 1,000 or more reported outbreaks that happen each year reveal familiar culprits—like Salmonella and other common germs.

Other people visiting the doctor may also feel sick from tainted food, making it important that our public health system reliably links people with similar lab results. Testing the stool sample is important for the patient, doctor, and public health officials to know if your sickness is connected to other illnesses.   Tracking illnesses and investigating outbreaks helps to show how food can be made safer. Even though most people get better without visiting a doctor, CDC estimates that each year 48 million people get sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases.

Testing, detection, and prevention matter.  Do the stool sample.  It could save your life; and, those of others.

* There are new tests that can be performed right in the doctor’s office, please check back for a later blog post on the pros and cons of these tests.

By: Heather Van Tassell, Contributing Writer (Non-Lawyer)