KNOXVILLE, Tenn. (WATE) — At least eight Tennessee children were recently hospitalized as part of an outbreak of E. coli infections following a school field trip.

E. coli is bacteria, the CDC explains. Many strains are harmless, but there are some that can make you sick. Among those is Shiga toxin-producing E. coli, the strain health officials have determined the children were exposed to during their field trip.

“The toxin causes two main things. So hemolysis, which is the H in hemolytic uremic syndrome, which is a breakdown of blood cells and also uremic syndrome, which is kidney damage,” said Suzanne Rybczynski, M.D., M.S.H.C.M., chief medical officer at East Tennessee Children’s Hospital.

Several of the children were taken to East Tennessee Children’s Hospital in Knoxville for treatment. While she did not comment on their conditions, Rybczynski explained that severe E. coli can cause children to have severe diarrhea that’s often bloody with vomiting and a lot of abdominal pain.

“Once it’s diagnosed, antibiotics are not recommended and actually are detrimental. So really the care of those kids is supportive. So, if they need IV fluids they should get that. They need to be monitored for nutrition. If a kid does develop hemolytic uremic syndrome, they might end up in the hospital. They might end up in intensive care. And the kidney damage can be pretty severe, so they might end up needing dialysis, or they might actually need a blood transfusion,” said Rybczynski.

She went on to say that E. coli is typically spread through “a fecal-oral route”, which means food could have been contaminated during production or transportation, someone doesn’t wash their hands well, food wasn’t cooked well or milk wasn’t pasteurized, and the bacteria lives. It is very contagious and can lead to an outbreak.

“So, if you have a kid who has diarrhea or doesn’t realize that they have this infection brewing, they don’t wash their hands well. They touch things after going to the bathroom and then it kind of lives on surfaces. Another kid touches it, eats it, goes into their GI tract. So that’s how it’s typically spread,” said Rybczynski.

“The most important thing is to wash your hands a lot,” she added. “Sanitize your areas where you have food and you’re cooking. Make sure you cook your food well to kill any bacteria that’s in there, not just E coli, but other things. And one of the other things is to avoid unpasteurized milk and cheeses.”