For decades, researchers working with L-form bacteria have warned that while standard antibiotic therapy successfully kills classical bacterial forms, it leaves bacteria that transform into the L-form unscathed. In fact, when the beta-lactam antibiotics are administered to patients with acute infection, they actually foster the growth of L-form bacteria, meaning that patients treated with these antibiotics can certainly plan on dealing with numerous symptoms of chronic disease in the years to come.

Because L-form bacteria grow so slowly, few researchers have made the connection between acute infection and chronic symptoms that rear their heads decades down the road. However, several research teams have finally taken note of the fact that food poisoning victims, who at one point suffered from a severe acute infection, are much more likely to develop chronic symptoms later in life.

“It’s a dirty little secret of food poisoning,” says Lauren Neergaard of Yahoo News. “E. coli and certain other foodborne illnesses can sometimes trigger serious health problems months or years after patients survived that initial bout. Scientists only now are unraveling a legacy that has largely gone unnoticed.”

In a recent interview with the Associated Press, researchers at the University of Utah described how many survivors of severe E. coli infections as children are suffering from severe kidney issues later in life. The research team, which has long tracked children with E. coli, found that about 10 percent of E. coli sufferers develop a life-threatening complication called hemolytic uremic syndrome, or HUS, where their kidneys and other organs fail.[1]

Ten to 20 years after they recover, between 30 percent and half of HUS survivors will have some kidney-caused problem, says Dr. Andrew Pavia, the university’s pediatric infectious diseases chief. That includes high blood pressure caused by scarred kidneys, slowly failing kidneys, even end-stage kidney failure that requires dialysis.

“Folks often assume once you’re over the acute illness, that’s it, you’re back to normal and that’s the end of it,” said Dr. Robert Tauxe of the Centers for Disease Control and Prevention. “The long-term consequences are an important but relatively poorly documented, poorly studied area of foodborne illness.”

Donna Rosenbaum of the consumer advocacy group STOP (Safe Tables Our Priority) told the Associated Press that every week, her group hears from patients with health complaints that they suspect or have been told are related to food poisoning years earlier. One woman to contact the group survived severeE. coli at 8 only to have her colon removed in her 20s. Other people report developing diabetes after a bout of food poisoning that inflamed the pancreas. Then, there are children who survived food poisoning dialysis as toddlers and are now suffering from learning problems.

“There’s nobody to refer them to for an answer,” says Rosenbaum.

So STOP this month is beginning the first national registry of food-poisoning survivors with long-term health problems — people willing to share their medical histories with scientists in hopes of boosting much-needed research.

One person to share her story is Alyssa Chrobuck of Seattle, who at age 5 was hospitalized as part of the Jack-in-the-Box hamburger outbreak 15 years ago that resulted after several people ate meat infected with a dangerous form of E. coli.

Today she’s a successful college student but ticks off a list of health problems unusual for a 20-year-old: High blood pressure, recurring hospitalizations for colon inflammation, a hiatal hernia, thyroid removal, endometriosis.

“I can’t eat fatty foods. I can’t eat things that are fried, never been able to eat ice cream or milkshakes,” says Chrobuck. “Would I have this many medical problems if I hadn’t had the E. coli? Definitely not. But there’s no way to tie it definitely back.”

Further evidence connecting acute infection to chronic illness later in life comes from studies which have shown that about 1 in 1,000 sufferers of campylobacter, a diarrhea-causing infection spread by raw poultry, develop far more serious Guillain-Barre syndrome a month or so later. Their body attacks their nerves, causing paralysis that usually requires intensive care and a ventilator to breathe. About a third of the nation’s Guillain-Barre cases have been linked to previous campylobacter, even if the diarrhea was very mild, and they typically suffer a more severe case than patients who never had food poisoning.

Similarly, a small number of people develop what’s called reactive arthritis six months or longer after a bout of salmonella. It causes joint pain, eye inflammation, sometimes painful urination, and can lead to chronic arthritis. Certain strains of shigella and yersinia bacteria, far more common abroad than in the U.S., trigger this reactive arthritis, too, Tauxe says.

It remains to be seen how long it will take Tauxe and other researchers to connect these chronic infections of L-form bacteria. But when the connection is finally made, the medical community will become aware of the fact that persistent L-form infection is affecting the entire population, not just food poisoning victims. As biomedical researcher Trevor Marshall describes, the chronic illnesses that all people develop are a direct result of the “peasoup” of L-form bacteria and other pathogens they have collected over a lifetime.

The implications of this situation are clear: when a person develops an infection, treatment must be administered that kills both the classical and L-form bacteria. Happily, the Marshall Protocol works effectively to kill L-form bacteria. This means that people can now do a short course of the Marshall Protocol after developing an acute infection, allowing them to get rid of any L-form bacteria that have formed, and saving them from a host of chronic symptoms later in life.


  1. Siegler, R. L., Pavia, A. T., Christofferson, R. D., & Milligan, M. K. (1994). A 20-year population-based study of postdiarrheal hemolytic uremic syndrome in Utah. Pediatrics, 94(1), 35-40. []