The symptoms of an E. coli infection can vary depending on the strain involved. Typical symptoms include diarrhea, which may be bloody, abdominal cramps, nausea, and vomiting. Symptoms usually manifest within 2 to 5 days after exposure. Severe cases, especially those involving Shiga toxin-producing E. coli, can progress to hemolytic uremic syndrome, characterized by reduced urination, fatigue, and pallor.