Tag Archives: Germany

E. coli O104 death toll at 5, 276 with HUS, over 600 ill, Spain complains

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German public health authority Robert Koch Institute (RKI) confirmed Friday that five people have now been killed by E. coli O104 linked to organic cucumbers from Spain.

"The Andalusian authorities are investigating to find out where the contamination comes from and when it took place," said a spokesman for the Spanish food safety agency AESA on Friday.

Spanish senior official Josep Puxeu said Germany informed the press about the disease before informing the EU, as it should have done, and that Spain has stopped cucumber deliveries while stressing there is no proof that the EHEC entered Germany through Spanish cucumbers.

There has been no report of contamination within Spain, AESA said.

Meanwhile, the outbreak is spreading across northern Europe. Health officials in Denmark and Sweden reported Friday a total of 32 confirmed cases of people afflicted by the EHEC bacterium, all of whom had previously been travelling in Germany.

Denmark’s veterinary and food products agency said Friday it had found contaminated cucumbers from Spain in the stocks of two wholesalers in the west of the country and ordered them withdrawn.
 

Spanish lettuce watered with raw sewage – 2005 preview to German E. coli O104 outbreak?

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In May 2005, hundreds of people in Northern Europe became sick from lettuce grown in Spain that was watered with human sewage.

As reported by Eurosurveillance, the rare multiresistant Salmonella Typhimurium DT 104B caused an outbreak of 60 microbiologically confirmed cases in May 2005, widely distributed across southern and western Finland. The isolates had an identical pulsed field gel electrophoresis (PFGE) and antimicrobial resistance pattern (ACSSuT); also, 80% of the confirmed cases were in females and 45% were in people aged between 15-24 years (range 7 to 53).

Hundreds were also sickened in the U.K. The Daily Mail was direct: “Drought-hit Spanish farmers have been using household sewage to water lettuce.”

Spain’s environment minister at the time said, "When they don’t get irrigation water they turn to other kinds of water."

Farmers from Beniel, in south-east Spain, told the El Pais newspaper, "The water we receive is not enough, so we are forced to mix it with the sewage from our own homes."

Farmers’ leaders in the Murcia region insist it would be wrong to view all Spanish produce as unsafe based on the behavior of a few growers.

Francisco Gil, a local union leader who grows peppers, said at the time, "That is like calling all Englishmen drunks just because one or two of them can’t hold their drink.”

So assuming German health types are correct and Spanish cucumbers are to blame for an E. coli O104 outbreak that has killed five and sickened over 600, it reinforces a food safety basic: know thy supplier – and know what they are doing when the auditor or inspector isn’t around, which is 99.99999 per cent of the time.

Night soil? Or ruminant soil.
 

Spanish cucumbers in German E. coli O104 outbreak traced to organic producers; over 600 sick, 214 with HUS, 4 dead

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Three of four cucumber samples that tested positive for E. coli O104 in Germany were grown on two organic farms in Spain.

The news comes as the number of victims suffering from hemolytic uremic syndrome reached 214 out of approximately 600 ill, and at least four dead.

Kai Kupferschmidt writes in Science Insider today that authorities in Hamburg announced they had isolated the bacterium that is likely causing the outbreak, E. coli O104:H4 , from four cucumbers. Three of the samples came from a big market in Hamburg that sells to greengrocer’s shops as well as restaurants and caterers. Those cucumbers came from two organic producers in Spain. Scientists had speculated in the last few days that manure from infected animals used on an organic farm might have spread the bacteria to vegetables. A fourth sample came from a restaurant, and it was not immediately clear where that cucumber had been grown. After the announcement, stores started taking Spanish cucumbers off the shelves.

Consumers had already been hesitant about vegetables since scientists at RKI and the Federal Institute for Risk Assessment announced the results of a first case-control-study on Wednesday evening: Women who had become infected with EHEC were a lot more likely to have eaten raw tomatoes, cucumbers, and lettuce in the days before falling ill than women who had not fallen ill.

The scientists used a detailed questionnaire to ask 25 female EHEC patients and 96 women living in the same areas about what they had eaten in the days before the outbreak. Only women were included in the study because they have fallen ill more often than men in the outbreak. "It also strengthened the results of the study, because it meant that we could ignore all sex-specific differences in eating habits," says Gérard Krause, head of the department for infectious diseases epidemiology at RKI.

A statistical analysis revealed that 92 % of the women who had become infected had previously eaten tomatoes. Only about 60% of healthy women had done so. "For something that people eat so frequently, this is a big difference," says RKI expert Klaus Stark. The results for cucumbers and lettuce were similar but slightly smaller. All three results were statistically significant. The experts advised Germans, particularly in the north, not to eat any raw tomatoes, cucumbers, or lettuce until further notice.

That advice remains in place. "It is certainly a possibility that more than one of these foods is responsible," says Reinhard Burger, president of RKI. Scientists also want to be sure that the results from Hamburg are confirmed in another lab.

Kurt-Henning Klamoth, president of the German Farmers Federation (DBB) accused the media of scaremongering and condemned speculation that the illness has been spread through organic fertilizers.

Spain is Germany’s second biggest supplier of cucumbers within the European Union, sending 179,500 tonnes of the vegetable to Germany in 2009, according to the Federal Office for Agriculture.
 

Blame Spain: Germans finger Spanish cucumbers as source of E. coli O104 outbreak

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German health officials identified imported cucumbers from Spain Thursday as the source of a two-week E. coli O104 outbreak that has killed at least four people and made more than 100 others ill.

Three of four contaminated cucumbers analyzed by the Hamburg Institute for Hygiene and the Environment came from Spain, said the state health minister for Hamburg, Cornelia Pruefer-Storcks.

Cucumbers from the affected producers have been pulled from shelves and officials have told people to stop eating cucumbers. The country of origin of the other cucumber is not yet known.

138 now with HUS in German E. coli O104 outbreak; 3 dead, over 400 sick

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Kai Kupferschmidt, who initially reported it was E. coli O104 that has killed three and sickened over 400 in Germany, writes for Science Insider today that an initial sorta-case control study hasn’t provided any clues as to the source of the outbreak.

But Kupferschmidt does provide excellent background on E. coli O104, and notes that German authorities reported earlier today that the number of hemolytic-uremic syndrome (HUS) cases had reached 140; there are normally 60 HUS cases in Germany in a year.

Most EHEC infections are caused by a notorious serotype called O157:H7; researchers refer to that serotype and four others frequently found in Europe as the "gang of five." But the German reference laboratory for EHEC in Wernigerode has so far identified the serotype of EHEC in stool samples from five patients as O104.

Scientists have been baffled not only by the outbreak’s size and rapid spread in northern Germany but also by the fact that it affects mostly adults and females, an odd pattern because EHEC usually sickens children.

That makes the outbreak highly unusual, says Helge Karch, head of the National Consulting Laboratory on Hemolytic Uremic Syndrome in Münster. Among Karch’s E. coli isolates from 588 HUS patients collected over the past 20 years, only two are O104. In another unusual twist, Karch has found the strain to be eae-negative. The gene eae codes for the protein intimin, which the bacteria uses to attach to the intestinal wall. Most pathogenic EHEC serogroups are eae-positive.

It is still unclear whether the serotype might explain the strange pattern of infections. E. coli O104 first emerged as a pathogen in a small outbreak in Helena, Montana, in early 1994. Four people developed abdominal cramps and bloody diarrhea. Experts at the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta identified a serotype called O104:H21 as the culprit. A CDC investigation later found up to 18 patients; most of them were women and the median age was 36 years.
 

E. coli O104 cause of German outbreak; 3 dead, over 400 sick; fresh produce suspected

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Klaus Stark, group leader of gastrointestinal infections and zoonotic diseases at the Robert Koch Institute (RKI) told Der Tagesspiegel that E. coli O104 appears to be the cause of an E. coli epidemic sweeping Germany, with at least three dead, over 400 sick including 80 cases of hemolytic uremic syndrome.

"It looks right now like it is a type EHEC O104 cause of the disease."

A table of non-O157 STEC (shiga-toxin producing E. coli) outbreaks is available at http://barfblog.foodsafety.ksu.edu/blog/148324/11/05/16/non-o157-stec-outbreak-table-available. E. coli O104 was the causative agent in a 1994 outbreak in Montana that sickened at least 18 people.

Marian Turner of Nature magazine reports early cases were confined to northern Germany, but this afternoon, the first suspected cases have been reported in the southern German state of Bavaria.
 

3 dead in German E. coli outbreak; more than 400 sick

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The food safety news from Germany continues to be disturbing. Below is a translation of a German article, so excuse any inaccuracies.

The killer germ called EHEC now appeared three lives: In Lower Saxony (Diepholz) passed away a woman (83). She was admitted nine days ago because of bloody diarrhea hospitalized and treated in hospital. The laboratory evidence of EHEC infection was positive. The woman died on Saturday. Investigations by the health department in the immediate death Diepholz also ongoing.

Meanwhile it was announced that a woman possibly died (25) to EHEC in Bremen. The young woman had shown the symptoms of EHEC pathogen, such as the Bremen health authority said. The EHEC pathogens had not been demonstrated so laboratory diagnosis. In Schleswig-Holstein, died in a 80-year-old woman infected. Whether the pathogen was the cause of death is still unclear.

In their search for the source of the infections with the dangerous intestinal bacteria EHEC is making the Frankfurt FDA. All 19 previously in the Main metropolis ill have eaten in the same canteen, a Frankfurt-based consultancy, said Bellinger Oswald from the Health Department. Two canteens of PWC Consulting had been closed on Monday as a precaution.

The fault is probably a loaded delivery to the canteen: "We assume that the source of infection is located in Northern Germany," said Bellinger. Currently, experts evaluated the delivery notes of the two affected canteens. "We still believe that the transfer has taken place through raw food." Safety reasons are investigated and the kitchen staff, results of samples are expected by the end of the week. As long as the canteens were closed.

More than 40 of these patients also suffered under the hemolytic-uremic syndrome (HUS), which is caused by the intestinal bacteria.
 

First death in German E. coli outbreak; up to 200 sick

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A deadly outbreak of the E. coli bacterium has claimed its first victim in Germany, authorities confirmed Tuesday, following reports that at least 140 people had fallen ill after becoming infected over recent weeks.

Health officials said the 83-year-old from the northern state of Lower Saxony died Saturday after having suffered since May 15 with the bacteria.

The outbreak, thought to have been spread through contaminated vegetables, is unusual in that it has affected mainly adults.

E. coli outbreak spreading in Germany; 80 sick, dozens hospitalized

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Two victims of a potentially fatal strain of E. coli have been placed on artificial respiration machines, a Frankfurt hospital said Monday, while hospitals across Germany were reporting a surge in infections.

German media report that EHEC, or Enterohaemorrhagic Escherichia coli, is a virulent strain of gut bacterium which can cause stomach cramps and diarrhea, and can lead to anaemia and kidney damage.

The strain of E. coli is not specified in media reports, but the kidney failure bit makes it sound like a Shiga-toxin producing E. coli.

In Frankfurt, 10 people had been hospitalized, of whom four were in intensive care, while a further 50 people were ill with mild symptoms of EHEC.

A total of 40 people were being treated in Hamburg, most of whom were female, the city’s health authorities said.

Around 800 to 1,200 cases of EHEC are recorded in Germany each year, predominantly affecting children. The current outbreak is unusual for causing severe symptoms in adults, primarily women.

The bacterium is commonly transmitted through contaminated raw or undercooked ground meat products or milk, but disease experts said there was evidence that uncooked vegetables might have helped to spread the latest outbreak.

Gerard Krause of the Robert Koch health authority responsible for epidemiology, said,

“Women prepare food more often, and it is there they could have come into contact with it, possibly while cleaning vegetables or other foodstuffs.”

In a German version of blame-the-consumer, the Robert Koch Institute has recommended people improve kitchen hygiene, making sure in particular that cutting boards and knives are clean.

It’s doubtful that all 80 sick people practiced lousy kitchen cleanliness at the same time across Germany.

Germany plans hygiene ratings for restaurants

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Spiegel Online reports that Germany is about to implement a restaurant inspection disclosure system, based on the traffic-light – red-yellow-green pioneered by Toronto – but the crack journalists forgot to mention Toronto.

Consumers worried about filthy kitchens full of rotting food will soon know just how clean German restaurants are thanks to a new hygiene rating system set to begin in 2012. A "traffic light" scheme will show which eateries are spick-and-span — and which have nasties lurking under the cupboards.

On Thursday, consumer ministers from Germany’s federal states, with the exception of the southern state of Bavaria, agreed to institute a color-coded hygiene rating system that will be clearly posted at the entry of every restaurant in the country.

The "traffic light" scheme will indicate how closely each restaurant adheres to health standards. Green rankings will go to eateries with the highest marks for cleanliness. Yellow will indicate some concerns, and red will point to grave violations. The exact graphic incarnation of the ratings remains undecided, though.

The decision came after more than a year of internal wrangling over whether the scheme should mirror Denmark’s food safety "Smiley system," which has been in place since 2001.

"Exemplary establishments can use their rating to advertize, while those that aren’t as good have incentive to improve, and the black sheep have nowhere to hide," the national association of consumer initiatives said.

The German Federation for Food Law and Food Science (BLL) said the program could only work if states were willing to conduct more frequent tests and spend more money.

Meanwhile heavy criticism came from the national hotel and gastronomy association DEHOGA, which said current regulations are sufficient. "This system is built to endanger people’s existence," they said in a statement.