E coli outbreak: WHO says bacterium is a new strain

[Bernkastel]

Here is a link to the article.

A new and more virulent strain of the E coli bacterium caused the outbreak that has killed 17 people and left more than 1,500 ill across Europe, the World Health Organisation has announced.

Hilde Kruse, a food safety expert at the WHO, told the Associated Press it was "a unique strain that has never been isolated from patients before ... [its characteristics] make it more virulent and toxin-producing". According to the Health Protection Agency three British nationals have been infected as well as four Germans in the UK. All are believed to have caught it in Germany. Three are believed to have developed haemolytic uraemic syndrome, a rare and severe kidney complication that destroys red blood cells and can affect the central nervous system.

The HPA has said it is working with the Food Standards Agency and there is no evidence of suspect produce being distributed in the UK. As the number of cases continues to rise , Russia has extended its ban on imports of raw vegetables from the European Union – a move condemned by Brussels as "disproportionate" – and Spain is threatening legal action over the initial attempt by Germany to blame the outbreak on imported Spanish organic cucumbers.

Russia initially banned imports of raw vegetables from Germany and Spain but is extending the ban to all EU countries. Gennady Onishchenko, head of the Russian consumer protection agency Rospotrebnadzor, told the Interfax news agency the deaths "demonstrate that the much-praised European sanitary legislation which Russia is being urged to adopt does not work". "How many more lives of European citizens does it take for European officials to tackle this problem?" he told the RIA Novosti news agency.

Exports of all vegetables, including raw vegetables, from the EU to Russia were valued at €594m euros last year, with France, Germany and Poland the biggest exporters. European Commission spokesman Frederic Vincent said health commissioner John Dalli would be writing to Moscow "within hours" warning the ban was disproportionate. Spain is seeking compensation from Germany of its farmers, claiming lost sales are costing €200m a week and could put 70,000 people out of work.

In Germany a health official admitted the precise source of the disease may never be traced. Reinhard Burger, head of the Robert Koch Institute, told the BBC: "I think the number of cases will come down, but how long it takes I'm not sure. It could be indeed weeks or months and I'm not sure if we will really find the source." The RKI reported 365 new cases on Wednesday and said a quarter involved a life-threatening complication.

At the European Centre for Disease Prevention and Control, Denis Coulombier, head of surveillance and response, said there was a strong link between the disease and consuming fresh vegetables. "To have such a high number of severe cases means that probably there was a huge contamination at some junction," he told Reuters. "That could have been anywhere from the farm to the fork – in transport, packaging, cleaning, at wholesalers or retailers – anywhere along that food chain."

In Britain the HPA is urging travellers to Germany to avoid eating raw tomatoes, cucumbers or leafy salad, especially in the north of the country, and anyone returning with symptoms including bloody diarrhoea is being told to seek urgent medical attention.

Dr Dilys Morgan, head of the HPA gastrointestinal department, said: "The HPA continues to actively monitor the situation very carefully and we are working with the authorities in Germany and with our counterparts across Europe as to the cause of the outbreak. We have alerted health professionals to the situation and advised them to urgently investigate and report suspected cases with a travel history to Germany."

Professor Hugh Pennington, a microbiologist from the University of Aberdeeen, told the BBC that the oubreak was unusual because it didn't seem to be affecting young children. "Children under five have had a very hard time with this kind of bug in the past. They seem to be escaping it – maybe just due to the nature of the food that's causing the problem."

[Dargos]

Bioterrorism. Yeah I said it. I can't believe no one else might think this. Huge contamination at some junction but no one can say where ? No one knows exactly what the vector is just a strong link between the disease and consuming fresh vegitables. Yeah I have no proof but tell me I'm not the only one who might have thought about it.
::back to reality::
The farmers in my region (Unterfranken, Bayern) are going ape shit. First the extreamly low amount of rain this region has gotten this year and now this. On the radio they had one guy say he deliverd 25 heads of lettce, he usually delivers up to 25,000. More then one is going bankrupt this year because of this.

[Shroom Man 777]

I love how the Russians are just gloating at them and being all out dicks about it. If you were a conspiracy nut, you'd think they engineered the bacteria.

[PeZook]

Bioterrorism. Yeah I said it. I can't believe no one else might think this. Huge contamination at some junction but no one can say where ? No one knows exactly what the vector is just a strong link between the disease and consuming fresh vegitables. Yeah I have no proof but tell me I'm not the only one who might have thought about it.
::back to reality::

More likely, welcome to the world where rampant use of antibacterial products is the norm. Shit like this is going to become more and more common.

[Broomstick]

Part of the problem is the current system of food production and distribution. In the past, producers/processors/shippers/retailers all dealt in smaller volume from smaller areas. Thus, outbreaks were smaller and more limited in scope. Now, the scale of all that has changed - we have huge farms which funnel their produce to even larger processors. In the past, if one farm was contaminated the problem remained localized and there was plenty of uncontaminated food available. Now, if 90% of vegetables go through the same processor (just an ass-pull example) then one contaminated shipment can contaminate all that goes through that funnel, meaning now 90% of food is now contaminated.

The centralization is more efficient only when nothing goes wrong. When contamination happens, it then becomes quite efficient at spreading it.

Based on prior experience in the US, I'm guessing the E. coli outbreak in Europe might be due to

1) Farm laborers taking a shit in the fields. Yes, something that simple. In some places in the US it is now mandated that employers provide porta-potties to farm labor, wow, what a concept. Seems that people doing hour upon hour of manual labor in fields sometimes have to piss or shit, they can't hold it for 10 or 12 or however many hours are involved. Just because, since prehistory, people have been shitting in farm fields when they feel the urge to relieve themselves doesn't mean we have to continue this unsanitary practice. And, oh yes - you have to have water for washing hands, too. That seems so basic, yet for some reason not only do farmers think it's OK to shit in farm fields, but they've resisted providing a means for laborers to wash their hands after doing so.

2) Some prior outbreaks have been traced to contaminated fertilizer. Human shit is not a commonly used fertilizer in the industrial world but cowshit still is, as well as shit from various other farm animals. This can be just as contaminated as human shit. It doesn't have to be, though - shit can be made into safe fertilizer, even human shit, such as produced by the Massachusetts Water Reclamation Authority from sewage, Bay State Fertilizer, which comes from critters at the very top of the food chain and thus is more prone to concentrating certain types of bad stuff. The hitch: you have to process it properly, you have to have consistent quality, and you have to test it regularly to make sure the quality and safety is maintained. It doesn't matter if the E. coli comes from people or cows or pigs or whatever - if the fertilizer spread on vegetable fields is contaminated the produce will be, too.

3) Pre-washing of produce - sure, it's convenient to have bags of, say, lettuce mix that you snap open and dump into a bowl, all nicely washed beforehand, but if the wash-water at the processing plant gets contaminated then all subsequent baggies of nicely washed vegetables will also be contaminated. This really applies to any pre-treatment of produce that gets contaminated. It doesn't matter if the contamination comes from someone deliberately taking a dump in the machinery, or just failing to wash their hands thoroughly enough after using the toilet, or vermin in the plant shitting in the mix, the effect is the same.

Of course, it's sooooo tempting to just point fingers and blame someone else. Germany blaming Spanish cucumbers, Russia refusing to import EU produce (and probably hoping to boost their own domestic sales, which may be extremely appealing after last year's agricultural losses). Here in the US we had California Central Valley producers screaming during the E. coli outbreak in spinach a few years ago (if I recall, that was traced to laborers shitting in the fields) and people boycotting it. Just don't buy from X place and you're safe, right?

No, you're not. Centralizing of food production will always carry the risk of outbreaks of food-borne diseases.

Personally, I'm all for toilets for farm workers, hand washing stations, smaller and more processing facilities, and tracking of food origin. All of which are resisted by one group or another, for reasons from "it's too expensive" to "that's not how we've been doing it." Add into all this the fact that it is now commonplace for the local market to have food from all over the world (a situation that did not exist to the same extent when I was a child) and more tracking/control is vital to both monitoring food health and tracing problems back to their sources. Of course, as long as the kneejerk reaction to a bad batch of, say, lettuce is BAN EVERYTHING FROM THAT COUNTRY!!! you're not going to get cooperation. As usual, people and politics complicates things.

[Zaune]

Bioterrorism. Yeah I said it. I can't believe no one else might think this. Huge contamination at some junction but no one can say where ? No one knows exactly what the vector is just a strong link between the disease and consuming fresh vegitables. Yeah I have no proof but tell me I'm not the only one who might have thought about it.
::back to reality::

More likely, welcome to the world where rampant use of antibacterial products is the norm. Shit like this is going to become more and more common.

That's pretty much what I was going to say. But that doesn't mean we should rule it out completely quite yet.

[Broomstick]

Bioterrorism. Yeah I said it. I can't believe no one else might think this. Huge contamination at some junction but no one can say where ? No one knows exactly what the vector is just a strong link between the disease and consuming fresh vegitables. Yeah I have no proof but tell me I'm not the only one who might have thought about it.

Actually, my spouse brought it up last night while we were watching TV - no, you're not the first to think it. It is possible, but prior outbreaks of E. coli and other bacteria in food have all been traced back to some inadvertent contamination that then spreads widely due to modern food practices - with one exception.

The one exception I'm aware of is the 1984 Rajneeshee bioterror attackp in The Dalles, Oregon. 751 people contracted salmonellosis and 45 were hospitalized, but no fatalities. So yes, it is plausible that this might be terrorism, but as I said, past outbreaks have usually been traced to unintentional contamination.

ALSO: I wish to correct something I said my my prior post. I referred to the E. coli outbreak of 2006 in US and said it was caused by laborers shitting in the fields. I fact-checked. That is incorrect. It was believed to have been a combination of infected cows shitting on nearby farms, wild pigs roaming the area between those farms and the spinach fields, and waterways that also connected the farms and fields. Still, it's a problem of infected shit getting onto food plants, and on top of that the initial outbreak was in pre-washed spinach, where some contaminated food contaminated the entire machinery performing the washing and bagging. That outbreak was 199 people ill, 31 cases of hemolytic urinary syndrome or HUS (the same thing killing people in the current outbeak) and 3 deaths.

So, really, the current outbreak in Europe is definitely a large one, and serious. I realize this is being called a "German outbreak" but it's not, really - it's centered in Germany, but it's really a European problem as it's not just Germans getting sick, and it's going to have an impact on farms across Europe with all the finger-pointing already going on.

For that matter, the US has three cases of this, too, now - a few tourists coming back from a visit to Germany. They're being treated, of course, but there's some concern about this new strain getting established over here. We already have O15:H7 to worry about, we'd prefer not to have to deal with Europes's O104:H4. I'm the Europeans don't want our version of killer E. coli, either.

[Alferd Packer]

Does the the contamination have to occur right before harvesting/processing of the vegetables? How long, practically speaking, will it linger on plants?

[Broomstick]

Indefinitely.

It can occur at any step from field to kitchen to serving it up at the table.

[PainRack]

Does the the contamination have to occur right before harvesting/processing of the vegetables? How long, practically speaking, will it linger on plants?

Try forever.

What happens is that E coli contamination can happen at harvesting or during processing. The washing process puts cabbage into lots of water, and machines meant to clean and remove dirt may bruise the stalk, leaving spaces open for e coli to contaminate.

Then its packed into your plastic bag and so forth, leaving it in a nice, tight seal where growth can occur... especially if said plastic bag isn't airtight.


Now, you could take some more drastic steps, such as adding more chlorine or etc, but any simple, mass production effort to clean vegetables alter the veggetable taste, such as chlorine.

[Alferd Packer]

OK, but it remains on the surface of the plant, right? Like it doesn't get absorbed through the root structure, like, say, a heavy metal or other contaminant might?

[Broomstick]

Last major outbreak in the US there was some concern that it might actually be taken up into the plants. This was not proven, by the way, but it was raised as a concern and is a reason such contaminated produce is destroyed rather than an attempt being made to clean it.

In other words, if at some point you find yourself in possession of such vegetables or fruits as may have been contaminated don't take the chance of attempting to clean them - just toss them out. Particularly with this current strain it's not worth the risk.

[Korgeta]

i understand this E.coli strain is signficantly more stronger then previous strains but I still think it'll be reasonably contained and dealt with but the economic impact on agriculture within the EU could be significant. This hasn't helped with Germany being premature in its claims on where the bacterium came from and is a bit baffling why they assumed it would be Spain when Spain has yet to be have a reported case of E.coli infection on its own soil.

[Broomstick]

I think it's just normal human reaction to be so eager to find a source of contagion that it's too easy to jump to conclusions - the misidentification of the origin of such contamination is common in food disease outbreaks. Invariably, the first reaction is that the bad food comes from somewhere or someone else. It's an emotionally based reaction, perhaps a vestige of prehistory when we didn't have science or sophisticated laboratories to identify food-based threats and guessing was the best we could do. Food being so basic to survival it's hard to get rational thought to override those emotions.

[Serafina]

Except that that identification was actually the result of a laboratory study. They found out that a majority of the patients had eaten cucumbers, then they found out where the major supplier in the initially affected region got them, and then they tested them for the bacterium.
Intitial results found that those cucumbers were indeed contaminated. Those results turned out to be wrong, but it's hardly just a "oh hey let's blame the foreigners"-reaction. At least not by the scientists, the media might be another matter.

[Broomstick]

The media took it and ran with it, at least on this side of the Atlantic.

Even if the cucumbers originated in Spain the contamination could have occurred anywhere between field and table. I'm logical enough to question results like that when Spain isn't having an E. coli outbreak but Germany is - not so sure about the average person.

If those getting ill are either in Germany or have recently visited Germany then logically the contamination is occurring in Germany. Figuring out exactly how it happened, though, isn't as easy as most people would like it to be.

[weemadando]

In other: "The world is trying to fucking kill us news".

Australian beef has been implicated in an E Coli outbreak in Japan.

And cows have started producing milk full of a new type of MRSA in the UK.

Well, the second one is just proof of what happens when you have antibiotics as part of hte feed regimen.

[Serafina]

The media took it and ran with it, at least on this side of the Atlantic.

Even if the cucumbers originated in Spain the contamination could have occurred anywhere between field and table. I'm logical enough to question results like that when Spain isn't having an E. coli outbreak but Germany is - not so sure about the average person.

If those getting ill are either in Germany or have recently visited Germany then logically the contamination is occurring in Germany. Figuring out exactly how it happened, though, isn't as easy as most people would like it to be.

Actually, the contamination could have reasonably occurred in Spain. After all, when you have large areas of farmland whose products are solely bought up by one supplier, a contamination in that area will affect solely that supplier. If that supplier is solely shipping to one region, well, you might get what we currently have.

And as you yourself laid out above, a contamination in the field is quite likely. Yes, i could also have happened at the suppliers warehouse - but at the time, contamination in Spain was a likely possibility. The scientists weren't ruling out alternatives, nor were the (better) media.

Keep in mind that the further away you are from an event, the more superficial the media will generally report on it. Media in Germany had quite diverse reports exploring plenty of possibilities - the media in the USA would focus on the most outstanding of those. It's unavoidable - reporting about 12 different possibilities takes up a lot of space and time, and when you're reporting on remote events you just don't dedicate that many resources to them.
So it's really no surprise that your impression is "we solely blame Spain". While that was the major media focus, it's not like it was the sole one.

[PainRack]

OK, but it remains on the surface of the plant, right? Like it doesn't get absorbed through the root structure, like, say, a heavy metal or other contaminant might?

For food safety purposes, E coli contaminated produce are difficult to wash off safely even at home.

[aerius]

Looks like it was sprouts from an organic farm in Germany.

NPR link

Germany: Sprouts Likely Cause Of E. Coli Outbreak
by The Associated Press
June 5, 2011

Initial tests have confirmed that bean sprouts grown in northern Germany are the likely cause of an E. coli outbreak that has killed at least 22 people and sickened over 2,200, an agriculture official said Sunday.

Different kinds of sprouts from one organic farm in the greater Uelzen area, between the northern cities of Hamburg and Hannover, could be traced to infected persons in five different German states, Lower Saxony Agriculture Minister Gert Lindemann told reporters.

"There were more and more indications in the last few hours that put the focus on this farm," Lindemann said at a press conference in Hannover.

"Many restaurants that suffered from an E. coli outbreak had those sprouts delivered," his spokesman, Gert Hahne, told The Associated Press.

The farm was shut down Sunday and all of its produce — including fresh herbs, fruits, flowers and potatoes — was recalled. At least one of the farm's employees was also infected with the E.coli bacteria, the minister said.

Lindemann said 18 different sprout mixtures were under suspicion including sprouts of beans, broccoli, peas, chickpeas, garlic lentils, mungo beans and radish. The sprouts are often used in mixed salads.

Lindemann urged Germans to not eat sprouts until further notice and said definitive test results would be available Monday. He said authorities could not yet rule out other possible sources for the outbreak and urged Germans to continue avoiding tomatoes, cucumbers and lettuce until further notice.
No one answered the phone at the farm linked to the outbreak on Sunday night.

The crisis is the deadliest E. coli outbreak in modern history.

The head of Germany's national disease control center raised the death toll to 22 people Sunday — 21 in Germany and one in Sweden — and said another 2,153 people in Germany have been sickened. That figure included 627 people who have developed a rare, serious complication of the disease that can cause kidney failure.

The World Health Organization said 10 other European nations and the U.S. have reported a total of 90 other victims.

Earlier in the day, Germany's health minister fiercely defended his country's handling of a deadly E. coli outbreak as he toured a hospital in Hamburg, the epicenter of the crisis.

The comments by Health Minister Daniel Bahr reflected a sharp shift in his public response to the crisis and came after AP journalists reported on the chaos and unsanitary conditions at the emergency room of the same hospital, the University Medical Center in Hamburg-Eppendorf.

Prior to his visit, Bahr admitted that hospitals in northern Germany were overwhelmed and struggling to provide enough beds and medical care for patients stricken by the bacterial outbreak, and suggested that other German regions start taking in sick patients from the north.

But while touring the hospital in safety gear, Bahr said medical workers and state governments in the north were doing "everything necessary" to help E. coli victims.

[Zaune]

Lindemann urged Germans to not eat sprouts until further notice and said definitive test results would be available Monday.

What wouldn't I have given for oficial advice like that when I was little.

[Dargos]

was just reported on radio that the sprouts were not the source. We are back to square one. Posting from phone so I can't supply a link.

[Broomstick]

It's being reported on the major media sites, so finding an article should be easy for those interested in more detail.

[Dartzap]

Beeb

E. coli outbreak: First German sprout tests negative
The first tests on bean sprouts from a northern German farm suspected of being the source of an E. coli outbreak are negative, officials say.
Of 40 samples from the farm being examined, officials said 23 tested negative. Further tests are pending.
They said finding the outbreak's cause may prove difficult, because weeks have passed since it began.
The farm in Uelzen south of Hamburg was named on Sunday as the probable source of the bug that has killed 22 people.
Initially, German officials had pointed to Spanish cucumbers as the likely cause.
More than 2,200 people have fallen ill in at least 12 countries, though cases outside Germany have been linked to travel there.

'Can't understand'
"Investigations are continuing," Lower Saxony's agriculture ministry said on Monday as it announced that the first tests had proved negative.

It added that it did not expect "any short-term conclusions", and that given the complex testing procedure, the remaining 17 samples may not be returned for a few more days.

The organic farm in Uelzen is about 100km (62m) south of Hamburg, the epicentre of the outbreak.
It produces bean sprouts including adzuki, alfalfa, broccoli, peas, lentils and mung beans, all grown in a nursery for consumption in salads.

The farm's general manager, Klaus Verbeck, was quoted by the Neue Osnabruecker Zeitung newspaper as saying that he could not see how it was to blame.

"I can't understand how the processes we have here and the accusations could possibly fit together," said Mr Verbeck.
"The salad sprouts are grown only from seeds and water, and they aren't fertilised at all. There aren't any animal fertilisers used in other areas on the farm either."

The strain of enterohaemorrhagic E. coli (EHEC) involved in the outbreak is normally transmitted through faeces or faecal bacteria.

Spanish seek damages
Scientists say it is an aggressive hybrid strain toxic to humans and not previously linked to food poisoning.
Hundreds of those affected by the bacterium have developed haemolytic-uraemic syndrome (HUS), which can be fatal.
EU agriculture ministers are to hold an emergency meeting in Luxembourg on Tuesday, where they are expected to discuss the outbreak and how the EU can respond to its economic impact.

They are also expected to address a Russian ban on imports of fresh produce from the EU, introduced in response to the outbreak.

Spain has made it clear it will seek damages after Spanish produce was linked to the outbreak.
Spain's fruit and vegetables exporters association has estimated losses at 225m euros (£200m) a week.
"We have told Germany that it must reimburse us for the loss, Spanish Agriculture Minister Rosa Aguilar told Spanish public television.

"If it covers 100%, which is what we are demanding, the affair will be closed. Otherwise we reserve the right [to take] legal action."

I rather suspect this is going to boil down to an even more extensive forensic search of shipping, which as everyone knows can take bloody forever.

Can't say I blame the Spanish government for calling in the lawyers over the initial allegations.