As seven cases of the food poisoning bacteria were diagnosed in Britain, the agency said that the mutant strain was so virulent that sufferers risked spreading the infection to friends and relations through close contact.
With more than 30,000 people travelling between Britain and Germany every day, officials fear the outbreak could take hold here.
The agency said anyone who had recently travelled to Germany should be vigilant about their personal hygiene to minimise the risk of passing on the bacteria, which can attack the kidneys with potentially fatal consequences.
The outbreak is on course to be the world’s “biggest ever”, according to one of the country’s leading microbiologists. The agency added that it was shocked by its “unprecedented” scale and severity. More than 1,600 people have been infected worldwide, mainly in northern Germany. Hundreds have been left seriously ill and at least 18 have died.
It emerged last night that the food bug has struck two Americans who had recently travelled to Hamburg. Both are expected to survive but experts warned that the bacteria could be exported to the US.
E.coli bacteria
The World Health Organisation identified the bacterium as a “completely new” mutant strain which was more toxic and infectious than usual varieties. It is resistant to antibiotics and has an eight-day incubation period, which means that the outbreak may not have reached a peak.
It can cause the deadly complication haemolytic-uraemic syndrome (HUS) which affects the blood and kidneys. The Food Standards Agency said that contaminated produce had not entered the British food chain, although several supermarkets confirmed last night that they were still importing produce from Germany.
Experts are still unable to say where the outbreak originated, having ruled out the initial theory that it came from a consignment of Spanish cucumbers. Fears have heightened to such an extent that Russia yesterday banned the import of all raw vegetables from Europe.
The HPA said the seven cases diagnosed in Britain involved people who had recently travelled to Germany. Three are seriously ill with the HUS complication. Dr Bob Adak, an expert in gastrointestinal infections at the agency, said his organisation had interviewed the families of those involved and advised them to take precautions to avoid a secondary spread of the bacteria.
“We’re extremely concerned by it,” he said. “We are on the lookout for secondary infections, because it is quite infectious you don’t need many bacteria on your hand to spread it.
“People have got to be very careful, in the first instance those who are most at risk are other family members. People who have been to Germany and come back should be careful with their hygiene.
“If they experience abdominal cramps or diarrhoea they should seek medical advice. This illness can develop and spread very quickly. If you have young children in the house you want to protect them.”
E.coli is usually contracted by eating contaminated food, but it can spread from person to person if the strain is infectious enough. People must be particularly careful to wash their hands thoroughly after using the lavatory.
Hilde Kruse, a food safety expert at the WHO, said the strain had characteristics which made it “more
virulent and toxin-producing”. Preliminary genetic sequencing suggests that the strain is a new, mutant form of two different E.coli bacteria, according to the WHO. “This is a unique strain that has never been isolated from patients before,” Miss Kruse added.
Unlike previous outbreaks, this strain of E.coli mainly attacks women rather than children or elderly people. More than three quarters of those suffering from serious kidney problems are adult women. Dr Adak added: “The most simple explanation is that because women tend to eat more salad than men and children their risk becomes higher.”
Dr Alexander Mellmann, the scientist who mapped the DNA of the bacteria at the University of Munster in Germany, told The Daily Telegraph that the bacteria had evolved to become more toxic and better at “sticking” to human cells, increasing the chance of infection.
Scientists believe the strain originated in animals such as cattle before spreading to vegetables. The HPA is advising people travelling to Germany to wash salads and to avoid eating raw tomatoes, cucumbers and leafy salads.
Tesco yesterday said it has “small quantities” of cauliflower, cabbage and sweetcorn from Germany in its stores, adding that its suppliers observe the “strictest hygiene standards”. Lidl said it stocks cauliflower from Germany.
The seven people infected in the UK include four German nationals and three British people who recently visited Germany. Three of them are seriously ill with HUS. The other four have suffered from bloody diarrhoea.
Germany has reported 470 cases of HUS and 1,064 cases of bloody diarrhoea. Austria, Denmark, Germany, the Netherlands, Norway, Spain, Sweden and Switzerland have also reported cases, almost all in people who have just returned from Germany.
The Food Standards Agency in Britain has issued general advice on the need to wash fruit and vegetables. Peeling or cooking fruit and vegetables is also known to help remove germs.
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What is E.coli?
Escherichia coli (E.coli) is a bacterium commonly found in the gut of humans and warm-blooded animals. Most strains are harmless but some, known as enterohemorrhagic E.coli (EHEC), can cause serious illness.
Why is this strain so much worse than others?
This “super-toxic” strain of the bacteria has never before seen in people. Hilde Kruse, of the World Health Organisation (WHO), said it had “various characteristics that make it more virulent and toxin-producing”.
Consequently, it is affecting all ages groups, not just particular groups such as children and the elderly, which is more commonly the case with E.coli.
What exactly is it?
Analysis from the Beijing Genomic Institute shows it is an EHEC 0104 strain, but a “new serotype – not previously involved in any E.coli outbreaks”. It is 93 per cent genetically similar to a strain found in the Central African Republic “known to cause serious diarrhoea”, the institute said in a statement. However, it has also acquired “specific sequences” of DNA that made it even more dangerous.
What health problems is it causing in humans?
It is causing problems associated with previously seen EHEC bacteria, as well as a condition called haemolytic uraemic syndrome (HUS). Both can be fatal and have been in this outbreak.
EHEC can cause abdominal cramps, fever and bloody diarrhoea – known as haemorrhagic colitis. HUS affects the blood and kidneys. As well as being potentially fatal it can cause neurological problems such as seizure, stroke or coma, and can lead to chronic kidney problems.
What treatment are patients receiving?
While antibiotics are often used to treat bacterial infections, they can trigger further toxin production with E.coli. As such treatment is usually supportive, with patients made as comfortable as possible while their bodies fight the infections. Some with HUS might be offered dialysis.
Where has this strain come from?
Germany, specifically the north, is the geographical source. The source appears to be contaminated salad vegetables. Initially scientists thought cucumbers were the source of infection, however, this has not been confirmed. Other foods are now being investigated.
How could salad vegetables become infected with a gut bacteria?
Fertiliser could be the prime source of infection, while irrigation water from streams contaminated with faeces from infected animals could also be to blame. Cattle, for instance, can carry E.coli in their guts without becoming il
What is the scale of infection?
WHO figures show there have been 1,614 confirmed cases in Europe of which 16 have resulted in deaths. Of the cases, 1,115 have been EHEC and 499 HUS. However, latest figures on Thursday night showed 18 people had died
Germany has borne the brunt of the outbreak, accounting for 17 deaths. The country has had 1,064 cases of EHEC, leading to at least six deaths; and 470 of HUS, leading to at least nine deaths.
A Swedish woman, who had recently returned from Germany, has also died. Cases have also been confirmed in the Netherlands and Spain.
What about in Britain?
On Thursday the Health Protection Agency (HPA) said seven people in Britain had been infected, including three British nationals and four Germans. All are thought to have caught the infection in Germany before travelling back to the UK. Three of them have developed HUS.
Is there any cause for concern among people who have not been to Germany recently?
Experts say this strain is particularly “sticky”, increasing the chance of it being passed on by interpersonal contact like shaking hands. Those in contact with people who have just returned from Germany should therefore be particularly careful about personal hygiene.
What about imports of German vegetables?
Tesco is still importing small quantities of cauliflower, sweetcorn and cabbage from Germany; while Lidl is importing cauliflowers. Both said the imports met “strict hygiene standards”, while Lidl also said it was temporarily halting such German imports from next week.
What advice is the HPA giving?
While the cause of the outbreak remains unknown, the HPA is advising people travelling to Germany to avoid eating raw cucumber, lettuce or tomatoes. Anyone experiencing bloody diarrhoea should seek medical advice.
It is also reiterating standard food preparation and personal hygiene advice: that fruit and vegetables should be washed thoroughly before eating them; that they should be cooked above 70C where appropriate; and that people should wash their hands after visiting the lavatory and before mealtimes to prevent person-to-person contamination.