An outbreak of E. coli linked to contaminated salad vegetables has caused at least 16 deaths and hundreds of infections in Germany, Sweden and other countries.
What is E coli?
E. coli is short for Escherichia coli. It is a type of bacteria present in the gut of humans and other animals. Most strains are harmless but some are able to produce a toxin that can cause symptoms such as severe cramps and diarrhoea.
What do we know about this outbreak?
The outbreak is causing severe infections, affecting the blood, kidneys and sometimes the central nervous system.
The condition – haemolytic uraemic syndrome – is an unusual complication of some types of E. coli as well as other infections.
Symptoms include bloody diarrhoea, kidney failure and epileptic fits.
The strain suspected is O104, which is rare.
E.coli
Another serious strain – known as O157 – causes similar symptoms, and has been associated with E. coli outbreaks from the 1980s onward.
Where has it come from?
The source of this outbreak is believed to be contaminated salad vegetables.
Initial reports that cucumbers were the source of the bacteria have not been confirmed and other food sources are being sampled.
A whole host of foods have been linked with past E. coli outbreaks.
While E. coli infection is often caused by eating undercooked meat and eggs, there has been a recent rise in cases caused by fresh fruit and vegetables.
They include foods that are eaten raw or only lightly cooked, such as salads, fresh fruit and bean sprouts.
What is the health advice?
Until the cause is known, German officials are telling people to avoid eating raw tomatoes, cucumbers and leafy salad including lettuce, especially in the north of the country, until further notice.
The UK’s Health Protection Agency recommends travellers follow the same advice.
It says anyone returning from Germany with illness including bloody diarrhoea should seek urgent medical attention and mention their travel history.
There have been three cases in the UK – all in visiting German nationals.
The Food Standards Agency in the UK has issued general advice on the need to wash fruit and vegetables.
The agency says: “It’s a good idea to wash fruit and vegetables before you eat them to ensure that they are clean, and to help remove germs that might be on the outside.
“Peeling or cooking fruit and vegetables can also remove these germs.”
However, a Scottish expert said new research suggests washing alone may not be enough, as the bacteria may be inside the food.
E. coli bacteria
Dr Nicola Holden of The James Hutton Institute said: “The bacteria are able to get from animal sources on to crops through different routes, most likely in irrigation water or sometimes from slurry spraying, while some contamination can also occur during processing and packaging.”
She said the bacteria can colonise plant roots, moving up to the edible foliage or fruits.
“The threat to human health occurs because these bacteria are not simply sitting on the surface of the plant and are particularly difficult to remove post-harvest,” she added.
What do other experts say?
Professor Brendan Wren from the London School of Hygiene & Tropical Medicine said E. coli can attach to the surface of fresh produce such as lettuce leaves, spinach leaves and cucumber.
“These type of E.coli survive harsher environmental conditions than the typical E. coli and produce some nasty toxins to humans,” he said.
“They can survive in soil environments and fertiliser may be one source for the origin of the outbreak related to fresh produce such as cucumbers.”
Dr Jonathan Fletcher, senior lecturer in microbiology at the University of Bradford, said toxin-producing E. coli can cause very serious disease in humans, especially in the elderly or very young.
Cattle seem to carry the toxin in their gut, without showing signs of illness, and it will be shed in the faeces.
“If cattle manure is used as a fertiliser, it is probable that vegetables such as cucumbers will be contaminated with E. coli, and if not washed properly it would be present in sufficient numbers to cause the infection.”
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German scientists are looking for clues about the source of the killer E.coli food bug in a restaurant in the northern German town of Luebeck after 17 people fell ill after eating there, a newspaper reported today.
The 17 people who fell sick from the E.coli bacteria included a group of German tax officials and tourists from nearby Denmark, the Luebecker Nachrichten newspaper said.
“The restaurant is not to blame,” said Werner Solbach, a microbiologist at University Medical Center Schleswig-Holstein. “However, the supply chain could give us important clues about how the pathogen was passed along.”
So far authorities in Germany have yet to pin down the source of the bacteria, which has killed at least 19 people in Europe and made more than 1,700 ill in 12 countries – all of whom had been travelling in northern Germany.
A German woman, one of the tax officials at the Luebeck restaurant, died after contracting E. coli. Many who contracted E.coli have developed haemolytic uraemic syndrome (HUS), a potentially deadly complication that can affect the kidneys.
The group of German tax officials, who were attending a tax union event, ate at the restaurant on May 13, the union head told Reuters today. The Luebecker Nachrichten newspaper said all victims ate there between May 12 and May 14.
German news magazine Focus reported that officials are pursuing a theory in which the outbreak started at the beginning of May in Hamburg as people started becoming ill after a week, consistent with E.coli’s incubation period.
The food contamination is believed to have been caused by poor hygiene at a farm, in transit, a shop or food outlet.
Health authorities have repeated warnings to avoid some raw vegetables in northern Germany – rattling farmers and stores in the high season for salad – and said 199 new cases of the rare strain of the bacteria had been reported in the past two days.
European health institutes have tried to reassure the public that the spread of E.coli, a frequent cause of food poisoning, can be contained by washing vegetables and hands before eating.
Efforts to identify the source of the outbreak have been complicated by the fact that salads include a variety of ingredients from different producers and often different countries.
Germany is at the centre of the outbreak but people have also become ill in 10 other European countries and the United States, probably from eating lettuce, tomatoes, cucumbers or other raw salad vegetables in Germany.
The World Health Organisation said the strain was a rare one, seen in humans before, but never in this kind of outbreak.
People have also become ill in Austria, the Czech Republic, Denmark, France, Netherlands, Norway, Spain, Sweden, Switzerland, Britain and United States.
E.coli bacteria themselves are harmless but the strain making people sick has the ability to stick to intestinal walls where it pumps out toxins, sometimes causing severe bloody diarrhoea and kidney problems.
Many patients have gone into hospital, with several needing intensive care, including dialysis due to kidney complications.
A German government spokesman said Chancellor Angela Merkel had set up an E.coli task force and spoke to Spain’s Jose Luis Rodriguez-Zapatero about the impact on farmers there, who were initially blamed for exporting contaminated cucumbers.
The outbreak has put strains on trade relations. Spain is considering a compensation claim from Germany, which had to back down from its assertion blaming tainted Spanish cucumbers.