There has been a significant rise in the number of people in Europe infected by a strain of E. coli which has led to the deaths of 17 people, officials say.
More than 1,500 people in nine nations – though nearly all in Germany – have now been infected by enterohaemorrhagic E.coli (EHEC), which can cause the deadly haemolytic-uraemic syndrome (HUS).
The death toll in Germany has risen to 16, with officials saying an 84-year-old woman with HUS had died on Sunday.
The outbreak’s source is not yet known.
Earlier, the Spanish government said it was considering legal action against the authorities in Hamburg for wrongly blaming its produce.
“We do not rule out taking action against the authorities who called into question the quality of our products,” Deputy Prime Minister Alfredo Perez Rubalcaba told radio Cadena Ser.
Spain’s fruit and vegetable exporters estimate they have been losing more than 200m euros ($290m; £174m) since the outbreak emerged.
Germany has admitted the bacteria did not come from Spain as initially reported, but said the decision to issue the warning had been correct as a different strain of E.coli was present in Spanish cucumbers.
“Hundreds of tests have been done and the responsible agencies… have determined that most of the patients who have been sickened ate cucumbers, tomatoes and leaf lettuce and primarily in northern Germany,” German Agriculture Minister Ilse Aigner said.
E. coli virus
“The states that have conducted the tests must now follow back the delivery path to see how the cucumbers or tomatoes or lettuce got here.”
The Robert Koch Institute, the German federal institution responsible for disease control, said on Wednesday afternoon that 1,534 people in the country had been infected by EHEC.
EHEC is a deadly strain of E. coli bacteria, which is found in the digestive systems of cows, humans and other mammals.
On Tuesday, the RKI reported 1169 cases of EHEC, and said 470 people were suffering from HUS, up from 373 on Monday.
Experts said the number was unprecedented in modern medical history because HUS normally occurred in 10% of EHEC infections. They warned that the strain could be more dangerous than anything previously seen.
“There may well be a great number of asymptomatic cases out there that we’re missing,” Paul Hunter, a professor of health protection at the University of East Anglia, told the Associated Press.
“This could be a much bigger outbreak than we realise right now.”
“There might also be something genetically different about this particular strain of E. coli that makes it more virulent.”
But the European Commissioner for Health and Consumer Policy, John Dalli, ruled out any need for a ban on cucumbers, or for a warning against travelling to northern Germany.
“The outbreak is limited geographically to an area surrounding the city of Hamburg,” he told reporters.
“It appears the outbreak is on the decline.”
About half of the HUS patients in Hamburg clinics have suffered neural disorders three to five days after falling ill, such as epileptic fits and slurred speech, according to the German newspaper, Die Welt.
Germany typically sees a maximum of 50 to 60 annual cases of HUS, which has a fatality rate of up to 5%, according to the World Health Organization (WHO).
Unusually, more than 60% of the EHEC cases in Germany have been women – 88% over the age of 20 – and nearly 90% of the HUS cases have been women over the age of 20, officials have said.
Experts have said this may be because women were the ones most likely to be eating fresh produce or handling food in the kitchen.
In addition to Germany, cases of EHEC have also been reported in eight other European countries – Austria, Denmark, the Netherlands, Norway, Spain, Sweden, Switzerland and the UK, the WHO said. All but two of those infected either live in Germany or recently travelled to Germany.
Fifteen cases of HUS and one related death have also been reported in Sweden, seven cases in Denmark, three in the Netherlands, two in the UK, and one in Spain, according to the European Center for Disease Prevention and Control.
Several countries have taken steps to curtail the outbreak, such as banning cucumber imports and removing the vegetables from sale.
Health authorities have also advised people to wash fruit and vegetables thoroughly, to do the same with all cutlery and plates, and to wash their hands before meals.
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An E.coli outbreak which started in north Germany has already caused the deaths of 14 people, with more than 300 seriously ill.
Experts are warning that the worse is still to come. Other cases have been reported in the UK, Sweden, Denmark, France and the Netherlands, all linked to travel in Germany.
E. coli is a bacterium which lives in the gut of humans and animals. Usually harmless, but some strains can produce toxins which cause fatal disease in humans. People are usually infected after eating undercooked meat or eating vegetables grown on land which has become contaminated.
Another source of outbreaks in the UK in recent years has been petting farms.
Several of the cases in Germany have been linked to eating contaminated organic cucumbers from Spain. However, it is still not clear whether they are the original source of the bacteria, or became contaminated in Germany from another source.
Travellers in Germany are now being advised by the UK Health Protection Agency to avoid eating raw cucumbers, lettuce and tomatoes.
In the UK, E.coli 0157 is usually the cause of serious illness, such as haemolytic uraemic syndrome (HUS), which can cause kidney failure and death, but in Germany a rare and particularly virulent bacterial strain – E.coli O104 – is the cause of the outbreak.
This particular strain appears to be causing severe disease in more people. In general, up to 10 per cent of people infected with E.coli are at risk of HUS, but this figure is reaching 50 per cent in Germany.
Rather than affecting young children, the elderly and those with weakened immune systems, which is usually the case, the E.coli 0104 outbreak is mainly affecting adults – almost 70 per cent of whom are women.
How can I protect myself from E. coli?
There are four main areas where you can follow good practice to ensure that you minimize any risks:
Personal hygiene
Food storage
Food preparation
Cooking
Personal Hygiene
Always wash your hands after using the bathroom, before handling food and after handling raw meat. This will help to stop bacteria being transferred from raw to fresh or already cooked foods.
Food storage
Check your fridge is at the correct temperature for storing food – between 0 and 5 – degrees centigrade
Always store fresh food in the fridge. The bacterium thrives at warmer temperatures
Keep bottles and jars closed
Cover leftovers and keep them in the fridge
Eat leftovers within 2 days (1 day for rice based dishes)
Keep raw meats away from cooked meats
Store raw meats at the bottom of the fridge (to stop juices dripping onto other foods)
Food preparation
Wash your hands before handling food
Dry hands as wet hands can transfer bacteria more easily
Keep raw fish and meat separate from other food, including food which has been already cooked
Never use knives and other utensils on raw meats and fish and then on other foods
Always wash salads, including those which are pre-washed
Clean kitchen surfaces regularly
Cooking
Cooking at the correct temperature kills the bacteria. Undercooked food is a major cause of food poisoning. All parts of the food should reach 70 degrees centigrade for at least 2 minutes.
For rare beef and lamb make sure that the outside is properly cooked as this is where the bacteria are found.
Pork and rolled joints of other meats should not be served rare. The juices should have no pink or red in them.
Minced meats, sausages, pork, chicken, kebabs, burgers and chicken nuggets should always be fully cooked.
THE world’s largest E.coli outbreak has claimed two more lives as a huge international row broke out over its source.
Sixteen people are now confirmed to have died from the bug which was initially thought to be in organic Spanish cucumbers sold in Germany.
Vegetable growers in Spain have strenuously denied their produce was to blame, but the scare has caused exports to plummet after Germany, Austria and Russia all imposed bans.
News of the two latest deaths emerged yesterday.
Doctors in the Swedish town of Boras revealed a woman in her 50s died after returning from a trip to Germany. In Paderborn, Germany, an 87-year-old woman also died after contracting the virulent bug.
The German health department said 373 people were sick with the most serious form of the bug – up from 329 on Monday.
Another 796 people have been infected by the bacteria.
E.coli can cause diarrhoea, organ failure and strokes.
Cases found in other European countries, including Britain, are all linked to people who recently spent time in Germany.
Germans are being warned to avoid all cucumbers, lettuces and raw tomatoes after investigators admitted they had still not identified the source of the outbreak.
Initial test results last week suggested Spanish cucumbers were the source – but doubts have since been cast.
Hamburg state health minister Cornelia Prufer-Storcks said: “Our hope of discovering the source unfortunately has not been fulfilled by these first results.”
She defended pointing the finger at Spanish produce, saying it would have been “irresponsible” to withhold the information. The cucumbers could have been contaminated at any point along the route from Spain to Germany, officials have said.
An estimated 150,000 tons of Spanish fruit and vegetables are piling up, costing farmers £174million a week.
Andalusia’s agriculture minister, Clara Aguilera, yesterday ate a cucumber to show her faith in Spanish producers and went on to demand compensation for any who have suffered because of the scare.
Scottish MEP George Lyon called for the UK to ban imports of Spanish cucumbers.
The Food Standards Agency has said there were no plans for a ban yet as there was no evidence they were on sale in Britain.