“Those who cannot remember the past are condemned to repeat it.”(George Santayana). (Here’s *a reminder* for those who have forgotten or do not know.)
Main lessons to be taken from this short history:
|The type of food label needed here ?- from Bill Marler|
- Bean and various other seed sprouts are the suspects. Humans can carry and transmit the germ. The E. coli EHEC germ is spreading to other countries. Disease risks are severe. A serious global epidemic of a deadly disease is possible, even likely if immediate actions are not taken.
- Basic hygiene in all parts of fresh vegetable production and use in food needs to be given a thorough review everywhere and improvements communicated widely.
- Various special interests are likely to generate irrelevant noise that will obscure these messages getting through to potential victims: this noise should be ignored
- To avoid people being harmed, efforts and comments should be focussed on spreading the first two messages .
Updates (latest 24-06-2011. Further updates on the outbreak after that will be made at the Barfblog hot with the latest gossip post)
Video interview with Dr Tribe about E. coli worries and how to react to them.
Later Pundit posts about the outbreak or highly relevant to its emergence:
More about how the EHEC germ may spread in seeds
The banning of irradiation of foods 11 years ago in Germany
Barfblog again hot with the late
Other important items:
Epidemic Profile of Shiga-Toxin–Producing Escherichia coli O104:H4 Outbreak in Germany — Preliminary Report
Christina Frank, Ph.D., Dirk Werber, D.V.M., Jakob P. Cramer, M.D., Mona Askar, M.D., Mirko Faber, M.D., Matthias an der Heiden, Ph.D., Helen Bernard, M.D., Angelika Fruth, Ph.D., Rita Prager, Ph.D., Anke Spode, M.D., Maria Wadl, D.V.M., Alexander Zoufaly, M.D., Sabine Jordan, M.D., Klaus Stark, M.D., Ph.D., and Gérard Krause, M.D., Ph.D. for the HUS Investigation Team
June 22, 2011 (10.1056/NEJMoa1106483)
Food Safety Network
More Details on the Mysterious German Microbe
BY ROSS ANDERSON | JUN 24, 2011
Infections Associated with Eating Seed Sprouts: An International Concern
Peter J. Taormina, Larry R. Beuchat, and Laurence Slutsker†
Emerging Infectious Diseases Vol. 5, No. 5, September-–October 1999 page 626
FOODBORNE ILLNESS OUTBREAKS
Q&A: Dr. Robert Tauxe on the Outbreak in Germany
BY DANIEL B. COHEN | JUN 22, 2011
E. coli O104:H4 – 38 Dead, 824 with HUS, 3351 Ill – Massachusetts, Michigan, and Wisconsin with 5
POSTED BY BILL MARLER ON JUNE 15, 2011
GERMAN E. coli strain especially lethal, studies find
23.jun.11 via Barfblog
(HealthDay News) — The strain of E. coli bacteria that this month killed dozens of people in Europe and sickened thousands more may be more deadly because of the way it has evolved, a new study suggests.
Scientists say this strain of E. coli produces a particularly noxious toxin and also has a tenacious ability to hold on to cells within the intestine. This, alongside the fact that it is also resistant to many antibiotics, has made the so-called O104:H4 strain both deadlier and easier to transmit, German researchers report.
“This strain of E. coli is much nastier than its [more common] cousin E. coli O157, which is nasty enough — about three times more virulent,” said Hugh Pennington, emeritus professor of bacteriology at the University of Aberdeen in Scotland and author of an accompanying editorial published online June 23 in The Lancet Infectious Diseases.
Another study, published the same day in the New England Journal of Medicine, concludes that, as of June 18, more than 3,200 people have fallen ill in Germany due to the outbreak, including 39 deaths.
In fact, the German strain — traced to sprouts raised at a German organic farm — “was responsible for the deadliest E. coli outbreak in history,” Pennington said. “It may well be so nasty because it combines the virulence factors of shiga toxin, produced by E. coli O157, and the mechanism for sticking to intestinal cells used by another strain of E. coli, enteroaggregative E. coli, which is known to be an important cause of diarrhea in poorer countries,” he said.
Shiga toxin can also help spur what doctors call “hemolytic uremic syndrome,” a potentially fatal form of kidney failure. In the New England Journal of Medicine study, German researchers say that 25 percent of outbreak cases involved this complication.
The bottom line, according to Pennington: “E. coli hasn’t gone away. It still springs surprises.”
To find out how this strain of the intestinal bug proved so lethal, researchers led by Dr. Helge Karch from the University of Munster st
udied 80 samples of the bacteria from affected patients. They tested the samples for shiga toxin-producing E. coli and also for virulence genes of other types of E. coli.
That’s when they uncovered the strain’s use of shiga toxin and its propensity to adhere tightly to cells in the digestive tract. This tight bond between the bacteria and the intestinal cells ” might facilitate systemic absorption of shiga toxin,” the authors wrote, upping the odds that a patient might progress to the sometimes deadly hemolytic uremic syndrome.
The strain was also resistant to common antibiotics, specifically penicillins and cephalosporins. Luckily, it was susceptible to another class of antibiotics called carbapenems.
According to the New England Journal of Medicine study, severe cases involving the hemolytic uremic syndrome have occurred mainly among adults, predominantly women. In one medical center in Hamburg, 12 of 59 patients infected with the O104:H4 strain went on to develop the sometimes form of deadly kidney failure, according to a team led by Christina Frank, of Berlin’s Robert Koch Institute.
For their part, the authors of the Lancet study believe that the emergence of the new strain “tragically shows ” how E. coli can change and “have serious consequences for infected people.”
One outside expert agreed. Infectious disease expert Dr. Marc Siegel, an associate professor of medicine at New York University in New York City, said that “in this case the bug itself is more virulent and more transmissible.”
This is just part of how the bacterium develops to survive, Siegel explained. And these changes may well affect other strains of E. coli. “These bugs are becoming more virulent,” he said.
One culprit, according to Siegel, is the overuse of antibiotics in livestock. Dosing animals with large quantities of antibiotics can make bacteria such as E. coli resistant to the drugs, he said.
These bacteria can then find their way into produce via water contaminated with animal waste, Seigel added. From there, the pathogen need only find its way into a salad or other food to infect people.
For more information on food borne illness, visit the U.S. Centers for Disease Control and Prevention.
(SOURCES: Hugh Pennington, emeritus professor, bacteriology, University of Aberdeen, Scotland; Marc Siegel, M.D., associate professor, medicine, New York University, New York City, author of The Inner Pulse: Unlocking the Secret Code For Sickness and Health; June 23, 2011, The Lancet Infectious Diseases, online; June 23, 2011, online, New England Journal of Medicine )
the first cases of potential food poisoning were reported, diners in Germany are still contemplating their side salads nervously, spooked by the confused information and warnings that have been issued over the past few weeks. Which item of greenery might be home to the deadly Escherichia coli bacterium known as EHEC O104:H4? By 13 June, the microbe had infected 3,325 people and killed 36.
Death Toll Reaches 37
Two-Year-Old Boy Dies in German E. Coli Outbreak
As of Friday it remained unclear how the dangerous bacteria came to be present at the farm.
Even before this latest discovery, all the evidence had pointed to the farm in the state of Lower Saxony as the probable cause of the epidemic which has so far killed 29 people. Authorities had warned against eating raw sprouts. “It’s the sprouts”, the president of the Robert Koch Institute (RKI), Reinhard Burger, said in a press conference convened in Berlin on Friday.
EHEC: A detective story
Today (June 10) the Robert Koch Institute published an Information update on EHEC outbreak. It’s a long document, with one passage of special interest: How the experts narrowed the culprit down to the sprouts. Excerpt:
Recipe-based restaurant cohort study
With a high probability, the results of the “recipe-based restaurant cohort study” finally permit narrowing down the source of the infection to the consumption of sprouts. It was possible to apply this methodological approach only after a sufficient number of restaurant customers could be identified to ensure adequate statistical power of this analysis.
This is nasty:
FINLAND: EHEC infection discovered in Helsinki kindergarten
10.jun.11 via Doug Powell/ Barfblog
A case of the EHEC infection that has caused havoc in Germany was found in a Helsinki kindergarten on Thursday. Health officials were notified of the matter at around noon, according to infectious diseases specialist and Helsinki city epidemiologist Hannele Kotilainen.
The daycare centre is now attempting to determine if there is more than one case to the outbreak.
“The matter is being examined according to the usual channels. We are charting the group and anyone with symptoms, and running tests on them”, reports Kotilainen.
She did not specify whether the infected party was a child or one of the kindergarten’s adult staff.
So is this
SWEDEN reports first domestic EHEC case
For the first time, a Swede with no connections to Germany has been infected with the virulent enterohaemorrhagic E. coli (EHEC) bacteria that has claimed dozens of lives across Europe, Swedish health authorities reported on Tuesday.
“This means that the source of the infection is in Sweden, which is a lot worse, because it might mean that there is some form of infected food product in circulation that we haven’t yet identified, “ said Sofie Ivarsson, epidemiologist at the institute to news agency TT.
The infected Swede comes from Skåne, in southern Sweden, and has not been traveling in Germany. Neither does he have any other known connections to anyone else who have been taken ill after visiting Germany.
“All previous Swedish cases had a connection to Germany, but not this. This is a completely new case, which we identified this morning. We have not left any stones unturned and yet we have not been able to find any connection,” Ivarsson told TT.
The patient fell ill in the middle of June but is now reported to be feeling better, according to the institute.
There is an ongoing investigation to find the source of the infection, but it is not yet known if it originated in Sweden or if a connection to the German outbreak will be revealed.
According to the head of the institute, Johan Carlson, there are now only two alternatives. Either the Swedish man has been infected indirectly, or the source of the infection is in Sweden.
“And then we have more of a problem,” he told TT.
Thanks to Nick Loman for sproutbreak.