E. coli outbreak in Europe

14 June 2011

An outbreak of E. coli in Northern Germany has already caused the death of 35 people. Find out more about the symptoms and spread of the disease.....

On Sunday 5th June, agricultural experts in Germany identified bean sprouts grown on a farm in Uelzen, south of Hamburg, as the most likely cause of the outbreak of E. coli which has already caused the death of 35 people. During the past week tests have been conducted on bean sprouts at the farm. Although none tested positive for E. coli, Reinhard Burger, head of the Robert Koch Institute, Germany’s national centre for disease control, stated that an investigation of the pattern of the outbreak had produced enough evidence to conclude that locally grown bean sprouts were the cause of the outbreak.

The total number of cases in Germany has now reached over 3,250, with the outbreak centred on the northern city of Hamburg. The World Health Organisation said people in 12 other countries had also fallen ill; all but one had recently travelled to or from northern Germany.

What is E. coli and how does it spread?

E. coli is short for Escherichia coli. It is a type of bacteria which is normally present in the gut of humans and many animals. Most strains are harmless but some can produce toxins that cause a variety of symptoms in humans eg severe cramps and diarrhoea. Previous outbreaks of E. coli have been associated with the 0157 strain, but this outbreak has been caused by a new type of 0104 strain.

E. coli is acquired primarily through the ingestion of contaminated food or water. Person-to-person and animal-to-human transmission is through the oral-faecal route. This is why washing hands after using the toilet and before preparing food is so important as it breaks the transmission cycle.

What symptoms are caused by E. coli 0104?

It may take up to eight days for symptoms to develop. These symptoms include: bloody diarrhoea, severe stomach cramps and fever. In some cases, people go on to develop blood complications such as Haemolytic Uraemic Syndrome (HUS), which is potentially fatal and can cause permanent kidney failure and anaemia. An unusually high number of people aged 16 -60 affected by this outbreak have developed HUS symptoms requiring specialist hospital treatment.

Which countries have reported cases of E. coli 0104?

Austria, Czech Republic, Denmark, France, Germany, Greece, Luxembourg, the Netherlands, Poland, Spain, Sweden and the UK. A few cases have also been reported in the USA and Canada.

How many cases have been reported in the UK?

The total number of cases in the UK currently stands at eleven and all these cases have been associated with travel to Germany, where they are very likely to have contracted the disease. The Health Protection Agency said there was no evidence of E. coli being passed from person to person in the UK.

Advice for those travelling to or working in the areas affected

• Anyone with bloody diarrhoea should seek medical attention.
• If you are currently in Germany or have recently returned from Germany and are unwell and have bloody diarrhoea with or without abdominal pain with cramps you should seek medical advice as soon as possible and mention your recent travel to Germany.
• If you are in Germany, you should follow the current advice provided by the German authorities. They have advised everyone to stop eating bean sprouts.
• Practise good hygiene precautions including washing your hands after using the toilet and before preparing or eating food.
• Wash fruit and vegetables before you eat them to ensure that they are clean and to help remove germs from the outside. Peeling or cooking fruit and vegetables can also remove these germs.

Sources: ProMed mail, BBC News online, Health Protection Agency