Sunday, May 29, 2011

Escherichia coli in Germany

One of the worst food borne outbreaks in recent history is occurring in Germany. Cucumbers from Spain are suspected to be carrying an especially deadly form of  Enterohemorrhagic Escherichia coli or EHEC bacteria that has killed at least five people, possibly more and sickened over 1000. 

In the worst cases of this infection haemolytic-uremic syndrome (HUS) is occurring, an illness that can lead to acute kidney failure related to the toxins produced and therefore cannot be treated with antibiotics.

The outbreak has prompted an alert from the WHO :

Outbreak of haemolytic uraemic syndrome in Germany

While most E.coli bacteria are harmless, a group called enterohaemorrhagic E. coli (EHEC) can produce toxins, known as Shiga toxins or verotoxins, which damage blood cells and the kidneys. EHEC bacteria that produce these toxins are known as Shigatoxin-producing E. coli (STEC) or verocytotoxin-producing E.coli (VTEC), respectively. Many people have been hospitalized, several requiring intensive care, and new cases continue to be identified, the latest having an onset of 25 May. Some other countries have reported cases, notably Sweden, which has reported ten HUS cases, with two in intensive care. All the people affected recently visited Germany, mostly northern Germany.

Additionally from the WHO:

Useful information

Haemolytic uraemic syndrome (HUS) is a life-threatening disease characterized by acute renal failure (uraemia), haemolytic anaemia, and a low platelet count (thrombocytopenia). It predominantly but not exclusively affects children. It results from EHEC infection, and it is estimated that up to 10% of EHEC-affected patients may develop HUS, with a mortality rate ranging up to 5%. Overall, HUS is the most common cause of acute renal failure in young children. It can cause neurological complications (such as seizure, stroke and coma) in 25% of HUS patients and chronic renal sequelae, usually mild, in around 50% of survivors.

Shigatoxin-producing E. coli (STEC) or enterohaemorrhagic E. coli (EHEC) is a severe strain of E. coli bacterium that is commonly found in the gut of animals, mainly ruminants. EHEC produces toxins, known as verotoxins or Shiga-like toxins because of their similarity to the toxins produced by Shigella dysenteriae. They can cause severe foodborne disease. STEC is transmitted to humans primarily through consumption of contaminated foods, such as raw or undercooked ground meat products and raw milk, contaminated water, direct contact with animals or contact with infected people. It is destroyed by thorough cooking of foods until all parts reach a temperature of 70 °C or higher. Symptoms of disease include abdominal cramps and diarrhoea, which may be bloody. Fever and vomiting may also occur. Most patients recover within 10 days, although in a few cases (particularly in young children and the elderly), the infection may lead to a life-threatening disease, such as HUS. Preventive measures for STEC infections are similar to those recommended for other foodborne diseases, including basic good food hygiene practice, as described in the WHO Five keys to safer food.

For more information

Additional, possible pathogenic links to environment and climate:

Food poisoning likelier as climate warms

Survival of Escherichia coli in the environment: fundamental and public health aspects.

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