Another Outbreak of E. Coli in Germany

June 7, 2011

Another 94 people have been infected with E.coli in Germany. That figure comes as European ministers meet in Luxembourg to hold emergency talks on the outbreak and how to deal with it. Video courtesy Sky News.

No source of killer bug as toll hits 25

• June 08, 2011 6:13AM

GERMANY was no closer overnight to discovering the source of the killer E. coli bug that has so far killed 25 people, after tests on a suspected source proved negative.

The latest confirmed victims were two elderly women from Lower Saxony who died from complications linked to the bacteria. The number of sick people has climbed to more than 2300, AFP reported.

The number of sick Americans has also risen from four to six, The Wall Street Journal said. Two were US military personnel who were based in Germany. The other four were travelling in Hamburg in May. Three developed hemolytic-uremic syndrome and were admitted to hospital while the fourth developed bloody diarrhea...

Has E.coli claimed its first life in America? Fears after Virginia girl dies

A two-year-old girl in America who died at the weekend was found to have E.coli, prompting fears the killer bacteria has reached the U.S. 'The lab results confirm the presence of E.coli 0157:H7,' Mr Parker said.

The child, from Dryden, Virginia, died at Johnson City Medical Center Sunday after being exposed to the lethal strain.

According to Tricties.com, Virginia Department of Health Public Information Officer Robert Parker said tests proved the bacteria was in the child

'That's a strain of E.

The website says a Washington County, TN Sheriff's Office Coroner's Report says the child was brought to the medical center Pediatric Intensive Care Unit with bloody diarrhea after she was 'believed to be exposed to E. coli from a contaminated pool.'

Her brother was also been brought in with similar symptoms.

So far the bug has killed at 22 people and left 2,300 seriously ill.

And the virulent strain shows no sign of stopping as more cases of people falling ill from E.coli are confirmed in America.

Tricities.com reported the Northeast Regional Health Office Medical Director Dr. David Kirschke confirmed a similar severe strain in Northeast Tennessee.

Dr. Kirschke said a Northeast Tennessee child is suffering complications in a Knoxville hospital and there are seven other confirmed cases of E. coli from four Northeast Tennessee counties.

'Everyone is doing fine,' Dr. Kirschke said of the seven people. 'From the initial tests, these look like the less severe type of E coli. We are treating it like an outbreak. We are investigating it like an outbreak.'

Authorities have instructed people to thoroughly cook their meat, wash raw fruits and vegetables, and avoid swimming in places like rivers and lakes that could have access to agricultural run-off.

coli that causes severe illness.'

Germany says no proof organic sprouts caused E. coli outbreak; expert calls probe a 'disaster'

HAMBURG, Germany (AP)

First they pointed a finger at Spanish cucumbers. Then they cast suspicion on sprouts from Germany. Now German officials appear dumbfounded as to the source of the deadliest E. coli outbreak in modern history, and one U.S. expert called the investigation a "disaster."
Backtracking for the second time in a week, officials Monday said preliminary tests have found no evidence that vegetable sprouts from an organic farm in northern Germany were to blame.
The surprise U-turn came only a day after the same state agency, Lower Saxony's agriculture ministry, held a news conference to announce that the sprouts appeared to be the culprit in the outbreak that has killed 22 people and sickened more than 2,330 others across Europe, most of them in Germany, over the past month.
Andreas Hensel, head of Germany's Federal Institute for Risk Assessment, warned, "We have to be clear on this: Maybe we won't be able anymore to identify the source."
Last week, German officials pointed to tainted cucumbers from Spain as a possible cause, igniting vegetable bans and heated protests from Spanish farmers, who suffered heavy financial losses. Researchers later concluded the Spanish cucumbers were contaminated with a different strain of E. coli.

EHEC recommended: Early neurological therapy

Hundreds of people are currently using a hemolytic-uremic syndrome in German hospitals, particularly in the north. Note the neurological disorders. The professional society recommends therefore, neurologists involved early in the therapy.
BERLIN (NES). The current wave of EHEC is special - not only because of the rare pathogen and the size of the outbreak, but also because of the neurological consequences for patients.
The German Society of Neurology (DGN) reported about half of patients with hemolytic-uremic syndrome (HUS), which may suffer from severe and sometimes irreversible neurological disorders.
As alarming call it the two Hamburg neurologist Professor Joachim Roether and Professor Christian Gerloff, that the neurological condition in spite of early plasmapheresis does not improve or even deteriorating.
Gerloff is director of neurology at the University Hospital Hamburg-Eppendorf (UKE), Roether is Chief of Neurology at the Asklepios Clinic Altona. Hamburg, Schleswig-Holstein to the trouble spot of the current wave of EHEC.
Apparently striking is the early appearance of neurological symptoms.
Gerloff, 'You can already develop simultaneously with renal and gastroenterological symptoms. " Crucial features of HUS are bloody diarrhea, hemolysis, and renal dysfunction.


On the neurological symptom complex in HUS the first professional association is one of confusion, reduced vigilance, irritability and delirium. There are also many cases in aphasia and apraxia, and disturbances of the brain stem functions. In severe cases, patients develop myoclonic seizures and sometimes that can lead to coma. The neurologists suspect the cause of these symptoms in the Shiga toxin 2, the EHEC releases. In addition to the hemolytic effect of the toxin leads to a swelling of the vascular endothelium. As a result, the toxin could also lead to a widening of the intracranial vessels and a disturbance of autoregulation in the kidneys.
Also could play the complement cascade at the neurological deficit involved. Nephrologists suggest that Shiga toxin can activate the cascade, such as by binding to the C3 convertase of the alternative activation pathway.

One therapeutic approach is the monoclonal antibody eculizumab, which inhibits the C5 convertase and therefore interrupts the terminal cascade. Initial success in the current HUS cases were hospital doctors reported already. Whether the drug is a general treatment option, however, so far the doctors can not yet be estimated.
The neurologist and Gerloff Röther argue, given the severe neurological responses for 'drastic therapeutic measures'. Also, she said eculizumab should be considered in each case. UKE on 30 patients treated so far are just that, at the Asklepios Clinic in Hamburg-Altona five. At the first neurological abnormalities to speak both in favor of early anti-shock therapy, such as anti-epileptic levetiracetam. Diagnostic method of choice is the MRI, the findings are more sensitive than CT.


[link to www.aerztezeitung.de]
A Hatttip to Tetano

E.coli in Canada

3:32 PM
TORONTO – An Ontario man has Canada's first suspected case of E.coli linked to the deadly outbreak in Europe.


The Ministry of Health and Long-Term Care says the Peel Region man travelled to Germany earlier this spring where he ate local salad products.

The outbreak has also spread to the U.S. where four people in Atlanta were apparently sickened by the bacteria while visiting northern Germany last month.
In Canada, some farmers fear the outbreak is already proving bad for business.

The organization that represents Ontario's greenhouse vegetable growers says some of its members have reported a drop in sales as demand slips on news the source of the deadly bacteria remains unknown.

Sprouts from northern Germany were ruled out as the cause of the outbreak, as were contaminated cucumbers from Spain last week. Officials are focusing tests on tomatoes, cucumbers and lettuce from the EU to pinpoint the cause of the outbreak that has sickened thousands and left over 20 people dead

A spokesman for the Ontario Greenhouse Vegetable Growers ..

Official: Mich. resident sickened in outbreak

Jun 6, 2011 5:39am

DETROIT (AP) — A heath official says a Michigan resident who recently was in northern Germany is among four people in the U.S. apparently sickened by the food poisoning outbreak in EuropeKelly Niebel, a spokeswoman for the Michigan Department of Community Health, tells The Detroit News for a Monday story that the person is recovering in southeast Michigan.
The Centers for Disease Control and Prevention on Friday announced that three of the four were hospitalized with kidney failure, a complication of E. coli that has become a hallmark of the outbreak. The News reports the person from Michigan had kidney failure.
The E. coli outbreak in Europe that's linked to vegetables has killed 22 people and sickened more than 2,200.

E. COLI O104 - EUROPEAN UNION (11): CASE UPDATE, POSSIBLE SPROUT

05-JUN-2011
Subject	PRO/AH/EDR> E. coli O104 - EU (11): case update, poss. sprout source

SOURCE
Date: Sun 5 Jun 2011
Source: Associated Press [edited]
<http://news.yahoo.com/s/ap/20110605/ap_on_he_me/eu_contaminated_vegetables_europe>


Initial tests have confirmed that bean sprouts grown in northern
Germany are the likely cause of an _E. coli_ [O104:H4] outbreak that
has killed at least 22 people and sickened over 2200, an agriculture
official said Sun 5 Jun 2011.

Different kinds of sprouts from one organic farm in the greater
Uelzen area, between the northern cities of Hamburg and Hanover, could
be traced to infected persons in 5 different German states, Lower
Saxony Agriculture Minister Gert Lindemann told reporters. "There were
more and more indications in the last few hours that put the focus on
this farm," Lindemann said at a press conference in Hanover.

"Many restaurants that suffered from an _E. coli_ outbreak had those
sprouts delivered," his spokesman, Gert Hahne, told The Associated
Press. The farm was shut down Sunday [5 Jun 2011], and all of its
produce, including fresh herbs, fruits, flowers and potatoes, was
recalled. At least one of the farm's employees was also infected with
the _E. coli_ bacteria, the minister said.

Lindemann said 18 different sprout mixtures were under suspicion,
including sprouts of beans, broccoli, peas, chickpeas, garlic lentils,
mungo beans and radish. The sprouts are often used in mixed salads.
Lindemann urged Germans to not eat sprouts until further notice and
said definitive test results would be available Monday [6 Jun 2011].
He said authorities could not yet rule out other possible sources for
the outbreak and urged Germans to continue avoiding tomatoes,
cucumbers and lettuce until further notice.

Sprouts have been implicated in previous _E. coli_ outbreaks,
particularly one in Japan in 1996 where tainted radish sprouts were
found to have killed 12 people and reportedly sickened more than 12
000 others.

The current crisis is the deadliest _E. coli_ outbreak in modern
history.

The head of Germany's national disease control center raised the
death toll to 22 people on Sunday [5 Jun 2011], 21 in Germany and one
in Sweden, and said another 2153 people in Germany have been sickened.
That figure included 627 people who have developed a rare, serious
complication of the disease that can cause kidney failure. Ten other
European nations and the USA have reported a total of 90 other
victims.

[Byline: Kirsten Grieshaber and Tomislav Skaro]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[As the overall number of cases continues to accumulate, it is now
reported that German-grown sprouts may well be the major vehicle. It
is not clearly stated whether the outbreak organism has been isolated
from sprouts, but it is reported that a worker from the farm acquired
the infection. If this farm is the primary source of the organism, the
next step is to find out from where the presumed manure fertilizer
source was obtained. The organism itself is distinctly unusual, and
efforts should be made to try to assess how Mother Nature put the bug
together. - Mod.LL]

EHEC outbreak: Update 8

05-06-2011

In Germany the outbreak of enterohaemorrhagic E. coli (EHEC) continues.

Haemolytic uraemic syndrome (HUS)

As of 05 June at 10:00 CET, Germany had reported 627 cases of HUS (including 15 fatalities): 54 more than the previous day.

Enterohemorrhagic Escherichia coli (EHEC)

As of 05 June at 10:00 CET, 1536 cases of EHEC infection (without HUS) had been reprted in Germany (with 6 fatalities): 108 more than the previous day.

Other countries

As of 05 June at 18:00 CET, 11 other European countries had reported a total of 31 HUS (with 1 fatality) and 71 EHEC cases (with 0 fatalities):

Country	HUS	EHEC
Austria	0	2
Czech Republic	0	1
Denmark	7	11
France	0	10
Netherlands	4	4
Norway	0	1
Poland	1	0
Spain	1	0
Sweden	15	31
Switzerland	0	3
United Kingdom	3	8

In addition, the Centers for Disease Control and Prevention in Atlanta, United States of America, had earlier published information on 2 cases of HUS in the United States linked to this outbreak.

All except 1 of the above HUS and EHEC patients had travelled to or from Germany during the incubation period for infection, typically 3–4 days after exposure (range 2–10 days). An increasing number of cases is laboratory confirmed as EHEC serotype O104:H4 or, more precisely, a strain of enteroaggregative verocytotoxin-producing E. coli (EAggEC VTEC) O104:H4. All of the affected countries are reporting their cases to the German authorities and WHO. European Union countries are also sharing information through the secure Early Warning and Response System (EWRS).

Note

EHEC and HUS have exclusive notification categories, so case numbers should not overlap. The figures in any rapidly evolving outbreak, however, are provisional and subject to change for a variety of reasons.

killer germ EHEC - shoots suspected

Source appears to be a factory in Lower Saxony

Sprouts from a production facility in the district of Uelzen (Lower Saxony) are, according to Lower Saxony's agriculture minister Gert Lindemann (CDU) is a recognizable source of EHEC epidemic. When an employee therefore an EHEC infection was detected, another staff member was also suffering from diarrhea.

However, the minister said: ". We can not recognize that the farmer with a fault in the development of" some sprout mixtures of the operation thus imports from abroad.

The conclusions drawn from 19 different types of seed sprouts have been supplied to restaurants and bars as well as health food shops and weekly markets. According to initial findings, but they were not included in other retail outlets.

In the press conference as Minister of the product among others, the suspected "Sprossfit mild blend ', and it contains sprouts from alfalfa, fenugreek, mung beans, lentils, adzuki beans.

The sprouts were supplied directly or through intermediaries of restaurants in Hamburg, Schleswig-Holstein, Mecklenburg-Western Pomerania, Hesse and Lower Saxony - the spreading area of ​​the intestinal disease!

The operation of the district Uelzen is closed since Sunday, the product was recalled.

Nor the EHEC pathogens in sprouts is not established, however, in the laboratory. So far, the study results are based solely on the trade routes.

Nevertheless, it was certain that a "very strong track down the source of infection" had. "The sequence of events shows very, very strongly that the rungs of a very, very likely to be a clear source of the pathogen," said Lindemann.

The first six major outbreaks of EHEC pathogen can be, according to the Lower Saxony State Office for Consumer Protection (LAVES) supplies the manufacturer shoot back.

According to the Office three canteens in Hesse and North Rhine-Westphalia and three catering establishments in Lower Saxony and Schleswig-Holstein, intermediaries from the nursery in Bienenbüttel district Uelzen were supplied.

The Ministry recommends to refrain currently on the consumption of sprouts. It can not be excluded that the contaminated with EHEC pathogens goods had already been fully processed and sold.

The manager of the establishment concerned, Klaus Verbeck said the "New Osnabruecker Zeitung" that he could make no sense to the allegations against its products. The salad bars would grow only from seed and water and were not fertilized at all. In other divisions of the court will not use animal manure, not even horn meal, Verbeck said the newspaper.

Both samples were investigated in the past two weeks on your own behalf, as well as studies of the food control had been no EHEC strain result of its products. According to Lindemann, the shoots are produced in the operation in 38 degree hot water vapor. "Optimal conditions for the growth of EHEC pathogen," said Lindemann. The pathogen could have been imported already with the seed from which the shoots were produced.

According to Lindemann at the start, shaft and shoots were investigated as a possible cause already.

"But then there was a restriction on three types of vegetables," he said, referring to the warning of cucumbers, tomatoes and lettuce. In a total of 500 samples of vegetables so far no EHEC pathogens through the Lower Saxony State Office has been established. Lindemann did not lift yet on Sunday, the consumption warning tomatoes, cucumbers and lettuce.

Meanwhile, 21 deaths to be associated with EHEC. Nationwide, more than 1,500 cases of EHEC and 620 HUS cases have been reported.

Sprouts were already in Japan 1996 fall associated with EHEC disease is suspected. A final confirmation of the suspected but had not revealed Michael Kuehne said of LAVES. A wave of disease by shoots in Europe is not the LAVES known, he said.

Germany: Sprouts likely cause of E. coli outbreak

HAMBURG, Germany (AP) -- Health authorities say locally grown beansprouts in northern Germany have been identified as the likely cause of an outbreak of E. coli that has killed at least 22 people and sickened hundreds in Europe.
Lower Saxony agriculture ministry spokesman Gert Hahne told The Associated Press his state is sending an alert warning people to stop eating the sprouts, which are often used in mixed salads.
Hahne said official test results have not yet conclusively shown that the Lower Saxony-grown sprouts are to blame but "all indications speak to them being" the cause.

E. Coli Outbreak Now at 22

The death toll linked to Germany’s E. coli outbreak has risen to 22, the European Centre for Disease Prevention and Control said in an e-mailed statement today.

Sino-German research finds new E. Coli bacteria resistant to 8 classes of antibiotics

SHENZHEN, June 4 (Xinhua) -- Chinese scientists who have fully sequenced the genome of the new E. Coli spreading through Europe said Saturday they found genes in the bacteria that gave it resistance to eight classes of antibiotics.
Researchers with the Beijing Genomics Institute, the world's largest DNA sequencing center, have found genes in the newly identified 0104 strain of E. Coli bacteria that made it resistant to major classes of antibiotics including sulfonamide, cephalothin, penicillin and streptomycin.
This helped explain why doctors in Europe had difficulties in fighting the bug that has killed 18 people and sickened nearly 2,000, BGI's major research arm in Shenzhen said on its website Saturday.
This would help doctors choose right medicines for the treatment, it said.
The researchers are developing a diagnostic kit which will be used to detect the bacteria and prevent the epidemic from spreading further.
The Chinese researchers obtained DNA samples of the bacteria from collaborating scientists in Germany and fully sequenced its genome in three days this week.
They announced on Thursday the E. Coli spreading through Europe was "a new strain of bacteria that is highly infectious and toxic".
The 0104 strain of E. Coli was not previously involved in any E. Coli outbreaks. However, it has 93 percent sequence similarity with the EAEC 55989 E. Coli strain which was isolated in the Central African Republic and known to cause seriously diarrhea, BGI said.
The source of the outbreak is unknown, but scientists say it is highly likely to have originated in contaminated vegetables or salad in Germany.

Conflicting theories on source of E coli strain

Jun 4, 2011 11:17 AM By Sapa-dpa

Conflicting theories on the origins of the E coli outbreak, which has killed 18 people in Germany so far, emerged in the country's media on Saturday.

A restaurant in the northern coastal city of Luebeck, near Hamburg, was probed by health experts after 17 people who had eaten there became infected with the virulent strain known as enterohaemorrhagic Escherichia coli (EHEC), the regional daily Luebecker Nachrichten reported.

However, Focus magazine reported the origin could lie in an anniversary celebration for the port of Hamburg at the beginning of May. The celebrations drew around 1.5 million visitors over the period May 6-8.

Both reports were based on information that experts from the Berlin-based Robert Koch Institute, which is responsible for disease control and prevention and falls under the federal Health Ministry, had probed the conflicting theories.

The institute could not be reached on Saturday for confirmation.

The national daily Sueddeutsche Zeitung earlier reported in its online edition that 34 women from a trade union organization had met in Luebeck May 12-14 and that at least had eight come down with the EHEC bug, one of whom had died.

A Hamburg hospital admitted the first cases suffering from EHEC in mid-May. The outbreak has since claimed at least 19 lives in Europe.

Initial theories that the bug originated in Spanish cucumbers or in fresh produce from the Netherlands have largely been discounted.

German health authorities are advising against the consumption of raw cucumbers, tomatoes and lettuce. Vegetable growers and traders have had to discard large quantities of produce and suffered serious economic consequences.

The World Health Organization reported that by Thursday, 1,122 cases of EHEC had been reported, with 502 cases of haemolytic-uraemic syndrome (HUS), a form of kidney failure caused by this E coli strain, resulting.

Eleven European countries and the United States had all notified cases, the WHO said.

Search for E. coli clues leads to Lübeck eatery

4 Jun 11 11:51 CET





German health authorities scrambling to find the source of a deadly E. coli outbreak are zeroing in on a restaurant in Lübeck. According to a media report, 17 people sick from the bacteria ate there between May 12 and 14.

Staff from Germany's national disease centre, the Robert Koch Institute (RKI), were investigating the situation in Lübeck.

"The restaurant is not at fault, but the supply chain can potentially provide the crucial clue on how the pathogen came into circulation," Werner Solbach, a microbiologist at the university hospital in Lübeck told daily Lübecker Nachrichten.

The paper reported Saturday that a group of Danish visitors ate at the restaurant for lunch. Later on, eight participants fell ill.

During the same period, another group in town for a seminar also ate at the restaurant. The 30 women were members of the Deutsche Steuer-Gewerkschaft tax union and hailed from around Germany.

"So far, we know of eight cases, some of them very serious," Dieter Ondracek, the union's chairman in Berlin, told the paper.

"One woman from North Rhine-Westphalia has died."

Responding to a query from news agency DAPD, a spokesman for the Kiel health ministry confirmed that participants of the seminar had fallen ill following a visit to Lübeck.

Solbach told Lübecker Nachrichten that another serious case appeared to be linked to the restaurant. A child from southern Germany became ill after visiting the restaurant for a family gathering during the same time period.

Water, Dialysis Only Treatments for Deadliest European E. Coli Outbreak

Doctors treating the world’s deadliest E. coli outbreak have little beyond water and dialysis machines to help them clear the infection from patients, according to infectious disease specialists.

The new strain of E. coli, which has killed at least 18 people in Europe, produces a poisonous bi-product called shiga toxin that damages the kidneys of some patients and requires the use of dialysis to scrub the blood clean. Some patients need transfusions after the bacteria dissolve their red blood cells, said Robert Tauxe, deputy director of food-borne illness at the U.S. Centers for Disease Control and Prevention.

Germany, alone, has reported 520 cases of the kidney ailment. Overall, 1,823 cases of E. coli infection have been confirmed, according to the World Health Organization in Geneva. In less severe cases, doctors use fluids to maintain hydration and stream the diarrhea-causing toxins through the body. Antibiotics don’t help, and can worsen the illness.

“It’s clearly a more severe disease than is normally seen because of this kidney failure association,” said Stephen Calderwood, chief of the infectious disease division at Massachusetts General Hospital in Boston. “There is some data if you keep the patient hydrated it may lessen the kidney disease. What is recommended is supportive treatment -- no antibiotics but maintain hydration.”

Antibiotics can’t be used because they increase the release of toxins into the bloodstream, compounding kidney damage, Calderwood said. The one class of antibiotics that doesn’t do this, known as carbapenems, is unlikely to help with E. coli, though they may be useful for patients who are simultaneously fighting additional infections, he said.

Similar Symptoms

The new E. coli strain, previously identified in isolated cases but never linked to an outbreak, begins with symptoms similar to more common types of the bacteria. Diarrhea starts anywhere from two to seven days after eating tainted foods, though most cases occur in the three to four-day range.

Diarrhea often contains blood and can be accompanied by fever, abdominal cramps and vomiting, Claudia Stein, director of health information, evidence and research at the WHO, said in a telephone interview.

“It makes your guts bleed; the bloody diarrhea is really a hallmark,” Stein said. “Somebody with bloody diarrhea should not wait. Go straight to their medical practitioner and report this, and then they have to be hospitalized.”

At the hospital, patients will be given fluids to begin the cleansing process, intravenously if necessary, she said.

Usually Harmless

All humans and animals carry E. coli in their intestines, and those strains are usually harmless, according to the Stockholm-based European Centre for Disease Prevention and Control. Some variants cling to the walls of the intestines and produce toxins that cause illnesses ranging from diarrhea and nausea to the potentially fatal kidney complication, known as hemolytic uremic syndrome, or HUS.

In addition to the 520 German cases of the kidney illness linked to the spread of E-coli, another 30 have been reported in Sweden, Spain, Denmark, the U.K. and the Netherlands, said the European Centre for Disease Prevention and Control. Seventeen people in Germany and one in Sweden have died, the WHO and European disease agency have reported....

WHO warns against hasty antibiotic use for E. coli

WHO warns against hasty antibiotic use for E. coli

Friday, June 3, 2011 8:28 am

GENEVA (AP) — The World Health Organization has cautioned people against taking antibiotics if sickened by the E. coli outbreak that began in Germany last month.

The U.N. health agency says anti-diarrhea medication also isn't recommended as it stops the bacteria from quickly leaving the body.

WHO epidemiologist Andrea Ellis says use of either treatment "can actually make the situation worse."

But she told reporters in Geneva on Friday that doctors treating infected patients can prescribe such drugs in certain specific cases.

WHO has no active role in combating the outbreak that has so far sickened over 1,700 people, mostly in Germany, and killed 18.

4 in US now linked to German E. coli outbreak

By MIKE STOBBE, AP Medical Writer – 2 hours ago

ATLANTA (AP) — Four people in the U.S. were apparently sickened by the food poisoning outbreak in Europe, health officials said Friday. Three are hospitalized with a serious complication.

All four were in northern Germany in May. Though they didn't stay at the same hotel or eat at the same restaurants, officials are confident that they were infected with E. coli in that country.

Three of them — two women and a man — are hospitalized with kidney failure, a complication of E. coli that has become a hallmark of the outbreak. One of the four fell ill while on a plane to the U.S.

Two other cases are being investigated in U.S. service members in Germany, said Dr. Chris Braden, of the Centers for Disease Control and Prevention.

The source of the outbreak hasn't been pinpointed but the focus has been on fresh tomatoes, lettuce and cucumbers. More than 1,800 people have fallen ill, nearly all in Germany.

In a teleconference Friday with reporters, a Food and Drug Administration official said produce in the U.S. remains safe. The government has stepped up testing of food from Germany and Spain, but very little is imported from those countries or the rest of Europe.

The United States has "one of the safest food supplies in the world," said Don Kraemer, deputy director of the FDA's Center for Food Safety and Applied Nutrition.

Few details about the four ill people in the U.S. have been released..

Worst ever outbreak of HUS kidney disease: Expert

Jun 4, 2011

PARIS - THE deadly kidney disease reported in a quarter of the recent E. coli cases in Germany and 11 other nations is the worst ever outbreak of haemolytic uraemic syndrome (HUS), a top expert said on Friday.

'This is the largest epidemic of HUS to have occurred anywhere in the world,' said Dr Francois-Xavier Weill, head of France's National Reference Centre for Escherichia coli (E. coli).

More than 550 cases of the kidney-wrecking condition have been reported since the outbreak in northern Germany of a virulent strain of enterohaemorrhagic E. coli (EHEC), according to the European Centre for Disease Prevention and Control.

Twelve of these HUS cases - eleven in Germany and one in Sweden - have proven fatal as of midday on Friday, the ECDC said.

More than 2,000 people are known to have been infected by the rogue bacteria, whose origins continue to elude German and international health officials.

'Until we have discovered exactly what food stuff is responsible and withdrawn it, there will be new cases. Finding it is the absolute priority,' Dr Weill told AFP in an interview.

2 U.S. Military Members Sickened as E. Coli Outbreak 'Stabilizes' in Europe

Published June 03, 2011

KAISERSLAUTERN, Germany – Two U.S. servicemembers based in Germany were suspected of being victims of Europe's E. coli outbreak Friday, as European authorities said the outbreak was "stabilizing."

U.S. military medical officers were awaiting test results from samples taken from the ill servicemembers -- and they could be confirmed late Friday or Monday, according to Phillip Tegtmeier, a spokesman for the US military's Europe Regional Medical Command.

"We're testing [for E. coli] as a precaution," he told military newspaper Stars and Stripes on Friday.

[Click title for full article]

Germany: E. coli patients continue to rise

On Friday June 3, 2011, 6:54 am

BERLIN (AP) -- Germany's national disease control center says almost 200 new cases of E. coli infection were reported in the first two days of June, bringing the number of cases in the country to 1,733. Eighteen people have died, all but one in Germany.

The Robert Koch Institute said Friday that 520 of those sickened are suffering from a life-threatening complication that can cause kidney failure.

Suspicion has fallen on raw tomatoes, cucumbers and lettuce as the source of the germ but researchers have been unable to pinpoint the exact source.

The World Health Organization says nine other European nations have reported a total of 80 people sick from the bacteria, most of whom had recently visited northern Germany.

Outbreak in Europe blamed on 'super-toxic' strain

Food-poisoning outbreak in Europe blamed on 'super-toxic' E. coli strain that may be brand new

Maria Cheng and Kirsten Grieshaber, Associated Press, On Thursday June 2, 2011, 7:04 pm

LONDON (AP) -- Scientists on Thursday blamed Europe's worst recorded food-poisoning outbreak on a "super-toxic" strain of E. coli bacteria that may be brand new.

But while suspicion has fallen on raw tomatoes, cucumbers and lettuce as the source of the germ, researchers have been unable to pinpoint the food responsible for the frightening illness, which has killed at least 18 people, sickened more than 1,600 and spread to least 10 European countries.

An alarmingly large number of victims -- about 500 -- have developed kidney complications that can be deadly.

Chinese and German scientists analyzed the DNA of the E. coli bacteria and determined that the outbreak was caused by "an entirely new, super-toxic" strain that contains several antibiotic-resistant genes, according to a statement from the Shenzhen, China-based laboratory BGI. It said the strain appeared to be a combination of two types of E. coli.

-snip-
[click on title for full story]

Germany struggles to find source of deadly E.Coli outbreak

Published 2 June 2011

German health officials struggling to find the source of deadly E.Coli outbreak suffered another setback when Spanish cucumbers were found to have been incorrectly declared the source of the infections; so far seventeen people have died and more than 1,500 Europeans have been sickened by a rare strain of enterohemorrhagic E. Coli (EHEC); eighty new cases were reported in Hamburg between Monday and Tuesday alone and hospitals are treating 110 patients critically ill with hemolytic uremic syndrome (HUS); the current outbreak has disproportionately affected women, and health officials are struggling to understand why; health officials have urged to not purchase any vegetables declared as potentially dangerous

[click on title for full article]

E coli outbreak: WHO says bacterium is a new strain

Thursday 2 June 2011 12.22 BST
World Health Organisation says fatal E coli is a mutant blend of two different varieties and has never been seen before

Excerpt:

Preliminary genetic sequencing suggests the strain is a mutant form of two different E coli bacteria, with lethal genes that could explain why the Europe-wide outbreak appeared to be so big and dangerous, the agency said.

Hilde Kruse, a food safety expert at the WHO, told the Associated Press that "this is a unique strain that has never been isolated from patients before".

She added that the new strain has "various characteristics that make it more virulent and toxin-producing".

So far the mutant E coli strain has infected more than 1,500, including 470 who have developed a rare kidney failure complication. Researchers have been unable to pinpoint the cause of the outbreak, which has hit at least nine European countries.

[Full article please click on title]

Egypt Map 2011 Confirmed H5N1 Human Cases

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Russia Bans European Food Imports as Virulent E. Coli Strain Spreads

BERLIN — An unusually lethal strain of E. coli bacteria has infected more than 1,500 people in Germany, mystifying public health officials, ravaging Spain’s agricultural heartland, and touching off panic in Europe as people weighed whether it was safe to eat raw vegetables. In the latest indication the extent of the concerns, Russia, which had already banned fresh vegetable imports from Spain and Germany, extended the prohibition to all of the European Union on Thursday, news reports said.

The source of the outbreak, which has killed at least 16 people — 15 in Germany and a Swede who visited there recently — remained unknown.
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Scientists are at a loss to explain why this little-known organism, identified as E. coli 0104:H4, has proved so virulent.
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WHO: E. Coli Outbreak Caused by New Strain

The World Health Organization says the E. coli strain responsible for the deadly outbreak in Europe is a new bacteria that has never been seen before.

The agency says Thursday that preliminary genetic sequencing suggests the strain is a mutant form of two different E. coli bacterium, with lethal genes that could explain why the Europe-wide outbreak appears to be so massive and dangerous.

Hilde Kruse, a food safety expert at the World Health Organization, said "this is a unique strain that has never been isolated from patients before." She added that the new strain has "various characteristics that make it more virulent and toxin-producing."

Overuse of antimicrobials in livestock risks human health, warn experts

Student BMJ editorial: Antimicrobials in livestock

Excessive use of antimicrobials in livestock promotes resistance and risks the future health of both animals and humans, warn experts in an editorial published by Student BMJ today.

Jørgen Schlundt and colleagues at the National Food Institute in Denmark argue that the routine use of antimicrobials can be reduced substantially, while maintaining profitable animal production, and call for their use to be monitored in all countries.

Antimicrobials are essential for treating bacterial infections in humans and animals. Substantial amounts are used in modern animal production, but their use can result in bacteria that are resistant to treatment.

Resistant bacteria can spread from animals to humans, mainly through the food chain.

Three of four recently emerging infections in humans originate from animals: avian influenza H5N1, severe acute respiratory syndrome (SARS), and Salmonella.

Several global organisations have proposed a range of different actions to contain antimicrobial resistance from animals, including restricting use in animals of the most critically important antimicrobials for humans. The European Union has also begun monitoring resistance in food animals and is implementing mandatory monitoring of antimicrobial usage in all member states...

AVIAN INFLUENZA, HUMAN (44): EGYPT, WORLD HEALTH ORGANISATION

Date: Wed 1 Jun 2011
Source: World Health Organisation (WHO), CSR, Disease Outbreak News
[edited]
<http://www.who.int/csr/don/2011_06_01/en/index.html>


Avian influenza situation in Egypt -- WHO update 52
The Ministry of Health of Egypt has announced a new confirmed case of
human infection with avian influenza A (H5N1) virus.

The case is a 30-year-old female from Amria District, Alexandria
Governorate. She developed symptoms on 26 Apr 2011 and was
hospitalized on 3 May 2011. She was in a critical condition under
artificial ventilation and died on 9 May 2011. She had received
oseltamivir treatment at the time of hospitalization.

Investigations into the source of infection indicate that the patient
had exposure to sick poultry suspected to have avian influenza.

The case was confirmed by the Egyptian Central Public Health
Laboratory, a National Influenza Center of the WHO Global Influenza
Surveillance Network. Of the 144 cases confirmed to date in Egypt, 48
have been fatal.

--
Communicated by:
ProMED-mail Rapporteur Marianne Hopp

[This brings the overall total of human cases of avian influenza
A/H5N1 virus infection since the beginning of the outbreak in 2003 to
554, and the number of fatalities to 324. There have now been 38 cases
of avian A/H5N1 influenza in 2011 and 18 fatalities.

During the 1st 5 months of 2011, 25 of the 38 new human cases (66
percent) have been recorded in Egypt, but only 8 of the 18 fatalities
(44 percent).

A map of the governorates of Egypt can be accessed at
<http://en.wikipedia.org/wiki/Governorates_of_Egypt>.

The Hunt for the Source of Germany's E. Coli Outbreak

05/31/2011

The Epidemic Detectives

By Veronika Hackenbroch, Samiha Shafy and Frank Thadeusz

DPA/ HZI/ Manfred Rohde

Germany's E. coli epidemic, which has killed as many as 15 people so far, has alarmed doctors, who have never seen such an aggressive intestinal bacteria before. Epidemiologists are desperately searching for the origin of the deadly bacteria.

The eeriest thing of all, according to Rolf Stahl, is the way patients change. "Their awareness becomes blurred, they have problems finding words and they don't quite know where they are," says Stahl. And then there is this surprising aggressiveness. "We are dealing with a completely new clinical picture," he notes.

Stahl, a 62-year-old kidney specialist, has been the head of the Third Medical Clinic and Polyclinic at the University Medical Center Hamburg-Eppendorf (UKE) for almost 18 years. "But none of us doctors has ever experienced anything quite like this," he says. His staff has been working around the clock for the last week or so. "We decide at short notice who can go and get some sleep."

The bacterium that is currently terrifying the country is an enterohemorrhagic strain of the bacterium Escherichia coli (EHEC), a close relative of harmless intestinal bacteria, but one that produces the dangerous...

Hattip Emily

Worsening E. Coli Outbreak in Germany Baffles Health Officials

An outbreak of a deadly strain of the E. coli virus in Germany and its European neighbors has killed 16 and has infected 1,600 as health officials race to pinpoint the source of the epidemic and minimize its impact.

The bug being blamed for the deaths and a swath of hospitalizations—many of which require intensive care and kidney dialysis—is among a group of toxin-producing E.coli called enterohemorrhagic E. coli, which can cause kidney failure and bloody diarrhea.

The northern German city of Hamburg has become the epicenter of the outbreak, which German officials initially blamed on shipments of Spanish cucumbers.

John Dalli, the European commissioner for Health and Consumer Policy, said that..

Egypt, Indonesia report H5N1 cases, fatality

Lisa Schnirring Staff Writer

Jun 1, 2011 (CIDRAP News) – Health officials today reported two new H5N1 avian influenza cases, in an Egyptian woman who died from the disease and in an Indonesian toddler who is recovering.

Egypt's health ministry said the 30-year-old woman from Alexandria governorate got sick on Apr 26 and was hospitalized on May 3, where she was placed on a ventilator and received oseltamivir (Tamiflu), according to a report today from the World Health Organization (WHO). She died on May 9.

An investigation into the source of her illness revealed..

More than 100 children infected with viral encephalitis in E China

English.news.cn 2011-06-01 13:37:20

ANXI, Fujian, June 1 (Xinhua) -- More than 100 children in Fujian Province have been infected with viral encephalitis since the beginning of May, local health authorities said Wednesday.

Hospitals in Anxi County have reported 200 such cases since June 1, of which 115 have been confirmed, said Wu Zhengxin, director of the county's health bureau.

An investigation by experts from the Ministry of Health and local disease control centers has indicated that the outbreak was caused by the ECHO30-type intestinal virus, according to Wu.

Infected local children were being treated at Mingxuan Hospital of Anxi County and were in stable condition, Wu said.

Another nine children, also from Anxi County, were diagnosed in hospitals in Xiamen City of Fujian and were receiving treatment there, Wu added.

The children, all under the age of 12, are from 75 villages of 14 townships in the county.

Children of three to seven years old account for 78 percent of the total, and 117 children, or 65 percent, are from the town of Hutou.

Local heath authorities are closely monitoring the disease to prevent its further spread, Wu said