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.

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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

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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.

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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

Egypt: 13 bird flu outbreaks Balqlliopip

Monday, May 30, 2011
Dr. Adel Anwar, Undersecretary of the Department of Veterinary Medicine on Monday morning he was discovered 13 infected domestic focus of bird flu, and most of those spots thanked the city of Kafr Qalubia all in injuries in ducks and chickens.
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He said: that there are no human cases of bird flu have been recorded one case of the Directorate during the last period.

World Health form a committee to investigate the emergence of 4 cases of plague

Btabrq
Monday, May 30, 2011 - 13:11


Minister of Health. Ashraf Hatem
Dana wrote railway


In response to the report published by the "seventh day" yesterday for the emergence of 4 cases of plague city of Tobruk, Libya, which lies on the border with Egypt, stressed Dr. Naeema Deputy Regional Director of WHO, the organization began yesterday to investigate the health of the emergence of people with the plague in collaboration with the Center for Disease Control transition in Tripoli.

She added that this action is taken immediately after the announcement of the appearance of any cases of infectious disease to ensure the accuracy of the declaration, and non-infected to take preventive measures to prevent transmission, and for the possibility of transmission of Egypt, stressed that Egypt is one of the countries that have strict procedures to prevent the transmission of any diseases through its borders to the absence of any health problem on the Egyptian-Libyan border.

Detention of a woman on suspicion of being infected with bird flu Menoufia

Menoufiya Mohammed Issawi 30-5-2011 13:55 28
Flu Taioraandzt Directorate of Health Affairs Menoufia housewife unique Shaaban Abdel-Latif, honor (21 years), from the estate Hamza village Alguenatrin Ashmoon within the hospital on suspicion of being infected with avian influenza and the emergence of symptoms of the disease was taking a sample of blood and sent to labs central Ministry of Health for analysis .
And Department of Veterinary Medicine announced the emergence of bifocal are positive for bird flu each house of Mohammed Sabir structure of the village of Mit Abu Sheikha Bakuesna, and on the mind of a spectrum of Quesna and the execution of 45 birds infected with the disease of houses and Ttherhma and take the procedures followed in this regard.

The return of bird flu in Menoufia

Wednesday, 18 May 2011 15:31

Menoufiya - Fadel, Marwa

Dr. Ahmed Fouad, director of the Directorate of Veterinary Medicine Menoufia focus on the emergence of a new, positive for avian Taiorbaqrip facility Menouf Sultan Center.

He explained that the focus appeared the home of citizenship Hana Mahmoud Hamzawi as a result of education at home, where samples were taken from birds and sent to the central laboratory and the result was positive, pointing out that the focus has been discovered by field tests carried out by the Directorate and the execution of infected birds and vaccinated birds nearby to prevent the spread disease.

Egypt: The emergence of a new focus for bird flu

Saturday, 28 May 2011 19:52

Menoufiya - Fadel, Marwa

Dr Ahmed Fuad, the director of Veterinary Medicine Menoufia, the emergence of a new, positive focus of avian influenza, the home of citizenship Hayam Recep Mahi shebin Kom tribal district as a result of education at home.
The "Fuad" to the fact that the focus has been discovered by field tests carried out by the Directorate, and turned out to be domestic breeding samples were taken from birds and sent to the central laboratory and the result is positive, explaining that he had been culling of infected and vaccinated birds nearby to prevent the spread of the disease.

4 goals of plague in Libya, and fears of moving to Egypt

47 Sunday, May 29, 2011 - 11:47

Fears of disease transmission to Egypt

Recorded the Libyan city of Tobruk the emergence of several infectious disease, injuries plague, and a medical source said the city's central hospital, said that at least four cases have been isolated medical hospital.

He pointed out that there are 17 other case being the work of medical tests her on suspicion of being infected with the disease, said medical source, who preferred anonymity, that the state of panic and fear, which hit the city is not the first, which occurred before, in mid-June 2009, when it hit the Plague "14" state in the region Trcp on the outskirts of Tobruk, and resulted in deaths and one.

The source added that the Egyptian authorities to take necessary action on the Egyptian-Libyan border to prevent the transmission of the disease in Egypt.

An official quarantine alternate port Salloum, The fear of the spread of the disease in Egypt will be the biggest focus of the emergence of the former in 2009, and attributed to the Egyptian official lawlessness taking place in the Libyan-Egyptian border at the moment.

And suffer the border city of Tobruk, many difficulties in the field of health services, where it lost contact in the capital Tripoli since the outbreak of the revolution on February 17 last year.

Ten die from contaminated cucumbers

10:21 AEST Sun May 29 2011

German health chiefs announced four more deaths feared to have been caused by E. coli-contaminated cucumbers, bringing to ten the number of suspected deaths in the country.

Two of the ten deaths have so far been officially attributed to the deadly E. coli strain, with about 300 cases of infection reported in several countries in the past week

The four new deaths in north Germany were announced by the health ministry of Schleswig-Holstein state and a clinic in Hamburg. The victims were three women in their 80s and a fourth in her 30s.

Authorities in southern Spain said Saturday they had introduced restrictions on two distributors suspected of exporting cucumbers tainted with the bacteria that causes the potentially fatal haemolytic uraemic syndrome (HUS).

The regional council of Andalusia said suspect batches of cucumbers had been withdrawn pending laboratory checks whose results would be known Monday.

The European Commission said earlier that Spain had suspended the activities of two distributors in the southern provinces of Almeria and Malaga, but spokesman Frederic Vincent confirmed Saturday that only the greenhouses where the suspect cucumbers had been grown were affected.

We don't know where the contamination occurred, whether on the (Spanish) sites or along the distribution chain," he said.

A probe was launched and samples taken from the soil, water and products from the two agricultural sites, the European Union's executive arm said Friday.

The cucumbers are suspected to have been contaminated by the enterohaemorrhagic E. coli strain.

"Investigations are ongoing to identify other potential sources, while a third suspect batch of cucumbers originating either in the Netherlands or in Denmark, and traded in Germany, is also under investigation," it said.

A suspect consignment of Spanish cucumbers was distributed to Denmark, but authorities there traced the vegetables and withdrew them from the market, the statement said.

The Andalusian authorities said Saturday that exhaustive checks by the Malaga company on its cucumbers had shown them totally free of contamination.

"Nevertheless we decided to suspend the product as a preventive measure," a statement added.

In the other company, at Roquetas del Mar, a consignment had been identified with some difficulty, it said.

Samples from suspect batches had been sent to a laboratory in the northwest province of Galicia for testing.

Meanwhile the Spanish daily El Pais said the Malaga growers, Frunet Bio, had been advised from Germany four days after the dispatch of a consignment on May 12 that their cucumbers had been dropped on the ground in a Hamburg market.

"We have that in writing," it quoted a spokesman for Frunet Bio as saying Saturday. "When that happens we can no longer guarantee the product."

The Eppendorf clinic near Hamburg which recorded two of Saturday's deaths said it had introduced a new treatment with an antibody aimed at countering kidney damage, but would not know for several weeks if it worked.

Germany has confirmed 276 cases of HUS, by far the largest number in Europe.

Sweden has reported 25 E. coli cases, with 10 of those people developing HUS, according to the European Commission said. Denmark reported seven E. coli cases (including three HUS) while Britain counted three cases (two HUS).

The Netherlands had one HUS case and Austria reported two cases of enterohaemorrhagic E. coli, while Switzerland has one suspected case.

The French economy, health and agriculture ministries said Saturday that three suspected cases were being investigated in France, linked to the German epidemic and not to a batch of cucumbers withdrawn from sale earlier.

India trashes Lancet's superbug study as 'unscientific'

Sunday, May 29, 2011

After hurried action on controlling antibiotic resistance in response to the British study in superbug, Indian health authorities have questioned the study published in The Lancet Infectious Diseases which reported presence of NDM-1 superbug in water samples in Delhi. The British paper has little "scientific evidence", Indian officials led by Director General of Health Services R K Srivastava have claimed in an editorial published in Indian Journal of Medical Research, brought out by the Indian Council of Medical Research (ICMR). In the wake of the study which found the gene, known as New Delhi metallo-beta-lactamase or NDM-1 which makes bugs resistant to almost all antibiotics, in water samples in Delhi, the government hurriedly announced the long-pending antibiotic policy. The study had warned that there was a threat of spread of this gene around the world and advised people against travelling to India for medical treatment. The officials have argued that multi drug-resistant pathogens exist globally including the Western world with a death toll of over 2,500 in the US alone and some 2,500 deaths in Europe every year. "Does it mean that the whole of Europe is unsafe for medical treatment and that all such notorious pathogens originated in Europe?" The editorial says "the (British) authors themselves admit that there was no statistically significant strain relatedness between the Indian 'British research biased against us' and UK isolates which raises doubts about the alleged origin of so-called NDM-1 from India. Mere fact that some of the study patients, shown to possess NDM-1, had visited India for some kind of surgery during preceding years is not adequate proof to claim the huge link with India. The authors could link only 17 of 37 UK patients to the Indian subcontinent. Since no prescreening of the patients was done before their visit to India, it would be wrong to conclude that the 'bug' had its origin in India". "Even while the authors have admitted that there was no statistical proof of strain relatedness between Indian and the UK isolates, the Journal chose to publish the paper cautioning global community to refrain from undergoing surgery in India. The concluding remarks of the authors are biased ( against India)," the editorial says.