# 5603
A number of public health agencies (Robert Koch Institute, CDC, WHO Europe, ECDC, etc.) are putting out statements about the ongoing severe outbreak of Shiga-Toxin Producing E. Coli in Germany and Europe.
The numbers being reported by these agencies, and in the media, tend to vary. Reuters, for instance, is reporting 19 deaths and 1700 infected, while the ECDC’s numbers sit at 16, and 1605.
Which simply illustrates that there are delays in the lines of communication, these numbers are constantly changing, and by the time a number is published, it is already likely out of date.
So these numbers should be viewed as preliminary.
The ECDC has issued an epidemiological update on this health crisis every day now for a week, which not only provides the most current `official’ data, but a good way to go back and see how this outbreak has progressed.
We’ve today’s update, which I will follow with a little more.
Outbreak of Shiga toxin-producing E. coli in Germany (5 June 2011, 11:00)
05 Jun 2011
Outbreak of Shiga toxin-producing E. coli in Germany
Epidemiological update, 5 June 2011, 11:00On 22 May, Germany reported a significant increase in the number of patients with haemolytic uremic syndrome (HUS) and bloody diarrhoea caused by Shiga toxin-producing E. coli (STEC).
Since 2 May 2011, 658 cases of HUS and 1605 non-HUS STEC cases have been reported from European Union Member States, including 627 HUS cases and 1536 non-HUS STEC cases in Germany. Sixteen of the HUS cases and six non-HUS STEC cases in EU Member states have died. See table below.
While HUS, caused by STEC infections, is usually observed in children under 5 years of age, in this outbreak the great majority of cases are adults, with more than two thirds being women.
Laboratory results indicate that STEC serogroup O104:H4 (Stx2-positve, eae-negative, hly-negative, ESBL, aat, aggR, aap) is the causative agent. PFGE results shows indistinguishable pattern of 7 human O104:H4 outbreak strains in Germany and 2 strains of O104:H4 in Denmark.
The source of the outbreak is under investigation, but contaminated food seems the most likely vehicle of infection.
Most cases are from, or have a history of travel to the North of Germany (mainly Schleswig-Holstein, Lower Saxony, North-Rhine-Westphalia and Hamburg). Within the EU also Denmark, the Netherlands, Poland, Spain, Sweden and the United Kingdom have reported cases of HUS, related to the ongoing outbreak as well as cases of non-HUS STEC cases.
Based on the available information, cases are associated with an exposure in Germany (mainly northern parts). The vehicle of the outbreak has not yet been identified and intensive investigations are ongoing.
The results of these investigations will determine the assessment of this risk. Rapid identification of potential cases linked to this outbreak, within Germany or among persons who have travelled to Germany since the beginning of May, is essential to prevent the development of severe disease.
STEC is a group of pathogenic Escherichia coli (E. coli) strains capable of producing Shiga toxins, with the potential to cause severe enteric and systemic disease in humans.
With no firm leads on the source of this outbreak, speculation on the origins of this rare pathogen are running rampant.
Fresh produce from Spain was first suspected, followed by local meat, a restaurant in Luebeck, and now – according to this Reuters report – even the Biogas industry is being viewed as a potential source.
German hospitals swamped with E.coli victims
By Brian Rohan
HAMBURG | Sun Jun 5, 2011 8:10am EDT
(Excerpt)
Scientists are pursuing a number of theories as to where the deadly strain of E.coli originated.
Experts told Welt am Sonntag newspaper it could have spread from a biogas plant. During the biogas fermentation process new bacteria often develop.
The idea that scientists may have inadvertently brewed up some kind of a `Frankenstein Bacteria’ in biogas fermentation vessels no doubt resonates with a lot of people, particularly among those who are already critics of the industry.
And it might even be true.
But a new `prime suspect’ in this outbreak seems to emerge on practically a daily basis. While these theories make for good newspaper fodder, they can also unfairly malign and trample the innocent.
Collateral damage may be inevitable in cases like this, but I suspect they will provoke economic and legal repercussions long after this outbreak has concluded.
