HOW CAN WE BE SURE THAT THE TOXIC "GERMAN" E.COLI IS NEW IN THE U.S.?

The outbreak of toxic E.coli continues to create illnesses and panic in Europe. The latest genetic testing by a collaborating Chinese laboratory shows it to be a new strain - or, at least, a previously unidentified strain of E.coli. Yes, it is related to E.coli 0104 (about 80%) but the other 20% of the genetic composition comes from another very toxic bacterium. The closest thing we know to it is apparently a strain known as EAEC 55989 that causes very serious illness in the Central African Republic.

The experts are saying this strain of E.coli has never caused any illness in the United States. I think that conclusion is premature. How can we know we haven't had such incidents if laboratories do not test for them? Most laboratories only do serological typing for the more common E.coli 0157:H7, which crops up with some regularity in the North American food supply, with no testing for the other 2000 or so E.coli strains.

Remember the case of E.coli 0145 in a bag of Dole Baby Spinach in 2006 (and in Safeway lettuce in 2010)? The New York laboratory that found it was one of the few in the U.S. which tested for this strain. If the sample had been sent to another U.S. laboratory, the chances are that it would not have been identified. And if you were ill with E.coli 0104 and the sample was sent to a U.S. laboratory, the chances are that it would not have been identified either.

Let's not say the bacterium has never occurred in the U.S. Let's just say it hasn't been identified. It could have turned up, but simply been relegated to the cold case files of food borne illness.

To your good health.
TSF

CATCHING E.COLI BACTERIA FROM SOMEONE ELSE INSTEAD OF FOOD

There is nothing new to report on the ongoing outbreak of the deadly E.coli bacteria in Europe. Some experts believe that the number of new illnesses and life-threatening HUS complications (in about 30% of cases) might be slowing down a bit, but opinions seem to differ. So do the statistics. We still don't know the source of the outbreak (now that cucumbers are no longer the definite suspect), but the focus remains on vegetables.

And now everyone is talking about how rare and infectious and deadly this particular strain of E.coli is.

What no one seems to be mentioning is the risk of catching it, not from food, but from someone who is ill. I am talking about person-to-person transmission, or "secondary" illnesses. They can be just as bad. A study published by the U.S. Centers for Disease Control (CDC) in March, 2011, on an outbreak of the better-known and more common E.coli 0157:H7 in Scotland, found that about 11% of cases were secondary. Another study of a 2006 U.S. outbreak of the bacteria associated with spinach estimated that 12% were secondary. So, conservatively, let's say at least around 10% of cases of these deadly illnesses are likely to occur as a result of contact with someone who is ill - usually a relative or close friend. Since this particular E.coli bacterium is especially virulent, the rate of secondary infections could well be much higher. Well, what are we doing to prevent these cases? And, is the public being warned to be careful?

Of course, the basics of preventing person-to-person transmission of this bacteria, as with any other, are pretty simple. The usual route for infection is fecal-oral. Most of it boils down to using good personal hygiene. But remember too that care should be applied to touching the clothing or bedding of someone who is ill, and in cleaning the bathroom they have used. Disposable rubber gloves, which are available in most urban areas, can be very useful.

What most people don't know is that someone can have an infection and not show symptoms, and, that someone who is ill can be contagious for a few days after all symptoms have disappeared. In some cases, much longer.

Be careful.

To your good health!
TSF

YOU CAN MAKE THOSE CUCUMBERS SAFER TO EAT

I have just enjoyed a delicious cucumber salad, prepared the way I prefer it: with non-fat yogurt and fresh dill. It was left over from a party on the weekend, but still delicious.

Yes, I am continuing to eat raw cucumbers in spite of that outbreak of "cucumber illness" in Europe, mainly centered in Germany. But I live in North America, not in Europe. True, a couple of Americans returning home from travel to Germany have become ill with similar symptoms, but as far as we know at present, none of the suspect cucumbers from Spain are actually being sold in the U.S. or in Canada.

But I do take some precautions, not just to avoid any pathogenic E.coli, but also those common Salmonella bacteria, and parasites.

First, I buy carefully, not just checking to see how the cucumbers were grown (organic/conventional) but also where they came from. This information should be available. Mandatory "Country-of-Origin" (COOL) for fresh produce went into effect in the U.S. in 2008. If it's not actually on the cucumber, I look for information on the crate.

Secondly, I make sure the cucumbers I pick are firm and the skin is undamaged, which would allow easier entry of contaminants.

Thirdly, once in my home and before I let a knife anywhere near them, I wash the cucumbers well. Unless you are buying cucumbers in a farmers' market, these days most are covered with a layer of wax rather than dust or dirt, but I do it anyway.

Thirdly, I peel the cucumbers. Years ago, I used to eat them with the peel on, but now I remove it - pleasanter to eat with any waxed produce, and safer, although I am aware that I am losing some of the nutritional value.

Will this avoid any dangerous bacteria in my cucumbers, including those deadly E.coli 0104 that are popping up in Europe? No, but it is likely to reduce how many are present in what I eat. Realistically, some may be left in the actual flesh of the cucumber, and so may the toxins they produce.

Let's face it, as I stress in The Safe Food Handbook, raw is always riskier than cooked - including in the case of vegetables such as cucumbers. But at least you can reduce your risks a bit by making some smart decisions and actions.

To your good health!
TSF

THE "CUCUMBER BUG" COMES TO THE U.S.

It was simply a matter of time before it happened. Many of the illnesses from the very dangerous E.coli bacteria sweeping through Europe have been among visitors to Germany. And, Americans also travel, including to Germany. And there we have it - now the first two possible cases among Americans who have just returned from a trip there.

Notice that I said "possible." To my knowledge the tests haven't yet been finished. And there must be a lot of hysteria out there, particularly among people who have been in the Hamburg region eating salads. Secondly, notice that I said "first two." After all the correct predictions I made about radiation-contamination of food in the Fukushima area of Japan, I am on a bit of a roll. So let me make another "food safety prophecy." There will be more cases reported in the US in the next few days.

Let's see if I am right.

But if you are just back from Europe, and were in fact eating salads or eating raw cucumbers, keep yourself healthy and keep a watch on your symptoms. If you have diarrhea and it goes on for more than a few days, or is bloody - go see a doctor or go to the emergency room. Also, make sure you do not pass on bacteria to any of your relatives and friends. Practice good hygiene.

To your good health!
TSF

ACTION TO STOP THE CUCUMBER-LINKED OUTBREAK

This cucumber-associated outbreak of food borne illnesses in multiple countries in Europe is really frightening, mainly, because of the virulence of the hemorrhagic E. coli involved. A large percentage of people - around three fourths women - are not just having a few miserable days with diarrhea, but actually developing complications of Haemolytic Uremic Syndrome (HUS) and ending up in the hospital. As of today, at least ten have died. There will be more.

But don't panic. Action is being taken all over Europe to stop the outbreak of illnesses. Everywhere, the culprit food (that is, if it's only the Spanish cucumbers) is being withdrawn from the market - Germany, the Czech Republic, Luxemburg, Hungary and elsewhere. National authorities everywhere in Europe are checking what was imported, where it went, and trying to catch every vegetable before any more people eat them. The public is also being advised not to eat them and restaurants and consumers have been told to throw out any they might have bought.

Restrictions have been imposed on the two suspect Spanish cucumber growers, even before conclusive proof is available that the problem started with them. So, there won't be any more coming in from those sources. In parallel with these activities an investigation is ongoing. Interviews are being done with victims, laboratory testing is being performed on actual vegetables (including others, as well as cucumbers), and every point along the distribution line is being checked and examined for possible failures which could have resulted in contamination.

Assuming we have the right culprit vegetable (and that it's not eggplant or tomatoes or lettuce as well), and assuming that there is no other grower anywhere with the same problem, new illnesses should soon stop occurring since the incubation period for this bacterium is usually less than a week.

But then, there is the problem of secondary illnesses(people becoming ill from someone else - usually a family member - who did eat the food), or other indirect routes, as through swimming pool water (see previous post). Some studies have found around 10% of pathogenic E.coli illnesses to be secondary. But a few case studies I looked at had a higher incidence. Given the rarity of this particular E.coli 0104:H4, we don't really know what will happen.

To your good health!
TSF

CUCUMBER TRAVEL ADVICE FOR BRITONS - AND OTHERS

A couple of weeks ago, vacationing or business travel in Germany would have been considered very safe. Not any more. Particularly around Hamburg. This is the center of the "cucumber crisis." Most of the over-thousand hermorragic E.coli-related illnesses have been linked to eating food here. A considerable number have occurred among people from other countries such as Sweden, Denmark, France, visiting this area, or, residents of Germany who ingested the cucumbers and at home and then went abroad and became ill.

Britain is the latest country to be hit by cucumber fears. At least three cases among visiting Germans are suspected to be part of this outbreak, one of them confirmed. In fact, the advice to Britons now is not to eat raw cucumbers - or, raw lettuce or tomatoes (see earlier post) - when visiting Germany. And remember, washing or peeling is not guaranteed to solve the problem. If the cucumber has been sliced up or otherwise prepared in a restaurant or hotel, the risk could be even greater, as it could also be contaminated by a food worker who is a carrier of the bacteria (or others).

The "incubation" period for pathogenic E.coli (the time between ingesting it and developing symptoms of illness) can be as little as one day or a week or even longer. That means that you can feel perfectly well for a while after eating that deadly cucumber, keep working or vacationing and get on that plane and then become ill.

And yes, the bacteria are contagious. That is, they can be passed along not only in food or water, but also from person to person and even from the water in a swimming pool where it can survive for weeks, particularly if not well chlorinated. So I will add a bit more advice to travelers: don't let the water from a public swimming pool enter your mouth - not even a few drops. Don't dive in, don't dive under, and in fact, you may want to think twice about using the pool at all.

To your good health!
TSF

COULD TOMATOES OR LETTUCE ALSO BE CONTAMINATED?

The large outbreak of foodborne illness in Europe caused by Enterohemorrhagic E.coli 0104:H4 (EHEC) has been attributed to contaminated organic cucumbers imported from Spain. But keep an open mind. It could be another fresh vegetable as well, one such as tomatoes or lettuce.

In fact, German authorities have advised people to be careful when eating any of these vegetables raw. Why? Well, at least one study of women who had become ill (adult women are the main victims) found that a slightly higher percentage had eaten raw tomatoes than had eaten cucumbers in the preceding days. Lettuce also scored well in this survey.

So why were cucumbers pinpointed as the culprit vegetable? Actual testing did find the identical EHEC bacteria to be present in those imported whole cucumbers. To date, no testing has turned it up in tomatoes or in lettuce. But that doesn't mean it won't be found tomorrow, or in a week's time.

It wouldn't be the first time that the initial identification of a culprit food wasn't quite accurate. This happened with a large outbreak of Salmonella illnesses (Salmonellosis) in the United States in 2008. For weeks tomatoes were believed to be the cause, but later it was found that the culprit vegetable was Jalapeno and Serrano peppers (with "maybe" tomatoes as well). In other incidents strawberries have been blamed when it was actually raspberries. And so on. Nor is it impossible that more than one fresh vegetable is involved. This is quite likely if they came from the same farm or even the same area. The same improperly prepared organic fertilizer, E.coli 0104:H4 contaminated irrigation or processing water, or even packing ice could have been used.

So yes, if you live in Germany, and especially Northern Germany (where most of the illnesses have occurred) or are visiting there, I would avoid all three of these fresh vegetables for a little longer, until the investigation comes up with more answers. Washing may help a bit, but it may not work completely.

To your good health,
TSF

MORE WOMEN THAN MEN ARE BECOMING ILL AND DYING FROM CONTAMINATED CUCUMBERS

The bacteria causing the outbreak of cucumber-linked foodborne illness in Europe is E.coli 0104:H4. It is relatively rare. In fact, to my knowledge there has never before been a large outbreak caused by this particular E.coli. But E.coli 0104:H4 is one of the more deadly ones, since an illness can progress to Hemolytic Uremic Syndrome (HUS). This complication can be fatal, particularly for the elderly or the very young.

Usually it is children who are most likely to develop complications of HUS when they have one of these types of E.coli infections. The odd thing is that in the case of the currently ongoing outbreak in Europe, especially in Germany, most of those being hospitalized with HUS are adults. And, there are many more women than men. The reported illnesses change from day to day, but one analysis I did showed 78% to be female. Other earlier estimates were slightly lower. Of the ten people that have died to date in this outbreak, nine were women.

Why are more women becoming seriously ill than men? I doubt the explanation is very complicated. Women probably eat more raw vegetables such as cucumbers and are therefore statistically more likely to ingest the bacteria.

To your good health!
TSF

E.COLI CONTAMINATED CUCUMBERS CAUSE ILLNESSES IN EUROPE

There has been an outbreak of deadly foodborne bacteria in the European food market. It's one of the most dangerous E.coli - a bacteria which we usually associate with meat. And, the culprit food? Those innocent-looking cucumbers - organic ones. On May 26, the European Commission triggered its Rapid Alert System, which is does not happen very often.

It seems that the cucumbers originated in provinces of Almeria and Malaga in Spain and were exported. Many of the illnesses have occurred in Germany. Spain is one of Germany's largest suppliers of cucumbers (accounting for about 40% of all cucumbers imported). As of today, probably at least ten Germans have died of the infection, and hundreds are seriously ill with Hemolytic Uremic Syndrome (HUS). Not everyone who gets a case of E.coli-caused foodborne illness will get complications of HUS. Maybe one out of ten, or even less. Usually it will develop in people who are weaker - such as children and the elderly. HUS affects the kidneys, other body organs and sometimes even the brain. It requires hospitalization, and can be fatal. I should know. I almost died of it - although not from these cucumbers.

These cases of cucumber-related foodborne illness have also been reported in Sweden, Denmark, Britain, Netherlands, many of them among people who had travelled to Germany. People in other European countries which import cucumbers, such as Austria, Hungary, the Czech Republic and Luxemburg, are also becoming very nervous. Oddly, no illnesses have been reported in Spain. (Send your deadly food overseas!). There is also a possibility that lettuce, and maybe tomatoes may be contaminated as well.

My advice if you live in one of the countries that imports cucumbers from Spain: toss out any still in your home. If you have already eaten some of these raw cucumbers recently, don't panic. It is very unlikely that every cucumber will carry enough bacteria to make you ill. But watch out for symptoms such as diarrhea, nausea, weakness, stomach cramps. If you do become ill and don't get better in a few days, and particularly if you have bloody diarrhea, go and see your doctor.

UPDATE: Cucumbers were mistakenly identified as the culprit food by the German investigators, and too quickly announced to the public by the officials. It turned out to be locally grown sprouts.

To your good health!

TSF