HAVE DEADLY E.COLI 0104 NOW SPREAD TO SPROUTS IN FRANCE?

It was bound to happen. No sooner do you think an outbreak is over, when it isn't over. It looks like the super-toxic strain of E.coli bacteria that was traced to sprouts grown in Germany, may also have cropped up in sprouts grown in France.

But the French (who saw what slow action did in Germany) are acting much more quickly than the Germans did - and hopefully not fingering the wrong culprit. Not only have sprouted seeds been identified as the suspect food item, but investigators have found that all but one of the people who are ill attended a charity event at a children's play center in a suburb of Bordeaux at which they ate gazpacho garnished with sprouts.

True, the German and French E.coli strains haven't been conclusively matched as yet (it takes a while), and other less-lethal E.coli have been known to turn up in sprouted seeds (as well as other foods) as well. In fact, there were at least 3,500 cases of E.coli reported last year in the EU, with some 93 of these in France (though not all may be linked to food). And there was a case of E.coli contaminated frozen hamburger meat in northern France just about a week ago (investigators say the two cases are not linked).

But what makes one suspect that this French outbreak and the German one might be linked is the high incidence of Hemolytic Uremic Syndrome (HUS) complications with kidney failure among adults who are ill. Only 8 illnesses have been reported in France so far, but of these, apparently 5 (or, 7 - depending on which news report you read) are hospitalized with life-threatening HUS. Even if we assume that the actual number of illnesses is much greater, this is clearly an unusually toxic E.coli - like the E.coli 0104:H4 that turned up in Northern Germany this spring. I hope not.

But if it is, what does this mean? It means that the bacteria was/is most likely in seeds themselves (although they are different kinds of sprouts). That is, the contamination did not come from water used by sprout growers for irrigation or washing, and the cause was not some bacteria-carrying worker or unsanitary conditions at the sprout grower's in Germany. I imagine that this grower is very relieved.

But it can also mean that there is more to come...We have not heard the end of this yet. Until the next post..

To your good health,
TSF

THE EUROPEAN E.COLI O104 OUTBREAK IS ALMOST OVER - WE HOPE

Finally, that awful E.coli -104:H4 outbreak in Europe is winding down. Reports of cases are still coming in, because of reporting delays, but there are apparently few new illnesses.

Here are the latest numbers according to the World Health Organization (WHO) for June 20, as reported June 21. The total of illness linked to this outbreak is 3697, with all but 5 victims either having lived in or travelled to Germany. Of these, 814 people have developed Hemolytic Uremic Syndrome (HUS) - a high 22% rate. The most heavily affected have been adult women (I would assume this is because women eat more sprouts). Some 40 people have died. Most of the cases have been in Germany. Sweden and Denmark are next. WHO reports only 6 in UK and 5 in the U.S. If you want to check on your country or see the full breakdown, go to the WHO website (www.who.org) and click on the link to the European outbreak. It should be updated regularly.

The culprit food has now (after some false starts) been identified as bean sprouts (but the window seems to have been left open to include other sprouts as well). People throughout Germany have been warned by the Robert Koch Institute (which is in charge of this mess) not to eat sprouts of any origin. The rare and very deadly bacterium that caused all this misery (as well as political fallout and economic problems) - and this is really a mouthful - has been identified as: "enteroaggregative verocytotoxin-producing E. coli (EAggEC VTEC) O104:H4."

Let's hope this is really the end. But now the experts are talking about the outbreak as a warning of similar things to come. Maybe this bacterium, maybe another. And yes, as we have seen, food poisoning can be very widespread, and these days, global in its reach. If a food like sprouts is the vehicle - which only a small percentage of people eat at all - what if it the hazardous item is something like lettuce or tomatoes, which almost everyone eats, often in raw form?

Frankly, I am not going to lose sleep over it. But let's eat as safely as we can. And I do hope that if we have another outbreak like this, anywhere in the world, the investigators and researchers will do a better job.

To your good health,

TSF

THE LATEST ON THE DEADLY E.COLI OUTBREAK

The current outbreak of - presumably - food borne illness, is continuing in Europe. It has been declared to be the worst such outbreak in modern times. This is not only because of the numbers of people who are becoming ill, and the multi-country scope, but because of the severity of the illness. It is caused by a particularly deadly and rare strain of E.coli bacteria. While some E.coli live normally in our digestive system and serve a useful function in processing food, others are pathogenic and can cause very serious illness, including hemolytic uremic syndrome (HUS). This is one of the latter group. In fact, it may be the worst E.coli bacterium known because of the very high percentage of victims who develop HUS complications.

Since the outbreak is still ongoing, statistics are changing on a daily basis. Remember too that some people may be asymptomatic, and others have such mild cases that they don't see a doctor, and therefore do not get added to the list. As mentioned in earlier posts (see May 31), the real numbers in any foodborne illness are usually many times higher than the reported ones. By the time I post this, the below numbers will have increased again. But they give you some idea of where we are.

 In Germany: 1,534 people in the country have been confirmed as infected. The Robert Koch Institute in Germany has reported that out of these fully 470 are suffering from HUS (about 30%, which is in the range of my earlier guesstimate - see post of May 31 - of a quarter to a third). Seventeen deaths have been reported so far.

 In other countries: The World Health Organization said cases have been reported in nine European countries: Austria, Denmark, Germany, the Netherlands, Norway, Spain, Sweden, Switzerland and the U.K. But other reports also note two cases in the United States, and one in the Czech Republic (an American travelling from Germany, who is hospitalized in Prague). All but a few illness in other countries are among people who have recently travelled to Northern Germany, or among German residents who are have become ill while travelling abroad (There is a time-delay between getting infected and developing symptoms). The few instances that do not fit this patterns could be secondary infections caught from friends or relatives who are ill.

As of time of writing, the source of the outbreak is still unknown. Although cucumbers from Spain have now been dismissed as the cause, people in many countries are still being advised not to eat them. They are being fed to goats instead!

It seems that the focus of the investigation is still on vegetables which are eaten raw. But could it be something else?

To your good health!

TSF

SPANISH CUCUMBERS NOT THE CAUSE OF OUTBREAK

So we are back to the beginning. The Hamburg Institute for Hygiene and the Environment now says that it may not be Spanish cucumbers after all that are causing the deadly E.coli bacteria outbreak in Europe. Here we go again - another botched up case of investigating a food borne illness. It happens, particularly when researchers and authorities are under pressure. As we said in earlier blogs, it wasn't a conclusive link yet.

Apparently the testing found that the E.coli bacteria isolated from the stools of sick people don't quite match the bacteria in those suspect Spanish cucumbers.

That leaves us with several questions which have not been answered.

First, are they sure that food is really the cause of the outbreak? Conceivably, it could be contaminated water, or beer or coke or ice or something else. Did interviews with victims ask what they drank recently?

Secondly, if it is food, what is it? Yes, we seem to be back to the beginning on that one as well. Some of the alternatives that have been tossed out over the past week or so are tomatoes, lettuce and eggplant. Who knows, maybe it isn't even one of these. Maybe it's cabbage.

Thirdly, what are those E.coli 0104 bacteria doing in those Spanish cucumbers? Or, was that laboratory finding a mistake too, and they weren't really there?

The mystery deepens. And unfortunately, this one had better be solved quickly. Illnesses and deaths are increasing. And so are political tensions.

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

UPDATE ON THE "KILLER CUCUMBER BUG."

There have now been 16 confirmed deaths from pathogenic E.coli 0104:H4 bacteria in food in Europe - probably raw contaminated organic cucumbers that were imported from Spain. We are still not 100% positive. The number of illnesses is reported to be around 1,200.

But remember two things. First, there is always a time delay in reporting of food borne illnesses, so, while an outbreak is still ongoing, they are always a bit behind the actual numbers. Secondly, only a fraction of food borne illnesses are actually ever reported. Some people, who have a milder case - and they do exist, even in this outbreak, may never go to a doctor or a hospital, and never enter the reporting system. Let's assume the number is actually double, triple - or even more.

It looks to me as though about a quarter to a third of the cases of this illness are resulting in complications of hemolytic uremic syndrome (HUS), which is very serious and can be fatal when the kidneys are badly affected. If true, that is a very high incidence - much higher than usual with outbreaks of the more common E.coli 0157:H7 (closer to 10%). In other words, this is a very, very virulent bacteria.

As mentioned, the definitive cause of the illness is still largely unknown, although stories and rumors are flying. It has also become a political battleground, with every country that is accused - not just Spain, but also the Netherlands and Denmark, loudly denying any guilt, issuing threats and demanding apologies.

What we do know is that this is one of the deadliest food borne outbreaks that has ever occurred. Quoting Dr. Robert Tauxe, Deputy Director of foodborne, waterborne and environmental diseases at the U.S. Centers for Disease Control (CDC): "There has not been such an outbreak before that we know of in the history of public health."

Please be careful. If you live in Europe, follow government advice and avoid raw cucumbers for a while - and raw tomatoes and lettuce as well. Don't even use raw cucumber slices on your eyes or your sunburn!

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

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