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 Everywhere, the culprit food (that is, if it's only the Spanish cucumbers) is being withdrawn from the market - Germany, the Czech Republic, Luxemburg, Hungary and elsewhere.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

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

HOW DID SPANISH CUCUMBERS BECOME CONTAMINATED?

At the moment there seems to be a distinct possibility that the European Union could fall apart over cucumbers. I am not serious, of course, but the current E.coli contamination of cucumbers from Spain is certainly creating some tensions. Germany is blaming Spain for sending them deadly cucumbers. The Spanish authorities are saying "it's not us" and "this isn't our kind of bacteria." There are even some reports - which may not be true -that a source of cucumbers in the Netherlands is also involved. The Dutch authorities are denying any connection.

The bottom line: we don't know yet at what point in time or even in which country the bacteria got into the culprit cucumbers. Normally, in the case of a whole (that is, not cut up) vegetable such as a cucumber, one would suspect contamination at the farm level. It could be that the organic fertilizer was not properly treated, that the water used in irrigation was contaminated, or that the bacteria were in the soil. Of course, they could also have entered during washing (from contaminated water) or packing or transportation.

One argument that in my opinion does not hold much water is that of the agriculture minister of Spain, who is basically saying that because the strain of E.coli involved is very rare in Spain, the contamination could not have originated there. Just a moment - a strain can be rare and then suddenly it is everywhere. With microorganisms such as bacteria it happens all the time.

The culprit cucumber shipment has been destroyed and investigation is ongoing. But it could take weeks, even months, to get all the answers. But one thing we do know is that at some point the bacteria originated in animal feces. This kind of enterohemorrhagic E.coli can come from farm animals such as cattle, sheep and pigs. Wild animals roaming the fields such as rabbits may also carry it. They would not show symptoms of disease, but would shed it in their feces.

UPDATE: This was a misidentification. Cucumbers were later eliminated as the suspect. Considerable hardship resulted for innocent farmers all over Europe, and especially in Spain.

To your good health!
TSF