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

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

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