With at least 200 cases of E.coli being reported in the past two days, and the death toll up to 18, there appears to be little slowing of the outbreak which originated in Northern Germany in the beginning of May.
On Thursday, the US Centers for Disease Control and Prevention (CDC) issued a travel notice for US travelers to those areas of Germany recommending people to avoid eating raw tomatoes, fresh cucumbers, and leafy salads, until further notice.
The source of the outbreak, which has afflicted more than 1700 people in several European nations, including over 500 cases of hemolytic uremic syndrome (HUS), is still a mystery to scientists.
At least 10 countries have now reported cases, but virtually all of them have been traced to northern Germany.
According to the World Health Organization, Austria reported 2 cases, Denmark 7, France 6, the Netherlands 4, Norway 1, Spain 1, Sweden 28 and Switzerland 2. The organization said that all but two were people who had recently visited northern Germany or, in one case, had contact with a visitor from northern Germany.
The source of the rare strain, apparently a very toxic strain known as O104:H4 that has not previously been involved in any E coli outbreaks have eluded health officials who previously pointed to Spanish cucumbers ,but that was later withdrawn.
The Robert Koch Institute reports that a study conducted with Hamburg health officials found that people who fell ill had been “significantly more frequent consumers of raw tomatoes, cucumbers and lettuce” than a sampling of healthy people.
Why is this strain so pathogenic? According to Craig Hedberg, PhD, a foodborne disease expert at the University of Minnesota School of Public Health in Minneapolis, says there is still too little information to answer that question but the large number of cases diagnosed with HUS implies either a highly pathogenic organism, or a very large population exposed to the vehicle. It is too soon to really make those distinctions.
The CDC describes the symptoms of Shiga toxin-producing Escherichia coli (STEC) infections:
It can cause different gastrointestinal symptoms, but often include severe stomach cramps, diarrhea (often bloody), and vomiting. If there is fever, it is generally not very high (less than 101˚F [38.3˚C]). HUS is a disorder that usually occurs when an infection in the digestive system (such as STEC) produces toxic substances that destroy red blood cells and cause kidney injury. Early symptoms of HUS include decreased frequency or volume of urination, feeling very tired, and losing pink color in the cheeks and inside the lower eyelids. Signs of HUS typically start 5–7 days after the start of diarrhea, and diarrhea or bloody stools may no longer be present when HUS develops.
So if you have traveled to Germany and have bloody diarrhea and stomach cramps or symptoms of HUS as described above , go to a doctor right away and tell him or her about your recent travel.
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