EHEC - Outcome of the Investigations

[tetano]

The search for the cause of the EHEC epidemic continues, scientists are looking in Hamburg, Luebeck and Bremen. Fixed a lot of people will no longer be the cause. Meanwhile, the multi-criticism in crisis management.
Major events such as the Hamburg Harbour Festival is for knowledge of the Robert Koch Institute (RKI) is not the outbreak of EHEC-wave. "Press reports that EHEC infections have been associated with major events related to cover, not with the findings of the Robert Koch Institute and are inconsistent with the epidemiological profile of the outbreak," the institute in Berlin said in response to different media reports on Saturday mit.Das RKI informed with that right now three teams were in action. The employees interviewed in Hamburg, L?beck and Bremen patients and healthy control subjects after they consumed food. For the study sites were selected, where the results are due to high numbers of patients is particularly relevant. Overall, since the start of the outbreak more than ten RKI teams were on the road.

Reports on consumer protection Kiel L?beck Restaurant relativiertDas relativized Ministry also reports of a restaurant in L?beck could provide clues to the source of EHEC. This is "not currently covered by the facts," said a ministry spokesman. The authorities were in several different directions to provinces. Whether some of which could lead to the source of EHEC disease, is speculation, said the Kiel Landesregierung.EU Health Commissioner John Dalli has agreed to send an expert team to Germany to help in the search for the origin of the EHEC pathogens could. It could be supported by the German authorities in the current epidemiological investigations and participate in the analysis, "to accelerate the identification of the origin," said a spokesman for the Kommission.Lauterbach KrisenmanagementDer criticized SPD-health expert Karl Lauterbach calls, among which the establishment of a central EHEC Crisis Staff of the Federal Ministry of Health.
"For now, the jurisdiction extends between local health departments, hospitals, the Robert Koch Institute and the Health Authority", Lauterbach complained in an interview with the appearing in Berlin "BZ am Sonntag". Lauterbach criticized the previous EHEC crisis management. "The education of the population is not sufficient and must be optimized urgent," said Lauterbach. There is, for example, "no binding Overview", where exactly in Germany act new suspected cases of what degree. Also lacked "a central hotline", where the population can provide detailed information on symptoms and disease progression in order to protect themselves can.



The medical director of the Berlin Charit?, Ulrich Frei, criticized also the crisis management of the RKI. Is also necessary to better inform policy. The RKI denied the allegations. They acted quickly to outbreaks of EHEC, a spokeswoman said.
For fear of the intestinal organism, the U.S. has meanwhile ordered increased inspections of vegetables from Germany and Spain.

http://www.focus.de/gesundheit/gesundleben/ehec-welle-experten-tappen-weiter-im-dunkeln_aid_634099.html

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Re: Ehec: outcome of the investigations

BERLIN -- Attention focused increasingly on Saturday on a restaurant in the northern city of Luebeck as German medical researchers sought to track down the source of a virulent strain of E. coli that has claimed 19 lives and spread to 12 countries.

An expert with the World Health Organization (WHO) expressed skepticism that the strain, enterohaemorrhagic Escherichia coli (EHEC), could have come from salads, as initially thought, pointing to beef as the likely source.

The European Commission said in Brussels that European Union experts were awaiting the results of tests on the Luebeck restaurant.

The European Food Safety Agency (EFSA) on Friday put the number of cases in Germany at 1,213, with 18 deaths, and advised a focus on distribution routes and restaurants in the search for the source.

Some 520 people in Germany have contracted haemolytic-uraemic syndrome (HUS), a form of kidney failure caused by this E. coli strain that has led to patients falling seriously ill.

Sweden has reported 46 EHEC cases, with most patients having visited Germany, France (10), Portugal (three) and Switzerland (one). Austria, the Czech Republic, Denmark, Britain, the Netherlands, Norway, Poland and Spain have also reported cases.

The United States has three cases, all of whom had recently been in Europe.

WHO expert Donato Greco told the Italian daily La Repubblica that the pathogen was normally found in the gut of cattle, and thus in "steak tartar or poorly cooked hamburgers."

Greco said he had never encountered a virulent bug of this kind on fruit or vegetables, and suggested the use of antibiotics in animal feed could have given rise to the strain.

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Read more: http://www.sacbee.com/2011/06/04/367...#ixzz1ONe0R4P5

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Re: Ehec: outcome of the investigations

EHEC epidemic, Health Minister sees shortages in hospitals

Minister Daniel Bahr speaks of a tight supply situation in some hospitals. The speculations about the origin of the new EHEC bacteria continue derzweil. The EU will therefore help Germany in the search.
Federal Health Minister Daniel Bahr (FDP), told the Bild am Sonntag "one could the lack of capacity in some hospitals - offset by vacancies in the nearby hospitals - such as in the cities of Hamburg and Bremen. On Sunday he was going to the University Hospital Hamburg-Eppendorf (UKE), an overview of the situation. In many UKE on the intestine bacterial versorgt.Hilfe ill in intensive care from the EUUnterdessen the EU Commission has announced that it will help Germany in search of the EHEC of the outbreak. EU Public Health Commissioner John Dalli offered to send EU experts. Furthermore, an EHEC internet platform was made up Monday on the legs, the authorities can exchange information.
Among others, also references to treatments by the Robert Koch Institute (RKI), translated and made available to the EU countries werden.Bei of the search for the aggressive intestinal germ EHEC has a possible clue to L?beck: How ZDF reported are for three groups who have eaten in the same restaurant, later EHEC cases occurred. The restaurant was by the health authorities have already studied - according to restaurateur Joachim Berger, however, nothing found.

Experts believe biogas plants for some serious veterinary and laboratory physicians keep an origin of the deadly pathogen EHEC from biogas plants to be possible. In the fermentation tanks of the growing number of biogas plants incur bacteria that it had never existed before, "said Bernd Schottdorf, founder of the largest with 1,500 employees, private European medical laboratories Schottdorf MVZ in Augsburg, the" Welt am Sonntag ". The bacteria cross Schottdorf to grow within the plants and blend together. "What exactly happened there, is largely unexplored." This unprecedented combination of pathogens will be as fertilizer on the fields gebracht.Schottdorf considers it urgently necessary to examine the biogas plants in Germany quickly to potential pathogens. Otherwise might threaten the risk of further outbreaks. The head of the Agricultural and Veterinary Academy Horstmar empty, Ernst G?nther Hellwig considers this, the paper said also for vorstellbar.Der CEO of the Association of biogas contradicts According to the newspaper. There was no "demonstrable connection" between the current EHEC epidemic and the facilities.
The Association provides that any agents were inactivated by heating to 70 degrees. Whether that's enough, and always happened properly questioned again Hellwig. Another expert cited by the magazine rack, the theory also for very unwahrscheinlich.Bundesweit, the number of EHEC infections continue at the weekend. Alone in Lower Saxony on Saturday 458 cases and suspected cases were registered - 40 more than the previous day. At least 520 patients suffering throughout the country on the dangerous HU syndrome (HUS). It is in Germany at least 18 people died.

http://www.focus.de/gesundheit/news/ehec-epidemie-gesundheitsminister-sieht-engpaesse-in-krankenhaeusern_aid_634154.html

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Re: Ehec: outcome of the investigations

On vacation feels Hellwig even safer than at home. For keeps the vet
the EHEC epidemic for a home-made, German problem. "It is possible,
that the EHEC pathogens come from biogas plants "Hellwig warns.

The booming biogas industry has long been Hellwig
critical in view. There, keep to him for a troublemaker, which is the
will bring conversation. There was no "demonstrable connection" between the
EHEC current epidemic and operation of biogas plants, "explains the
Managing Director of the Association of biogas.


That's right. Is provable in researching the true causes of disease
so far. But there is no suspicion of it - and not only comes
by Hellwig.


It lasts for well-known laboratory's Bernd Schottdorf, founder of the MIT
1500 employees, the largest private European medical laboratories Schottdorf MVZ
in Augsburg, for possible, which would dismiss the biogas lobby crazy idea.
A connection between the emergence of EHEC pathogen and the ever-
increasing biogas production in Germany was by no means
excluded, says Schottdorf


..

This is the dangerous germs are killed, according to EU directives
so-called "sanitation" for biogas operators required. Any
Excitation states of the Association of biogas, are for a one-hour
Heating of the fermentation substrate to 70 degrees with security disabled.


But do professionals and Hellwig and Schottdorf not believe easily.
Also this area is not straightforward and largely unexplored, warns
of laboratory medicine. "Spores survive the examination required by biogas plants
Sanitation to 70 degrees easily, "he says. EHEC was not a
Spore - "but we do not know if the sanitation in all
Biogas plants is carried out properly. "


If the Restg?rmasse am taken to the fields, so Hellwig, they could
also have contaminated vegetables - especially since it is precisely in Northern Germany
Spring had not rained for weeks. The substrate was not then
the plants washed away.


..

http://www.morgenpost.de/vermischtes/article1662197/Woher-der-EHEC-Erreger-stammt-vier-Theorien.html

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Re: Ehec: outcome of the investigations

Despite the negative EHEC samples, consumers should continue to not eat sprouts, advises the Federal Consumer Protection Minister Aigner. Supermarket chains such as Rewe and Edeka stopped the sale.
Federal Consumer Protection Minister Ilse Aigner (CSU) does not recommend, despite the previously negative EHEC samples farther from the consumption of sprouts. Although initial investigations of grids in Lower Saxony been no pathogen was detected, they believe it is right to stick to the consumption reference, Aigner said on Monday in Berlin. This recommendation applies, not as long as all investigations are completed and the suspect was not completely excluded, the Minister said.
Also on the consumption of raw tomatoes, cucumbers and salad leaves, especially in northern Germany should continue to dispense werden.Von shoots 40 samples of the affected horticultural business in the district of Uelzen, Lower Saxony were, according to the Agriculture Department failed first 23 negative. For the other ran Untersuchungen.Aigner further stressed that the references were from the Lower Saxony operating an "important trace ', which must be pursued with all vigor. One should loosing sight of other investigative leads from the eye, she added. For operation in Uelzen it hot in practice that would have the customer lists and supply chains become the country's authorities carefully monitored and evaluated.

Nationwide will focus on producers and importers of sprouts and their products are reviewed. This would be to ensure that only uncontaminated goods reaching the market, "said Aigner. She stressed that the investigations were in full swing at all levels to find the source of the infection and stop the spread. "For the Federal Government of the fight against EHEC highest priority," said aigner.de President of the Federal Institute for Risk Assessment (BfR), Andreas Hensel said in Berlin of the largest bacterial outbreak of Escherichia coli, which have existed since the Second World War in Germany have. He asked the people in the search for the cause to be patient. "We can not overturn the laws of biology," said Hensel. In the detection of a bacterium, it would take time to grow this lassen.Aigner dismissed criticism of the cooperation between the competent authorities. There is no conflict of responsibilities, but "cheap opposition banter. The President of the Federal Office for Consumer Protection and Food Safety, Helmut Tschiersky-Schoneburg, spoke of an excellent cooperation in the EHEC-crisis team.

http://www.focus.de/finanzen/news/ehec-aigner-raet-weiter-zu-sprossen-verzicht_aid_634604.html

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Re: Ehec: outcome of the investigations

Why hunting is getting nowhere

Faster, more intense and better coordinated would have to search for the cause of the epidemic EHEC have to run, say critics. The Robert-Koch-Institute and other authorities to defend themselves against the charges - with some good arguments.

to hail a lot of criticism at present to those who fight the EHEC outbreak and track down the source of infection - Fast one would have to work more intensively investigate the coordination of all the search nationwide.

Finally, the epidemic of diarrhea with the first patient has already started in early May and now, five weeks later, 22 people died. 2325 patients are the Robert Koch Institute, EHEC cases have been reported, more than 640 of these patients suffer from life-threatening hemolytic-uremic syndrome (HUS), which can lead to kidney failure and death.




Have the health authorities, who would have just at the beginning of such an epidemic respond quickly asleep? Lacking in Germany, an organization in which converge all information activities defined and controlled the fight against germs?

The Robert Koch Institute (RKI), all EHEC cases are reported. The employees have the know-how to locate sources of infection, so proper warnings are possible from certain foods. But this has evidently does not work as expected by consumers.




To understand how it came to the current situation, you have both the development of the epidemic and the responsibility of the individual agencies and departments into account in Germany.




In early May, no one guessed that the first cases of diarrhea, the start of a pandemic Ehec announced. After all, not, as at the annual EHEC outbreaks, affecting mainly children, but adult women. The doctors had thus first get the idea to test their patients for EHEC. If the tests are positive, reported the cases to health departments, which make any checks. Next, the competent state authorities are made aware that the disease eventually report to the Robert Koch Institute.





May take days to get there before identifying the extent of disease shaft. It is therefore no surprise that after more than two weeks was finally clear: This is an unusual outbreak of EHEC. On 19 May eventually included the authorities of Hamburg, ten cases. Now it was decided to request the Robert Koch Institute for help.

Without this call, the Federal Institute could not have become active.




The next day, a team of experts RKI in the Hanseatic city to interview patients. With the help of 25 affected, they tried for hours in long conversations, find out what they ate in the days before infection, where they resided, which she visits restaurants and canteens, in which shops they had bought their food. In addition, 96 healthy hamburgers were interviewed with a similar life background as a comparison group. Other specialists of the Institute investigate the outbreaks in L?beck and Bremen, Frankfurt, in Schwerin.


..

http://www.sueddeutsche.de/wissen/ehec-suche-nach-infektionsquelle-warum-die-jagd-ins-nichts-fuehrt-1.1105749

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Re: Ehec: outcome of the investigations

Potsdamer Researchers: New Ehec waves possible

Experts from the Institute of Food Research feel that further outbreaks possible. On Tuesday two new cases were known in Brandenburg udn the EU is to compensate the vegetable farmers.
Potsdam / Luxembourg / Berlin - The current Ehec epidemic will be the view of Potsdamer researchers is not the last: the microbiologist Professor Michael Blaut said the German Institute of Human Nutrition in mountain-Rehbr?cke (DIfE) at Potsdam that the PNN, it does not exclude further outbreaks from. As is now known that the disease originates from the human gut said, remains always the danger that it is for the transmission of EHEC bacteria in the processes of food production comes. The current agent associations have already been disclosed with completely new properties. "The natural mutation something come about, what is more dangerous than previously known pathogens, Blaut, head of the department explained Gastrointestinal microbiology of the institute that deals with human intestinal bacteria.

http://www.pnn.de/campus/461430/

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Re: Ehec: outcome of the investigations

EHEC references to garden sprouts condense in Lower Saxony

Hannover (dpa) - The instructions on the locked garden sprouts in Bienenb?ttel condense as a possible source for the EHEC epidemic. The Minister of Agriculture of Lower Saxony said Gert Lindemann. Accordingly, a third worker fell ill in May of G?rtnerhof probably due to EHEC. It has now returned to work. So far only the EHEC disease in a co-worker was known, a second also suffered from diarrhea. Nationwide there are now nearly 3,000 people, where EHEC is suspected or has been demonstrated.

http://www.focus.de/politik/schlagzeilen/nid_74290.html

[tetano]

Re: Ehec: outcome of the investigations

Hannover / Goslar (AP) - The references to the locked rung farm in Lower Saxony Bienenbüttel condense as a possible source for the EHEC epidemic, according to Lower Saxony's agriculture minister Gert Lindemann (CDU). Accordingly, a third employee of the Gärtnerhof fell ill in May, probably due to EHEC, but is now healthy again. "This is a note, who prepared the LAVES (National Consumer Agency) and state health department together," Lindemann said Tuesday on the edge of a CDU-retreat Goslar in the news agency dpa. So far, only the EHEC illness of a staff member of the Court announced a second Durchfall.Auch also suffered two cases of EHEC in Cuxhaven reported links to the suspect on organic farm, said Lindemann. "These are victims who have consumed products from Bienenbüttel." The district Cuxhaven, with more than 60 EHEC patients, the focus of the epidemic in Lower Saxony.

http://www.greenpeace-magazin.de/ind...d=55&tx_ttnews[tt_news]=112550&tx_ttnews[backPid]=23&cHash=15020c82801eb3f545ce776e80e73fb3

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Re: Ehec: outcome of the investigations

Scientists Rush to Study Genome of Lethal E. coli

Science 10 June 2011:
Vol. 332 no. 6035 pp. 1249-1250
DOI: 10.1126/science.332.6035.1249

News & Analysis

Germany
Scientists Rush to Study Genome of Lethal E. coli

Kai Kupferschmidt*

As Science went to press, scientists have not been able to find the source of the deadliest outbreak of enterohemorrhagic Escherichia coli (EHEC) bacteria on record. Yet they are getting to know the pathogen causing it in unprecedented detail, aided by an armada of scientists around the world who are analyzing available genomic data on the fly and, via tweets, wikis, and blogs, disseminating results online.

http://www.sciencemag.org/content/332/6035/1249

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Re: Ehec: outcome of the investigations

EHEC pathogens: Warning of cheese and curry




After it became known that the EHEC pathogens may have spread from Egypt, was now curry and cheese as a possible source of infection, because these foods contain fenugreek seeds in EHEC outbreaks in Germany and France played a role.
After the EHEC pathogens in organic farm Bienenb?ttel was made by heart ', many Germans believe that the topic would have done and one can safely eat all the food again. The day before yesterday then the news that the EHEC pathogen was introduced under circumstances in Egypt. The aim is fenugreek seeds in the EHEC outbreaks in France and Germany have played a crucial role.
That, however, know that Boxhornkleesamen in many other foods, such as are used as cheese or curry. For this reason, the Federal Office for Risk Assessment a new source of danger in EHEC curry and cheese. In the meantime, we have tested various types of cheese, which fenugreek seeds has been set to. However, all results were negative.

http://www.gesundheitsfocus.net/ehec-erreger-warnung-vor-kase-und-curry/2386

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Re: Ehec: outcome of the investigations

Germany recalls Egyptian fenugreek seeds


Berlin (dpa) - For the EHEC outbreaks in Germany and France are also responsible, according to German federal institutions with a high probability of fenugreek seeds from Egypt. That said, among other things, the Robert Koch Institute. The seeds have been distributed through various distribution channels in many Member States of the EU. In Germany the sale of these lots is prohibited, it has started a recall.

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Re: Ehec: outcome of the investigations

The cause for the outbreak of EHEC outbreak in Germany is likely imported from Egypt, fenugreek seeds. From the EHEC O104 with: H4 contaminated seeds were in a garden in Lower Saxony operating shoots were produced, said the President of the Federal Office for Consumer Protection and Food Safety, Helmut Tschiersky-Beautiful castle in Berlin on Tuesday. Since there may still be contaminated with the dangerous intestinal germ sprout seeds in circulation, still shoots should not be eaten raw. Extant seeds sprout and seed mixes should be disposed of to landfill, the report said.

...

http://www.focus.de/panorama/vermischtes/ehec-ausloeser-waren-bockshornkleesamen-_aid_643141.html

[Pathfinder]

Re: Ehec: outcome of the investigations (probably imported lot of fenugreek seeds used to grow sprouts imported from Egypt by a German importer)

EFSA publishes report from its Task Force on the E. coli O104:H4 outbreaks in Germany and France in 2011 and makes further recommendations to protect consumers

Press Release
5 juillet 2011

The EFSA Task Force established to coordinate investigations to track down the possible source of the French and German outbreaks of E. coli O104:H4 has concluded that one lot of fenugreek seeds imported from Egypt and used to produce sprouts is the most likely common link between the two outbreaks. However, it cannot be excluded that other lots of fenugreek imported from Egypt during the period 2009-2011 may be implicated. Based on these findings, EFSA recommends to the European Commission that all efforts be made to prevent any further consumer exposure to the suspect seeds and that forward tracing be carried out in all countries which may have received seeds from the concerned lots. In this context, EFSA continues to advise consumers not to grow sprouts for their own consumption and not to eat sprouts or sprouted seeds unless they have been cooked thoroughly.

In response to an urgent request from the European Commission regarding the ongoing outbreaks of Shiga-toxin producing Escherichia coli (STEC), serotype O104:H4, EFSA set up a Task Force on 26 June 2011 to provide immediate scientific assistance. EFSA scientists were joined on the Task Force by officials and experts from the European Commission, relevant EU Member States, the European Centre for Disease Prevention and Control (ECDC), the World Health Organisation (WHO) and Food and Agriculture Organisation (FAO).

Since May 2011, an outbreak of Shiga-toxin producing Escherichia coli (STEC) has been ongoing in Germany, though the number of new cases is rapidly decreasing. On 24 June 2011, French authorities reported an E. coli outbreak in the region of Bordeaux. Since the start of these outbreaks, there have been a large number of patients with bloody diarrhoea caused by STEC and an unusually high proportion of these have developed haemolytic uremic syndrome (HUS). To date, the E. coli O104:H4 outbreak is responsible for 48 deaths in Germany and one in Sweden. The total number of cases reported in the EU, Norway and Switzerland is 4,178[1].

The analysis of information from the French and German outbreaks leads to the conclusion that an imported lot of fenugreek seeds which was used to grow sprouts imported from Egypt by a German importer, is the most likely common link but other lots may be implicated. The report highlights that negative results from microbiological tests carried out on seeds cannot be interpreted as proof that a lot is not contaminated with STEC.

In light of the findings from the ongoing investigation and the conclusions of the tracing back exercise leading to fenugreek seeds as the most likely common link between the German and French outbreaks, EFSA considers that its previous advice issued jointly with ECDC on 29 June with respect to consumer protection remains valid. As seeds sold for sprouting are often sold as seed mixes and cross-contamination cannot be excluded, it is important that consumers are advised not to grow sprouts for their own consumption, and also not to eat sprouts or sprouted seeds unless they have been cooked thoroughly. This advice will be kept under review in the light of developments.


In a letter to the European Commission, EFSA outlines the principal conclusions of its report and identifies several recommendations related to preventing possible consumer exposure to the suspect seeds as well as the value of carrying out a risk assessment on sprout production and processing in view of further protecting public health.

• Technical report of EFSA: Tracing seeds, in particular fenugreek (Trigonella foenum-graecum) seeds, in relation to the Shiga toxin-producing E. coli (STEC) O104:H4 2011 Outbreaks in Germany and France
• FAQ on Shiga toxin-producing Escherichia coli (STEC)

http://www.efsa.europa.eu/en/press/news/110705.htm