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Escherichia coli outbreak in Germany: Shiga toxin-Producing Escherichia coli (STEC) (EC EU, June 6 2011, Updated)

Giuseppe

Emeritus
[Source: European Commission, European Union, full page: (LINK).]

Escherichia coli outbreak in Germany: Shiga toxin-Producing Escherichia coli (STEC)




On 22 May Germany informed the European Commission's Early Warning and Response System (EWRS) of a significant increase in the number of patients with hemolytic uremic sysndrome (HUS) and bloody diarrhea caused by enterohemorrhagic Escherichia coli (EHEC). Investigations have now concluded that a Shiga toxin-producing Escherichia coli bacteria is responsible for this outbreak.

Commissioner Dalli has made the following statements in relation to the Escherichia coli outbreak in Germany:


Statement by Commissioner Dalli on the E. Coli outbreak in Germany - 31 May 2011

"This issue is an absolute priority. The European Commission is coordinating with Member States and is working with the German authorities, in particular, to ensure that the source of the problem is identified in order to be able to propose relevant solutions. The agreed statement of all Member States demonstrates the joint commitment to cooperation, vigilance and solidarity on this matter. It is positive that the number of new infection cases seems to be declining but all authorities must ensure continuous surveillance, which is crucial at this stage, as we are still working to pin down the possible source of contamination and eliminate risks for public health."

Statement by Commissioner Dalli on the E. Coli outbreak in Germany - 1 June 2011

The statement made by the Commissioner and the question and answer session with the press that followed it can be found on the Commission's audiovisual website.

Shiga toxin-producing Escherichia coli (E. coli) is a type of enterohemorrhagic E. coli (EHEC) bacteria that can cause illness ranging from mild intestinal disease to severe kidney complications. Other types of enterohemorrhagic E. coli include the relatively important serotype E. coli O157:H7, and more than 100 other non-O157 strains such as O111 and O26.

A number of people with STEC developed the haemolytic uremic syndrome (HUS), a serious form of the disease. Investigations are ongoing in Germany and other afected Member States to identify potential sources.

Public health advice on prevention of diarrhoeal illness with special focus on Shiga toxin - producing E. coli (STEC), also called verotoxin - producing E. coli (VTEC) or enterohaemorrhagic E. coli (EHEC).

A joint statement by the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA), 3 June 2011

The Commission has been following the outbreak closely since it became known on Sunday, May 22. It activated immediately all existing networks created to manage this kind of incidents the moment the outbreak was confirmed. This includes the Rapid Alert System for Food and Feed (RASFF) and the Early Warning and Response System (EWRS) ensuring rapid distribution of information throughout the EU on findings in, and distribution of, possible food sources, and human cases respectively.

Following a request from the Commission, the ECDC conducted a risk assessment which was communicated to the Commission and the Member States on 25 May and updated on May 27. The risk assessment can be found here.

Good hygiene practices should be applied when preparing food and, in particular, when handling vegetables. Fruit and vegetables need to be washed thoroughly. The same applies for hands before preparing food or eating, and after using the bathroom or changing diapers. Finally, washing thoroughly knives, plates and other utensils used to prepare fruit or vegetables helps avoid the risk of cross-contamination.

Reports of EWRS audio-conferences
An update of the outbreak was provided by the Member State authorities during a meeting of the Standing Committee on the Food Chain and Animal Health (SCoFCAH):
31 May 2011 - Section Biological Safety.

Germany provided information on the state of play regarding the results of the samples taken from cucumbers, tomatoes and lettuce. All Member States acknowledged the efforts of the German Authorities. Spain and other Member States provided more details regarding the actions taken following the RASFF notifications. Following the discussion the Member States endorsed unanimously a statement on the E. coli outbreak. All Member States confirmed that no unilateral measures have been taken against cucumbers from Spain. A table on the human cases and a table on results of the samples taken by all Member States will be kept updated at daily basis and circulated through the RASFF.

The official report of the meeting and the presentation given by the German representative in the SCoFCAH meeting can be found here.


Commission press releases
Further information

An overview of the number of cases and the number of deaths can be found here.
Information submitted to the RASFF can be found here.
Follow up
Information on EU legislation on food safety and the Shiga toxin-producing Escherichia coli
EU case definition for diarrhoea and Haemolytic Uremy Syndrome (HUS) caused by the epidemic strain Shiga Toxin 2 producing Escherichia Coli (STEC) 0140:H4



Useful links
The European Commission's public health portal
RASFF webpage
ECDC homepage
EFSA homepage
The German Robert Koch Institute concerning detailled information about the strain (please note the strain was isolated from an infected person)
The Robert Koch Institute with further useful information
Article on the current outbreak in Eurosurveillance, Europe's journal on infectious disease epidemiology, prevention and control
Page on EU reference laboratories in the area of biological risks
German Federal Institute for Risk Assessment (BfR) in the field of consumer health protection
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