(Updates with number of deaths in second paragraph, U.S. FDA comment in 16th paragraph.)
June 2 (Bloomberg) -- More than 1,600 people in Europe have been infected in with a strain of E. coli bacteria that’s never been seen in an outbreak before, the World Health Organization said, as authorities search for the source of the malady.
The bacteria, which began spreading in Germany, has sickened 1,064 there, an increase of 268, while 470 people have symptoms of a condition that can cause acute kidney failure, up by 97 from yesterday, the WHO said today in a statement on its website. Cases have also been reported in nine other European countries. Seventeen people in Germany and one in Sweden have died, Deutsche Presse Agentur reported, citing local officials.
“One of our partner institutes examined the bacteria,” said Gregory Hartl, a WHO spokesman, by telephone today. “It’s one that’s never been seen before in an outbreak situation.”
European authorities are searching for the source of the bacteria, which appear to be more virulent than previous E. coli outbreaks. Tests conducted on samples showed that cucumbers imported from Spain aren’t responsible for the outbreak, the European Commission said in an e-mailed statement yesterday, leaving investigators looking for fresh clues.
The strain appears to be the offspring of two versions of E.coli, said Paul Hunter, a professor of health protection at the University of East Anglia in England. One of the likely parent strains, known as O157, emerged in the U.S. about 40 years ago and has also been found in the U.K., Hunter said today in an interview.
“This is a new strain,” Hunter said of the German outbreak. “O157 was almost certainly one of its parents. It’s also got material from another type of E. coli. So you’ve got this germ that’s like O157 but has this extra weaponry, that makes it more nasty.”
Tests suggest a mutant form of two different E.coli bacteria, the Associated Press reported today, citing an interview with Hilde Kruse, a food safety expert at the Geneva- based WHO. Calls made to the World Health Organization’s Regional Office for Europe in Copenhagen weren’t answered today, a public holiday.
All humans and animals carry E.coli in their intestines, and those strains are usually harmless, according to the Stockholm-based European Centre for Disease Prevention and Control. Some strains produce toxins and cause illnesses ranging from diarrhea to hemolytic uremic syndrome, or HUS, a potentially fatal type of kidney damage, according to the ECDC.
The virulent strains of E.coli attach to the walls of cells in the gut, forming colonies. They then secrete toxins that damage the body, according to Ian Jones, a professor of virology at the University of Reading in England. About 10 percent of people infected may have a serious outcome and 1 in 100 may die, according to Jones, who also specializes in microbiology.
“The vast majority of strains are harmless, but there are a select few that are armed and dangerous because of the particular genes they happen to have,” Jones said today in a telephone interview. “These genes produce those toxins. If they produce these toxins, the outcome of infection, rather than just being a tummy upset, can be far more serious.”
Hospitalizations appeared to be on the decline, John Dalli, the European commissioner for health and consumer policy, said yesterday. The European Union is engaged in “intensive work” to identify the source of Germany’s largest-ever E.coli outbreak, Dalli said yesterday at a press conference.
Finding the source “is the most pressing thing,” Jones said. “It’s important from a diagnostic point of view what strain we are dealing with but I think it’s safe to assume it’s from the O157 ilk. It’s the type of rare E.coli that produces toxins which destroy blood cells and also destroy the kidney.”
The “epicenter” is the area around the northern German city of Hamburg, Dalli said. Austria, Denmark, France, Netherlands, Norway, Spain, Sweden, Switzerland and the U.K. have all reported cases, the WHO said. All infections found outside Germany, except for two, are in people who had recently visited northern Germany or had contact with a visitor from the area, according to the WHO.
The Metro supermarket chain removed Spanish cucumbers from its shelves last week, said Ruediger Stahlschmidt, a company spokesman. Customers in Germany are asking more questions about the origin of vegetables while shopping, Stahlschmidt said.
“We have also informed our staff to give hints to customers to clean and boil vegetables,” he said. “We’re noticing cucumbers, salad and lettuce are not bought as much as before and we’ve also seen a reduction in Spanish vegetable purchases.”
The U.S. Food and Drug Administration has increased its sampling and analysis of imported produce from countries tied to the outbreak in Europe as a safety precaution, according to Dara Corrigan, the agency’s associate commissioner for regulatory affairs.
There have been no shipments of tomatoes, cucumbers or lettuce from Germany to the U.S. since January, Corrigan said. Three shipments of lettuce have come from Spain during that time period and one shipment of cucumbers arrived in May. No fresh tomatoes from Spain have been imported in the last 18 months.
“As more information about the source of the outbreak emerges, FDA will adjust our public health protection efforts accordingly,” Corrigan said in an e-mailed statement today.
A Russian ban on imports of fresh vegetables from all 27 European Union nations is “unacceptable” and the European Commission will ask Russian authorities to have the embargo lifted as soon as possible.
The European Commission’s health department will send a letter to Russian authorities today, asking for a removal of the embargo on vegetable imports, while putting continued pressure on German authorities to determine the source of the outbreak as soon as possible, said Frederic Vincent, a spokesman for Dalli, said by telephone from France.
Infection with virulent strains can occur through contact with uncooked food or animals carrying the bacteria. The E. coli can live on leaves for as long as two weeks, the University of East Anglia’s Hunter said. People should wash their hands before preparing, serving or eating food and after handling fresh vegetables or raw meat, the ECDC said on its website.
“Even though the cucumber hypothesis no longer appears to be the best bet, people should still be encouraged to properly wash all raw salads prior to consumption, whether or not there happens to be an ongoing outbreak,” Hunter said.
People who have symptoms, including stomach cramps and bloody diarrhea, should see their doctors, the University of Reading’s Jones said. The bacteria respond to a range of antibiotics, and treatment is essential before kidney damage occurs, he said.
“Once the damage is done, you may have kidney disorders for the rest of your life,” Jones said.
--With assistance from John Martens in Brussels and Julie Cruz in Frankfurt. Editors: Kristen Hallam, Robert Valpuesta
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