VTEC O104:H4 outbreak in Germany and cluster in France: Update 6/7/2011
The VTEC O104 outbreak on the continent continues, but the rate at which new cases are being reported has fallen markedly. As of 5/7/2011, a total of 897 HUS cases, including 33 deaths, and 3314 non-HUS cases, including 17 deaths, have been reported. A number of countries have been affected; distribution of the cases is available on the website of the European Centre for Disease Prevention and Control. The last reported date of illness onset among all cases was 29 June 2011. No cases associated with this outbreak have been identified in Ireland.
The latest cases outside Germany appeared in the Bordeaux region of France; all were associated with attendance at a single event. The strain of VTEC responsible for the French cases is indistinguishable from that that led to the German outbreak. This suggests that these two events are related to a common source.
Click here for further information on VTEC and HUS.
VTEC O104:H4 outbreak in Germany and cluster in France: Update 29/6/11
On 24th June, France reported a cluster of cases of Haemolytic Uraemic Syndrome (HUS) and bloody diarrhoea in Bordeaux in France. As of 28th June, 15 cases have been identified, of whom eight cases have developed HUS. 11 of these cases attended an event, at which 9 reported having eaten sprouts (fenugreek, mustard and rucola). Left over seeds are currently being analysed. In three of the patients, infection with E coli O104:H4 has been confirmed
In addition, Sweden reported a confirmed case of E coli O104:H4 in southern Sweden in a person who had no history of recent travel to Germany and who did not recall having eaten sprouts prior to onset of illness.
The large outbreak of E coli O104:H4 in northern Germany has been shown to be associated with consumption of sprouts from a local producer. In this outbreak, 885 HUS cases, including 31 deaths, and 3,138 non-HUS cases, including 17 deaths have so far been reported.
Investigations are ongoing, but initial findings suggest that the consumption of sprouts is the cause of the infection in both France and Germany. Epidemiological, microbiological and trace-back investigations are currently ongoing to identify the origin of the contamination responsible for these outbreaks.
Until the investigation has been finalised, the European Centre for Disease Prevention and Control and the European Food Safety Authority strongly recommend advising consumers not to grow sprouts for their own consumption and not to eat sprouts or sprouted seeds unless they have been cooked properly. This is in line with advice from the Food Safety Authority of Ireland.
There have been no cases of E coli O104:H4 identified in Ireland. GPs and clinicians have been reminded to notify any potential cases promptly to Public Health.
The latest epidemiological updates from ECDC are available here.
Click here for further information on VTEC and HUS.
VTEC in Germany: Update 15/6/11
As of 15/6/2011, ECDC is reporting that in the EU/EEA, 821 HUS cases, including 24 deaths, and 2530 non-HUS VTEC cases, including 13 deaths, have been reported. Today, Germany reports two new HUS cases and 17 new non-HUS STEC cases. It also reports a new HUS death. In Luxembourg, one STEC case has recently developed HUS. This brings to 3351 the combined numbers of STEC/HUS cases. A total of 37 people have now died as a result of this outbreak. The latest reports on this outbreak from ECDC can be found here.
German Authorities are advising their citizens against consuming raw beansprouts until further notice. In addition, one of the outbreak cases has possibly contracted their illness from home grown bean sprouts, raising the possibility that beansprout seeds might have a role in this outbreak. As a result of this, German Authorities are also advising against the consumption of home grown beansprouts. Information from the German Authorities in English is available here.
VTEC in Germany: Update 10/6/11
Today the European Centre for Disease Prevention and Control is reporting that in the EU, 795 HUS cases, including 22 deaths, and 2287 non-HUS cases, including nine deaths, have been reported since the beginning of the VTEC/HUS outbreak associated with Germany. Cases have been identified in a number of countries. To date no cases have been reported from Ireland. The latest reports on this outbreak from ECDC can be found here.
Investigations in Germany indicate that illness is linked to the consumption of organic bean sprouts from one local producer. They have rescinded their warning against the consumption of tomatoes, cucumbers and lettuce. The Authorities in Germany are recommending that raw bean sprouts should not be consumed. Fuller information is available on the website of the Food Safety Authority of Ireland.
VTEC in Germany: Update 9/6/11
Today the European Centre for Disease Prevention and Control is reporting that in the EU, 757 HUS cases, including 19 deaths, and 2143 non-HUS cases, including eight deaths, have been reported since the beginning of the VTEC/HUS outbreak associated with Germany. Cases have been identified in a number of countries. To date no cases have been reported from Ireland. The latest reports on this outbreak from ECDC can be found here.
For advice for those travelling to Germany click here.
VTEC in Germany: Update 2/6/11
Cases associated with the outbreak of haemolytic uraemic syndrome (HUS) and verocytotoxigenic E. coli (VTEC) centered in Germany continue to rise. A number of countries have now reported cases to the European Centre for Disease Prevention and Control (ECDC). The latest reports on this outbreak from ECDC can be found here.
VTEC in Germany: Update 31/5/11
As of Tuesday May 31, German Authorities have identified 373 cases of Haemolytic Uraemic Syndrome (HUS) associated with an outbreak of VTEC (Verocytoxigenic Escherichia coli) VTEC O104. Six deaths in Germany are confirmed as being associated with this outbreak. The population in Germany affected in this outbreak are largely female and adult (71% are female and 88% are aged 20 years or older). Updates, in English, from German authorities are available here. Cases are being reported from a number of neighbouring countries (Sweden-15, Denmark-7, Netherlands-3, UK-2), largely among German visitors to the country in question, or in travellers to Germany. The latest Europe-wide SitRep from the European Centre of Disease Prevention and Control (ECDC) is available here. Daily updates will be posted on ECDC’s website here.
To date, there are no cases associated with this outbreak strain in Ireland.
Although salad vegetables have been shown in an initial analytical study in Germany to be associated with human disease, no definite microbiological evidence exists between illness and a particular food item. Further epidemiological and laboratory studies are ongoing, but contaminated food seems the most likely vehicle of infection. The Food Safety Authority of Ireland have issued an update in relation to this outbreak today.
HPSC warns travellers to Germany of E coli outbreak
HPSC has learned that German authorities are investigating an extensive outbreak of Verocytotoxigenic Escherichia coli (VTEC) complicated by Haemolytic Uraemic Syndrome (HUS). The VTEC strain responsible for this outbreak is 0104, a strain not reported as having caused human disease in Ireland.
VTEC is a serious diarrhoeal illness which is transmitted by contaminated food or water or close contact with a person suffering from the illness. Its primary symptoms are diarrhoea (often bloody) and abdominal pain. Occasionally HUS (a form of kidney failure) can develop. More information on VTEC and HUS is available on the HPSC's website at http://www.hpsc.ie/hpsc/A-Z/Gastroenteric/VTEC).
More than 200 cases of HUS have been reported resulting in at least two deaths. The outbreak affects the entire country but primarily the northern part; most cases are adult and a majority are female. Ireland has not yet seen any cases associated with this outbreak. Other European countries have seen cases among travellers returning from Germany.
Early indications are that the source of the outbreak is food, most likely salad ingredients such as raw tomatoes, cucumbers and lettuce. Authorities in Germany are advising the public not to eat raw tomatoes, cucumbers and lettuce, especially in the north of the country, until further notice.
HPSC advises that anyone travelling to Germany should follow the advice regarding this outbreak from the German authorities. In addition, returning travellers with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention any recent travel history.
HPSC and the Food Safety Authority of Ireland are monitoring this evolving situation closely. Health professionals are being alerted to the situation and they are advised to urgently investigate potential VTEC cases with a travel history to Germany.
