A Massive Enterohemorrhagic Escherichia coli Outbreak is Ravaging Northern Europe
A massive foodborne outbreak of enterohemorrhagic E. coli (EHEC; typically E. coli 0157:H7) has caused16 deaths and sickened over 470 persons in Northern Europe. The source of the outbreak is thought to be fecally-contaminated raw vegetables including cucumbers, tomatoes and leaf lettuce. The source of the outbreak is still uncertain. German public health officials initially pointed to several cucumbers from Spain as the culprits. But, while these products were contaminated with EHEC, it appears that a different EHEC is responsible for the German outbreak.
Most of the sickened individuals are in Northern Germany although public health officials fear that the outbreak may spread. To that end, the outbreak appears to have worsened over the last 24 hours, with nearly 100 more people suffering from severe and potentially fatal symptoms. Typically, there are only 50 to 60 cases of EHEC infections per year in Germany.
Fecal contamination of the raw vegetables is the likely cause of this massive outbreak because E. coli is found in large quantities in the digestive systems of humans, cows and other mammals. Enteropathogenic strains of E. coli have been responsible for a large number of food contamination outbreaks in a wide range of countries. In most cases, the disease caused by these organisms is characterized by severe abdominal pains, diarrhea and generalized malaise. However, EHEC can cause more severe symptoms, ranging from bloody diarrhea to the rare hemolytic uremic syndrome which can lead to kidney failure, seizures, strokes, comas and death. The uremic syndrome is caused by secretion of a potent and sometime lethal enterotoxin manufactured by EHEC.
Unlike Salmonella gastroenteritis, where large number of organisms must be ingested to cause disease, EHEC infections can be caused by far fewer bacteria following ingestion of contaminated foodstuffs. In this regard, infections caused by EHEC are similar to those caused by Shigella spp which can be caused by between 1 to 10 ingested bacteria.
Let’s hope that the source of the outbreak is quickly identified before more people get sick or die.
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