A well-done and comprehensive article on Der Spiegel online by Veronika Hackenbroch, Samiha Shafy and Frank Thadeusz confirmed a few things but also raised more questions.

By the numbers: This E. coli O104:H4 outbreak is the third largest that I have found (behind Japan’ E. coli O157:H7 outbreak in 1996 and Canada’s E. coli O157:H7 outbreak in 2000). To date, 1,200 are reported ill in Germany, Sweden, Denmark, Britain, Austria and the Netherlands. There have been others reported ill with E. coli infections in both Switzerland and Spain, but as yet not confirmed as part of this larger outbreak. Two U.S. residents who recently traveled in northern Germany appear to be among victims of a massive outbreak, federal health officials confirmed Tuesday.  373 have been confirmed with acute kidney failure (hemolytic uremic syndrome) and there are 16 deaths. Nearly 70% of those sickened have been women. The numbers in this tragedy seem clear, the cause, perhaps less so.

Arion_vulgaris_Orth.jpgEarlier reports from Germany officials linked the outbreak to Spanish cucumbers after the lab at the Hamburg Institute for Hygiene and Environment found “four positive results … on three cucumbers from Spain and one from somewhere else, possibly the Netherlands … Two of the cucumbers were organic … [However, the lab] isn’t sure about the other ones yet.”

Then today Hamburg’s health minister announce that “Spanish cucumbers were probably not the source … [as] the bacteria on two of the four cucumbers did not match” the bacteria in stools of ill patients. However, warnings against eating cucumbers, tomatoes and lettuce have not been lifted.

Speculation has also arisen as to the original method of contamination (assuming it is cucumbers, tomatoes and/or lettuce). Liquid manure, water contamination have been discussed. However, apparently now the lowly slug is being fingered, albeit the Spanish slug, Arion vulgaris.

Whatever the source, this bug is nasty. Mr. E. coli in Germany, Dr. Helge Karch, reported that “the O104:H4 bacteria responsible for the current outbreak are a so-called “chimers” that contains genetic material from various E. coli bacteria. It also contains DNA sequences from plague bacteria which makes it particularly pathogenic.”

I can only imagine what is happening in hospitals throughout Europe (and now in the U.S.). The health and agricultural ministries from the various countries involved are talking past each other and shifting blame when they can. There clearly seems to be some confusion as to the vector of the outbreak, but there should be no confusion that public health comes first.