HAMBURG Some are too weak to talk, others drift in and out of consciousness, but for many in German isolation wards the most difficult thing to deal with in a fight with a new strain of E.coli is not knowing what happens next.
Many of the 2,900 people taken ill so far with what starts as stomach bug symptoms face uncertainty over whether they will develop hemolytic uremic syndrome (HUS), which destroys red blood cells and causes severe kidney problems.
The outbreak has killed 29 people so far. All but one have been in Germany.
"The really frightening thing is you don't really know what it does in the long term, and the treatment is so exhausting," Philipp Guelland, a photographer, said in Hamburg's Eppendorf clinic, which is treating the largest number of victims.
German health authorities have not yet found out what caused the outbreak a month on, first blaming Spanish cucumbers, then tomatoes and lettuce, and now German organic bean sprouts.
"I've eaten all the things under suspicion so it's not worth thinking about where it came from," Guelland said at the clinic in the northern German port city of Hamburg which is at the center of the outbreak.
"It's a pure guessing game -- I'll probably never know."
Doctors say there are still many unknowns surrounding the virulent new E.coli strain, known as O104:H4, and its effects on patients, who can be hit by a variety of neurological disorders including delusions.
The symptoms can be limited to diarrhea and stomach cramps, or worsen into HUS and include seizures and kidney failure, some of which requires long-term treatment. The speed of the onset varies radically.
"With some patients, you'd be talking to them one minute, then you'd turn around and 15 minutes later they'd be having epileptic seizures," said Joerg Debatin, medical director of the clinic which lies on a leafy campus in the northern port city.
FOCUSED ON SURVIVAL
Holger Radloff fell ill on May 21 and was in hospital having plasma transfusions and dialysis four days later.
"It was incredible," the 49-year-old writer, who has tested positive for HUS, told Reuters. "You have no sense of reality, no idea what's going on, and you don't want to."
Once a healthy amateur triathlete now pained by immobility at times from treatment, he trembles occasionally and has taken on a yellowish complexion.
Radloff caught the illness after first his teenage daughter and then his 12-year-old son fell ill, the son most seriously.
"It's shocking how the body focuses on its own survival," he said. "I couldn't even ask how my son was doing. He lost his sight partially for five days, then had trouble speaking and was paralyzed on one side."
Testifying to the strength of the bacteria, many of the stricken are young adults who should have robust resistance.
"The worst thing is not the bacteria itself, it's the toxins it produces," says Torsten Wygold, medical director of another hospital, the Regio clinic, in the Hamburg suburb Pinneberg.
"It takes a while for vascular damage to appear in the kidneys sometimes, so long in fact that the patient can have already recovered from the intestinal infection in the meantime."
While authorities have taken nearly a thousand samples in a hunt for the source, they say that a smoking gun may never be found. Many patients are perplexed as to how they were infected, and concerned about possibly passing it on.
"I work at a nursing home and I could have been infected there, but my major worry, a terrible one, is that I could have passed it on to an older person with a weaker immune system," said 46-year-old Daniela Witzel in the ward of the Regio clinic.
Health officials say the spread of the epidemic is slowing, though that the death toll may still rise.
Debatin at the Eppendorf clinic sees "light at the end of the tunnel" and has been helped by extra staff from across Germany, and even by the army. But his doctors and nurses are so overwhelmed that they are undergoing psychological counseling.
Radloff, the 49-year-old writer, can now eat without vomiting despite still battling HUS.
"The best part of recovery was hearing from my son. He just called me and spoke a full sentence for the first time in days. It was: 'Papa, I can move my arm again'," he said. "It was unbelievable."
(Writing by Brian Rohan; editing by Stephen Brown and Elizabeth Piper)