June 1, 2011 / 5:33 PM / 8 years ago

German E. coli outbreak shocks EU health expert

LONDON (Reuters) - The E. coli outbreak gripping Europe is on a scale never seen before, but infection rates should start to slow if people in Germany heed advice to avoid raw vegetables, a leading EU scientist said on Wednesday.

Slices of cucumber and a tomato slice are pictured in this illustration photo taken in Berlin May 30, 2011. REUTERS/Pawel Kopczynski

Denis Coulombier, head of surveillance and response for the European Center for Disease Prevention and Control (ECDC), which monitors disease in the region, said health experts are shocked at the number of cases, which point to a “huge contamination” probably of vegetables, at some point in the food chain.

That contamination could have happened “anywhere from the farm to the fork,” he said, and it is now down to food safety authorities in Germany to pinpoint where as quickly as possible.

“It’s certainly something we haven’t seen before in the EU (European Union) and probably in the world. Such a large outbreak ... with so many severe cases has never been seen in the past,” Coulombier said in a telephone interview from the ECDC’s headquarters in Stockholm.

German officials on Wednesday reported a dramatic increase in the numbers infected in the E. coli outbreak which has so far killed 16 people.

The outbreak, which began in May and is centered on the north German city of Hamburg, has made more than 1,500 people ill in eight European countries, and led to an international row over the source of the contamination.

Coulombier, a medical doctor and a specialist in tropical diseases and public health, said there were three types of food that, if contaminated, could cause such an outbreak of E. coli — meat, milk and vegetables. There is currently no indication that raw milk or meat is to blame here, he said, but studies so far show a strong link between disease symptoms and the consumption of fresh vegetables.

The ECDC has identified the most severe illnesses as hemolytic-uremic syndrome (HUS), a serious complication of a type of E. coli known as Shiga toxin-producing E. coli (STEC).

Coulombier said the size and severity of the outbreak suggested contamination of a very large number of vegetables.

“To have such a high number of severe cases means that probably there was a huge contamination at some junction,” he said. “That could have been anywhere from the farm to the fork — in transport, packaging, cleaning, at wholesalers, or retailers — anywhere along that food chain.”

German authorities have advised people to avoid eating raw fresh vegetables and salads, including cucumbers, lettuce and tomatoes. Coulombier said the next few days would be crucial in showing whether that advice was working.

“The duration of the incubation and the duration of the disease to develop into a severe form suggests that the cases we have seen in recent days were probably infected before the public health announcements,” he said. “So those measures should show their effectiveness from now and in the coming few days.”

To try to limit the number of deaths, it was vital that potentially severe cases are picked up as early as possible, he said. While stomach upsets, vomiting and diarrhea are common symptoms of E. coli infection, bloody diarrhea is one of main tell-tale symptoms of the most severe cases of STEC which may develop into HUS. HUS affects the blood, the kidneys and, in severe cases, the central nervous system.

Editing by Jon Hemming

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