E.coli: panic grips Germany while Britain waits nervously.

E.coli outbreak:

E.coli: panic grips Germany while Britain waits nervously
Crisis ‘not over yet’ say health officials

By Tony Paterson in Berlin
Saturday, 4 June 2011

Hospitals in Germany have appealed to the public for more blood donations, as the number of new victims of E.coli rose to almost 100 a day.

The Robert Koch Institute, the main health body investigating the outbreak, said 18 people had been killed by the bug in Germany in the past two weeks. In addition, one person in Sweden has died and more than 1,800 others have been infected around the world.

Four new cases were identified in the UK yesterday, bringing the total to 11 people being treated for the infection. All are from or have visited northern Germany, where experts are desperately working to find the source of the outbreak.
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Travellers to Germany are warned not to eat salad

Four more people in the UK have food poisoning suspected to be linked to a toxic E.coli outbreak, the Health Protection Agency said tonight.

Those affected have bloody diarrhoea and have recently travelled to Germany.

This is in addition to three Britons and four German nationals who are already being treated in the UK, including three for haemolytic uraemic syndrome (HUS) - a deadly complication of E.coli.

[b]The number of HUS cases in Germany has risen to 520 and 1,213 cases of bloody diarrhoea linked to the outbreak have been reported. Seventeen people have died.

Globally more than 1,800 people have been infected in the outbreak, and 18 people have died. People in 12 countries have fallen ill.
Around one in three of those affected have been hit by HUS, a complication that affects the blood, kidneys and, in severe cases, the central nervous system.

Experts in Germany said today there were signs that the infection could be slowing, but have warned more cases will arise.

The outbreak is thought to be the deadliest in recent world history, and is one of the biggest.

In 1996, 12 people died during a Japanese outbreak, while seven died in a Canadian outbreak in 2000.

Most of the recent cases are among people from northern Germany or those who have visited the area, where experts are trying to find the source of the outbreak.

Scientists believe salad vegetables and leaves may be to blame, although WHO says the origin “of the outbreak still remains unknown”.

The bug has now been identified in people in the Czech Republic, France and the United States, as well as Germany, Austria, Denmark, the Netherlands, Spain, Sweden, Switzerland and the UK.

Last night, experts from WHO said the strain of E.coli was extremely rare and, although seen in humans previously, it has never been at the centre of an outbreak.

The strain is known to be resistant to many antibiotics, making treatment difficult.

Experts have been warning people to follow good hygiene, including washing hands after using the toilet and before touching food, to avoid spreading E.coli.

German newspapers reported doctors having to give blood transfusions to those hardest hit in the north of the country.

Lutz Schmidt, medical chief of the Hamburg blood donation service, told Die Welt: “We need blood, plasma too. The stocks need to be replenished.”

In the UK, the Health Protection Agency (HPA) is urging people travelling to Germany to avoid eating raw tomatoes, cucumbers and leafy salad, including lettuce.

Anyone returning from Germany with an illness, including bloody diarrhoea, should also seek medical attention.

Analysis of the bug at the Beijing Genomics Institute (BGI) showed the bacterium is an enterohemorrhagic E.coli (EHEC) O104 strain, but is a “new serotype - not previously involved in any E.coli outbreaks”.

The most severe E.coli cases are usually seen in children and the elderly, but female adults appear to be the worst affected this time.

One possibility is that they eat more salad and fresh vegetables than men and children.

Professor Giuseppe Cornaglia, president of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), said: "This most recent E.coli epidemic, of a strain previously unseen in an outbreak, shows us yet again that new bacteria and infections are just around the corner, and we are far from winning the fight against infectious diseases in Europe.

“It reminds us that we continue to face new challenges, and must ensure we are vigilant in our preparedness, including monitoring, detection, and speedy and appropriate treatment.”

The ESCMID said northern Germany was experiencing problems with a lack of intensive care beds due to the high number of cases with life-threatening complications.

Using antibiotics to treat patients has been previously discouraged due to fears it could make the disease more aggressive.

However, experts in Germany have now said antibiotic therapy should not be withheld in some circumstances and “experiments with new therapies that neutralise the toxin are currently taking place”, according to the ESCMID.

Dr Katie Laird, senior lecturer in pharmaceutical microbiology at De Montfort University in Leicester, said: "The evolution of bacteria is a constant battle for health professionals to overcome.

“By the sharing of genetic material, bacteria become increasingly resistant to antibiotics and gain traits that allow them to present more severe symptoms in patients than have been previously seen.”

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