The 2011 E. coli outbreak - should we be worried?

Summer holiday is nearly upon us and I am really looking forward to a planned family holiday in Europe. One dark cloud is the E Coli outbreak which started in May. I hope that health authorities find the cause of the problem very soon. At least then the authorities will be better equipped to manage the outbreak and I’ll know how worried to be.

Here’s what I have found out about the current E. Coli situation. Let me caveat this by saying I am not a scientist or a doctor. So this isn’t medical advice.

• The official name of this particular E. coli strain is ‘Shiga toxin-producing Escherichia coli O104:H4 (STEC O104:H4)’.
  


• Hamburg in Germany seems to be the epicenter of the outbreak.
  
  
• The European Centre for Disease Prevention and Control says that the disease has caused 27 deaths and sickened at least 2,899 people.
  
  
• Most infections have been reported in people in northern Germany (mainly Bremen, Hamburg, Lower Saxony, and Schleswig-Holstein) or in people who have recently traveled to these areas.
  
  
• Symptoms of STEC infection include severe stomach cramps, diarrhea (which is often bloody), and vomiting. If there is fever, it usually is not very high.
  
  
• Most people get better within 5-7 days, but some patients go on to develop hemolytic uremic syndrome (HUS)—usually about a week after the diarrhea starts.
  
• Symptoms of HUS include decreased frequency of urination, feeling very tired, and losing pink color to skin and membranes due to anemia.
  
  
• According to European Health Commission 373 people have developed full-blown HUS, a condition associated with bloody diarrhea and kidney failure.
  
  
• No particular food item has been confirmed as the source of the infections. Sprouts, tomatoes, cucumbers and leafy salad vegetables have been under investigation. In any event, it is best to avoid eating raw vegetables.

So, what is E. coli?

E. coli is a bacterium. Most E. coli strains are harmless but some can cause serious food poisoning in humans. E. coli cells are a major component of feces and fecal-oral transmission is the most common route of transmission. Therefore, hygiene is a critical factor in the prevention of the disease. Optimal growth of E. coli occurs at 37°C (96.5°F) hence it is important to store food in cool places. Food poisoning caused by E. coli can result from unwashed vegetables, under cooked meat or unpasteurized juices. Heat can kill E. coli. Therefore, it is recommended that meat is cooked thoroughly. Washing fruits and vegetables thoroughly helps remove surface bacteria but at this time, it is best that vegetables are cooked and not eaten raw. It is also important not to introduce the bacterium to food prior to eating. So, wash your hands thoroughly before cooking or eating a meal.

Whilst there are no reported cases of any Hong Kong residents being affected by this outbreak of O104:H4 E. coli, the infection could easily spread due to the frequent movement of goods and the freedom of travel. Many of you would remember Germany’s announcement at the start of the outbreak that organic cucumbers grown in Spain were the cause of the infection. This has been established as untrue. Cucumbers from the greenhouses did not show E. coli contamination. One possibility is that cross-contamination occurred during transportation to Germany.