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HPA - Update on E. coli O104 outbreak in Germany and cluster of cases in France

Fewer new cases of Haemolytic Uraemic Syndrome (HUS) and bloody diarrhoea (VTEC or EHEC infection, caused by E. coli O104) were reported in Germany this week and there are no additional cases in France. This will therefore be the last update from the HPA on this issue unless there are any significant developments.

The European Food Safety Authority (EFSA) has concluded that one lot of fenugreek seeds imported from Egypt and used to produce sprouts is the most likely common link between the two outbreaks, but they have not ruled out that other lots of fenugreek imported from Egypt during the period 2009-2011 may be implicated. EFSA are therefore continuing to advise consumers not to grow sprouts for their own consumption and not to eat sprouts or sprouted seeds unless they have been cooked thoroughly. This advice remains in place because the risk of cross-contamination between different seeds cannot be ruled out.

The advice from the UK's Food Standards Agency (FSA) is also unchanged. Sprouted seeds – such as alfalfa, mung beans (usually known as beansprouts) and fenugreek – should only be eaten if they have been cooked thoroughly until steaming hot throughout; they should not be eaten raw. Equipment that has been used for sprouting seeds should be cleaned thoroughly after use. People should always wash their hands before and after handling seeds intended for planting or sprouting as well as when preparing food. This advice is being kept under review by the FSA.

To avoid infection with E. coli, the HPA recommends that, as always, people should follow normal hand hygiene procedures and anyone suffering from symptoms of bloody diarrhoea and vomiting should immediately contact their GP.

Notes to editors

In Germany, 860 cases of HUS have been reported since the beginning of May. Of these, 194 were laboratory confirmed as E. coli O104. A further 3,029 cases of bloody diarrhoea have also been reported, of which 557 were confirmed as E. coli O104. The number of bloody diarrhoea cases and deaths in Germany is lower than previously reported due to a change in case definition. Fifty one deaths are now linked to the outbreak – 35 HUS (34 in Germany and one in Sweden) and 16 bloody diarrhoea.

In the UK, the total number of cases linked to the outbreak remains at 17 – three HUS (all in England) and 14 bloody diarrhoea (13 cases in England, one in Scotland). Seven of these cases have been microbiologically confirmed and all 17 cases are related to travel to Germany.

In France the number of cases linked to the E. coli O104 cluster is 15 – eight HUS, six bloody diarrhoea, and one non-bloody diarrhoea. Of the 15 cases, 11 have been microbiologically confirmed as VTEC O104; 13 were linked to an event in the commune of Bègles near Bordeaux on 8 June and two were secondary cases.

For more information from the Food Standards Agency, visit: http://www.food.gov.uk/news/newsarchive/2011/jul/efsaecoli

To view the European Food Safety Authority's report, visit: http://www.efsa.europa.eu/en/press/news/110705.htm

The HPA carries out surveillance of E. coli in England. Its guidance on avoiding E. coli infections is as follows:

  • Wash your hand thoroughly after using the toilet (or helping others including changing nappies), handling raw meat, before meals and after contact with animals.
  • Cooking all minced meat products (i.e. burgers, meatloaf, meat balls etc.) thoroughly, until the colour is the same all the way through, and no blood runs from them;
  • Ensure that refrigerators are working correctly, bacteria grow more quickly at temperatures over 4°C;
  • Only leave cooked foods, meat and dairy products out at room temperature for a short time;
  • Store uncooked meats below cooked meats and salad vegetables to avoid dripping juices onto ready to eat food;
  • Store uncooked and cooked meats on different plates, avoid all contact between raw and cooked meats;
  • Thoroughly wash all salad vegetables that will be eaten raw, do not prepare them with utensils that have also been used for raw meat;
  • Children and the elderly who are particularly susceptible to the severe effects of VTEC should avoid eating or drinking unpasteurised dairy products;
  • People who have been ill should not prepare food for others for at least 48 hours after they have recovered;
  • Boil any drinking water if you are unsure of its source;
  • Do not swim in water that you think may be contaminated by cattle and sheep in nearby fields.

For a Q&A on this topic, visit the HPA website: http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1296689351788

The National Travel Health Network and Centre (NaTHNaC) is funded by the HPA and healthcare professionals and members of the public can find more information about travel health, including country specific advice, by logging onto their website: www.nathnac.org

For media enquiries please contact the national HPA press office at Colindale on 020 8327 7901 or email colindale-pressoffice@hpa.org.uk. Out of hours the duty press office can be contacted on 020 8200 4400.



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