German E Coli Breakout: Death Toll One

Investigations into the outbreak are ongoing
Sausages could be the cause of the outbreak (Photo: Andrk Langfield-Petrides)

An outbreak of E Coli STEC O157 in Germany linked to minced meat is being investigated after one person died and up to 30 fell sick, according to a journal report published this week.

The issue is ongoing; the most recent symptom onset for a confirmed case was April 30 of this year. The journal claims 14 of the cases have been confirmed as linked to the outbreak, with a further 15 'probably' linked to it. 

All of the 14 cases live in north west Germany and Berlin, half are male, and the age range is between one and 36.

According to eurosurveillance.org, a journal on infectious disease epidemology, prevention and control: "We report an ongoing, protracted and geographically dispersed outbreak of haemolytic uraemic syndrome (HUS) and gastroenteritis in Germany, involving 30 cases since December 2016. 

"The outbreak was caused by the sorbitol-fermenting immotile variant of Shiga toxin-producing (STEC) Escherichia coli O157. Molecular typing revealed close relatedness between isolates from 14 cases. 

"One HUS patient died. Results of a case–control study suggest packaged minced meat as the most likely food vehicle. Food safety investigations are ongoing."

None of the victims suffered from any relevant pre-existing conditions.

Researchers added: "We interviewed 11 of the confirmed cases or their parents using a standardised trawling questionnaire containing questions on clinical symptoms, travel history, animal contacts, farm visits, other leisure activities and food consumption during 10 days before symptom onset.

"During 11 explorative interviews, we identified a number of frequently named food items, e.g. minced meat (beef and pork mixed), hot dog-style (Vienna) sausages, as well as several commercially available yoghurts or puddings. 

"Cases and parents also reported having frequently shopped at supermarket chain X. They reported no common place of exposure." 

Investigations into commercial sausage-style meats are ongoing (Photo: Matthieu Joannon)

State food safety authorities conducted inspections and sampling at minced meat producing plants supplying supermarket chain X and others. 

All results of official samples on production sites, retail level and from regional monitoring programmes have been negative for SF STEC O157 so far. Trace-back investigations starting from locations where cases had purchased minced meat or hot dog-style (Vienna) sausages are ongoing.

The report concludes: "Several previous investigations into outbreaks with SF STEC O157 have been unsuccessful in identifying the source, despite intensive efforts of health and food safety authorities. 

"This is the largest outbreak of SF STEC O157 in Germany since 2002 and it has lasted for more than four months already. We assume that the source of infection may still be active and further cases may still occur. 

"According to the feedback obtained via the Epidemic Intelligence Information System (EPIS) of the European Centre for Disease Prevention and Control (ECDC), the German outbreak strain has not been detected in other European countries. 

"In Germany, continued epidemiological investigations, sampling of food isolates and trace-back of food items are needed and ongoing to identify the cause of the outbreak."

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