German E coli outbreak kills 3 more, reaches 3,800 cases

Jim Wappes  Editorial Director

Jun 23, 2011 (CIDRAP News) – World Health Organization (WHO) officials today announced 105 new cases of enterohemorrhagic Escherichia coli (EHEC) and 3 new deaths in an outbreak linked to German sprouts, while the United States added a new case and is investigating whether a death in Arizona is linked to the 3,802-case outbreak.

Of the total, 864 cases have involved hemolytic uremic syndrome (HUS), a potentially deadly kidney disorder, according to a report from the WHO's European regional office. The other 2,938 cases are classified as non-HUS Shiga toxin–producing E coli (STEC).

All but 114 of the cases have been in Germany, and all but 5 of those patients had traveled to Germany. The latest onset of symptoms recorded was Jun 16.

Two of the latest deaths were reported in patients with HUS, while one was in a patient who had STEC. The implicated outbreak strain is E coli O104:H4, a rare variant.

Yesterday the WHO's Regional Office for Europe reported no increases in cases but the day before reported 93. The European Centre for Disease Prevention and Control (ECDC), which covers fewer countries, posted slightly lower numbers in general, with 90 new cases today (for a 3,792-case total) and 15 new cases yesterday.

On Jun 10 Germany's Robert Koch Institute, the country's public health agency, announced that contaminated raw sprouts from a German farm are the likely source of the outbreak. The farm has been shut down and its sprouts are no longer being distributed.

In the United States, the Centers for Disease Control and Prevention (CDC) announced a new case in North Carolina, bringing the nation's total of confirmed cases to five, and said it is investigating a death in Arizona for ties to the outbreak.

In its previous update, on Jun 15, the agency reported four confirmed case plus a suspected case.

Of the five confirmed US cases, three (in Massachusetts, Michigan, and Wisconsin) are HUS, while the other two—the new case and one in Michigan—are non-HUS STEC. The second Michigan case was the only one not associated with travel to Germany, but today's CDC update said the patient likely contracted the disease by contact with the Michigan patient with HUS.

The report said, "Arizona has reported one death in a HUS case with recent travel to Germany. This case has not yet been confirmed to have STEC O104:H4 and is currently under investigation." That person had recently traveled to Germany, the CDC said.

See also:

Jun 23 WHO update

Jun 23 ECDC report

Jun 22 ECDC report

Jun 23 CDC update