Jun 29, 2011 (CIDRAP News) New trace-back investigations in German and French Escherichia coli outbreaks are pointing to two lots of fenugreek seeds that were imported from Egypt, according to the latest threat assessment from European officials.
Sprouts from Egyptian fenugreek seeds are suspected in both a cluster of French E coli O104:H4 illnesses and the large outbreak in Germany involving the same strain, the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA) said in a risk assessment today. But the agencies cautioned that there is no lab evidence yet tying the seeds to the outbreaks.
The ECDC and the EFSA said they have urgently requested that the German-based company that imported the seeds help them track other customers who received fenugreek seeds from the two lots.
Officials suspect that Egyptian fenugreek seeds imported in 2009 are linked to the French E coli cluster and that a batch from 2010 is linked to the German outbreak. The ECDC identified the seed importer as AGA SAAT GMBH, based in Dusseldorf, Germany. It said a UK company that reportedly supplied the sprout seeds linked to the French cluster obtained the seeds from AGA SAAT GMBH.
So far investigators have not found a sprout connection to a Swedish E coli O104:H4 case reported yesterday, but the investigation is ongoing, the ECDC said. The patient, a man from southern Sweden, does not have a travel history to Germany and does not recall eating sprouts. Food safety experts have cautioned that sprout consumption can be hard to trace, because the item often appears inconspicuously in salads, sandwiches, and garnishes.
Warnings about sprout consumption should cover all sprouts, because seeds sold for sprouting are often sold as mixes, and cross-contamination could occur during repackaging, the ECDC said. The ECDC and the EFSA are urging consumers not to grow their own sprouts and to avoid eating sprouts unless they have been thoroughly cooked.
If the link between the French cluster and the German outbreak is confirmed, more E coli O104:H4 cases are expected in Europe, along with other countries that received the contaminated seeds, the ECDC warned. It urged clinicians to be on alert to quickly identify new E coli infections that might be part of clusters or the outbreak.
In the French cluster, 15 cases of bloody diarrhea have been identified so far, and 11 of the patients attended the same Jun 8 event where sprouts were served. Eight developed hemolytic uremic syndrome (HUS), a potentially fatal kidney complication. Leftover seeds are being tested.
The ECDC said it has received reports of 32 more E coli infections, raising Europe's outbreak total to 4,055. No new HUS cases or deaths were reported, keeping those totals at 885 and 48, respectively,
Jun 29 ECDC risk assessment report
Jun 29 ECDC outbreak update