Sprout seeds suspected in French E coli cluster

Jun 27, 2011 (CIDRAP News) – France has reported a cluster of Escherichia coli O104:H4 infections that officials suspect may be linked to sprouts from a local source, fueling suspicions that contaminated seeds might be the source of both Germany's huge E coli outbreak and the French illnesses.

The European Centre for Disease Prevention and Control (ECDC) said today that eight people in the same area of the Bordeaux region got sick with bloody diarrhea after attending the same event, and E coli O104:H4—the same serotype as in the German epidemic—has been confirmed in three patients. Seven of the patients have developed hemolytic uremic syndrome (HUS), a potentially fatal kidney complication. A high proportion of patients with HUS has also been seen in Germany's outbreak.

A spokeswoman for the regional health agency in Aquitaine, France, said most of the infections have been traced to a charity event in Begles, a suburb of Bordeaux, where many of the sick patients said they ate gazpacho garnished with sprouts, the New York Times reported yesterday.

The World Health Organization's (WHO's) European regional office said today that six of the patients are women and two are men. A high proportion of women patients was also a feature of Germany's outbreak, especially during the first several weeks.

Investigation into the source of the French infections is ongoing, but the WHO said in a statement that the first findings suggest locally produced sprouts might be the culprit. It said trace-back studies are underway to determine if the French and German producers shared a common source for sprout seeds. Other potential food vehicles are also under consideration, according to the WHO.

The European Food Safety Authority (EFSA) said yesterday that it was setting up a task force to coordinate efforts to pin down the source of any contaminated sprout seeds. In a statement, it said the task force will explore the production and distribution chain of seeds, bean spouts, and other sprouted seeds throughout the European Union. The task force includes experts from the ECDC, the European Commission, EU member states, and the WHO.

Though seeds haven't definitively been established as the source of the French cases, if confirmed they could be a common link between the French cluster and the German outbreak, the EFSA added.

According to media reports, investigators have suggested a possible link to sprout seeds from British company Thompson & Morgan, which has said it doesn't believe its seeds are the source of the French outbreak, Reuters reported. However, the company is no longer selling white mustard, rocket, and fenugreek sprouting seeds, though it has not recalled the products from stores and customers, the Telegraph, a London-based newspaper, reported today.

Britain's Food Standards Agency (FSA) said that despite a possible link to the British seed distributor, no cases in the UK have been linked to the French outbreak, according to a Jun 25 statement. In light of the French cluster, it revised its guidance on eating sprouts from seeds such as alfalfa, mung, and fenugreek, emphasizing that the sprouts should be not be eaten raw, but only after they have been cooked thoroughly.

Meanwhile, the number of cases in Germany's E coli outbreak continued to grow, but at a slower pace, according to the WHO update. Since Jun 24, it has received reports of 84 more cases, which include 7 patients with HUS. Three more deaths were reported. So far the outbreak has sickened 3,920 patients, of which 877 had HUS. So far 48 deaths have been reported.

See also:

Jun 27 ECDC press release

Jun 27 WHO Europe regional office press release

Jun 26 EFSA press release

Jun 26 New York Times story

Jun 27 Reuters story

Jun 27 Telegraph story

Jun 25 FSA statement

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