Thursday, June 2, 2011

NYT > Health: E. Coli Strain Was Previously Unknown, Official Says

NYT > Health


E. Coli Strain Was Previously Unknown, Official Says
2 Jun 2011, 8:19 pm

BERLIN — The unusually lethal strain of E. coli that has infected more than 1,500 people in Germany, mystified public health officials and threatened to touch off panic in Europe, is a previously unknown, "super toxic" variant, international health experts said Thursday.

With hospitals coping with seriously ill victims, sectors of European agriculture staggering and consumers weighing what foods were safe to eat, Russia extended a ban on fresh vegetable imports beyond Spain and Germany to encompass all of the European Union, drawing a sharp response from European officials who called the move "disproportionate."

In Geneva, Gregory Hartl, a spokesman for the World Health Organization, said, "What we understand is this is a strain which has never been detected in an outbreak situation before." He said scientists at "many laboratories" were working to gather more information about the strain.

The origins of the outbreak, which has killed at least 17 people — 16 in Germany and a Swede who visited there recently — remain unknown. A total of 10 countries have now reported cases, but virtually all cases have been traced to northern Germany, where the outbreak began several weeks ago.

In a statement on Thursday, a Chinese laboratory collaborating with German scientists said the contagion had been caused by a "new strain of bacteria that is highly infectious and toxic." The lab, the Beijing Genomics Institute in the southern city of Shenzhen, referred to the strain as "entirely new" and "super toxic," saying it was similar to one known as EAEC 55989 that is found in the Central African Republic and known to cause serious diarrhea. The Chinese laboratory has been working with scientists at the University Medical Center Hamburg-Eppendorf.

"The situation is still tense," said Jörg Debatin, director of the medical center. "At the beginning of the week we had been hoping to see a trend towards fewer infections, but that has not happened."

Holger Rohde, a bacteriologist at the same medical center, said tests conducted with the scientists in Shenzhen had shown that the new strain was a hybrid that causes the virulent complication called hemolytic uremic syndrome, or H.U.S., which attacks the kidneys and can be lethal.

Some 470 of the 1,500 known cases in the E. coli outbreak include H.U.S., a stunning large proportion. Generally, 5 to 10 percent of E. coli illnesses result in this complication.

Dr. Rohde said that about 80 percent of the genetic composition derived from the E. coli strain 0104, but that the other 20 percent came from another more toxic bacterium.

In recent days, the European Center for Disease Control and Prevention, a European Union agency based in Stockholm, and other health authorities in Europe have placed blame for the outbreak on a rare strain of E. coli called O104:H4.

Since 2008, only eight cases have been linked to the strain reported in the European Union, according to the agency, whose Web site was still reporting on Thursday that laboratory results indicated O104:H4 carried in contaminated food was "the causative agent" of the outbreak in Germany and had also been detected in Denmark.

Britain's Health Protection Agency, confirmed that the number of cases in Britain had risen to seven from three, with the bacteria found in people who had recently traveled to Germany.

The W.H.O. said that Austria reported 2 cases, Denmark 7, France 6, the Netherlands 4, Norway 1, Spain 1, Sweden 28 and Switzerland 2. The organization said that all but two were people who had recently visited northern Germany or in one case, had contact with a visitor from northern Germany.

Quite apart from health concerns, the impact of the outbreak spread increasingly to European politics and the Continent's economic relations.

Russian news reports quoted health officials as saying that Moscow's ban on European produce would begin immediately. If strictly enforced, the prohibition would magnify the woes of European Union farmers since Russia ranks among their biggest markets. Farmers in Germany and Spain have already complained that public fear of contagion has forced them to destroy their crops.

"What Russia is doing is disproportionate," Frederic Vincent, the spokesman for the European Union's health commissioner, John Dalli, said Thursday. He said the commission would send a letter later Thursday to Moscow explaining why Russia should remove the restrictions. Russia relies on imports from the European Union for up to 40 percent of its fruits and vegetables and the market is worth up to $5.5 billion annually, according to the commission.

Major growers in Germany are losing up to $7 million daily, and two-thirds of all vegetables, including lettuce and tomatoes, produced by members of the German Federal Association of Producers of Fruit and Vegetables are being destroyed, said Karl Schmitz, director of the association. In Spain, the damage is much broader, with the loss estimated at about $286 million a week.

Late Wednesday, the European Commission removed an alert about the possible dangers of infection from Spanish cucumbers that German authorities originally suspected were responsible. The commission said it lifted the alert after tests conducted by German and Spanish authorities failed to detect the strain of E. coli that caused the illnesses. Mr. Dalli urged German authorities and other national authorities to "increase their efforts" to identify the source of the contamination.

Germans expressed growing anxiety.

When Sarah Winter, a 22-year-old economics student from Cologne,  first heard about the outbreak, she simply shrugged. "Another typical German food scare," she said. "We have these scares once a year. One time it's about contaminated eggs. Another time it's about fodder fed to pigs. And then you get all this media panic. I ended up simply ignoring all of it."

But by Thursday, Ms. Winter had changed her mind.     "It's a big conversation issue among my friends," she said. "Some are no longer eating salads. Others are ignoring the medical recommendations. As for myself, frankly, people have died. For me, that's the bottom line. I no longer eat salads. But then again, this E. coli strain could be in milk, meat, whatever. It is very worrying. I have no idea what to eat anymore."

Alan Cowell reported from Berlin, and James Kanter from Brussels. Reporting was contributed by William Neuman from New York; Victor Homola, Stefan Pauly and Judy Dempsey from Berlin; and Raphael Minder from Motril, Spain.

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