German E. Coli Sleuths Eye Sprouts as Source of Outbreak

Germany's Health Minister Daniel Bahr
The number of patients sickened by the outbreak has created a “tense situation” for hospitals in the northern part of the country, Daniel Bahr, Germany’s health minister, said in an interview with Bild am Sonntag yesterday. Photographer: Sean Gallup/Getty Images

German officials said sprouts from an organic farm near the town of Uelzen played a role in the country’s lethal E. coli outbreak, returning suspicions to the region where the infections began last month.

The outbreak has killed 22 people and sickened 2,333, according to the European Centre for Disease Prevention and Control, and put pressure on hospitals near the hard-hit areas of Hamburg and Bremen. At least one worker at the farm near Uelzen has been infected with E. coli and it supplied places where the bacterium was found, Gert Lindemann, the state agriculture minister, told reporters in Hanover yesterday.

German officials initially blamed Spanish cucumbers, causing outrage in the southern European nation. Sprouts may have been overlooked at first because they’re used in an array of dishes including salads and sandwiches, and as a garnish, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis.

“People don’t think of them as produce,” Osterholm said in a telephone interview today. Even so, “sprouts should have just screamed at the investigators” after they were implicated in earlier outbreaks, he said. E. coli-contaminated radish sprouts were blamed for sickening about 6,000 people in Japan in 1996, according to a 1997 report by the U.S. Centers for Disease Control and Prevention.

Bean and Broccoli

About 18 different sprouts grown by the company, including bean, broccoli and garlic, are under investigation, Lindemann said yesterday. The sprouts can’t be solely to blame for the outbreak, he added.

Pinpointing where and how the germ entered the food chain will enable authorities to control the outbreak, which the European Centre for Disease Prevention said caused 21 deaths in Germany and one in Sweden.

The organic farm, called Gaertnerhof Bienenbuettel, said in a statement it had informed customers and was “shocked and concerned” by the news. Only water and seeds are used to grow sprouts and no animal manure is used as fertilizer in the process, Klaus Verbeck, the owner, said in an interview with Neuen Osnabruecker Zeitung today. Black-and-white cows graze in a nearby field. Cattle are the main reservoir for E. coli.

More than a quarter of the people reported to have been sickened by the new enterohemorrhagic E. coli bacteria developed a potentially deadly kidney complication known as hemolytic uremic syndrome.

Definitive Tests

“The source of the outbreak is under investigation, but contaminated food seems the most likely vehicle of infection,” the Stockholm-based ECDC said in a statement.

Officials in Lower Saxony warned against eating sprouts, tomatoes, cucumber as well as salads and said results of more definitive tests may be released today.

It’s unclear whether the bacteria came from the water the sprout seeds were grown in or the seedlings themselves, which came both from within Germany and from outside the country, Lindemann said. The farm has been shut down, he said.

Sprouts were either delivered directly by the farm or through a distributor to the states of Hamburg, Schleswig-Holstein, Mecklenburg-Vorpommern, Lower Saxony and Hesse, Lindemann said.

Luebeck Restaurant

The German variant of E. coli, known as O104, is a hybrid of strains that can cause hemolytic uremic syndrome and bloody diarrhea as well as resistance to about a dozen antibiotics.

Some patients require the use of dialysis to cleanse the blood. Patients also may need transfusions after the bacteria dissolves their red blood cells, said Robert Tauxe, deputy director of food-borne illness at the U.S. Centers for Disease Control and Prevention.

E. coli commonly occur in the human gastrointestinal tract, where they usually cause no harm.

A restaurant in Luebeck, Germany, being investigated after 17 people became ill with the same strain of E. coli, received supplies from Hamburg, the owner told ZDF television in an interview yesterday. Luebeck is about 65 kilometers (40 miles) northeast of Hamburg, which European Union Health Commissioner John Dalli said last week was the “epicenter” of the outbreak.

Authorities investigated the restaurant as a possible source of cases in the outbreak, Luebecker Nachrichten reported last week.

Members of the German Tax Administration Union, a Danish tour group and a family became ill with enterohemorrhagic E. coli, after eating steak and salad at the Kartoffelkellar, owner Joachim Berger told ZDF. A 47-year-old female member of the tax union has died and two other members have life-threatening conditions, ZDF said, citing the union.

‘Tense Situation’

The number of patients sickened by the outbreak has created a “tense situation” for hospitals in the northern part of the country, Daniel Bahr, Germany’s health minister, said in an interview with Bild am Sonntag yesterday.

The lack of capacity at hospitals there, particularly in the hard-hit areas of Hamburg and Bremen, could be offset by hospitals in other regions, Bahr said in the interview.

The rate of new infections in Hamburg has slowed in the last two days, Cornelia Pruefer-Storcks, the north German state’s senator for health, said in an interview with television station NDR. The information should be assessed with caution and people should continue to avoid eating lettuce, tomatoes and cucumbers.

The EU is engaged in “intensive work” to identify the source of the outbreak after tests failed to confirm an initial view that cucumbers from Spain were to blame, Dalli said at a June 3 news conference. Further testing by authorities in Hamburg showed the strain taken from the cucumbers was not the same found in the stool of patients.

Import Bans

Qatar imposed a temporary ban on the importation of tomatoes, lettuce and cucumbers from Germany and Spain, the Qatar News Agency reported, citing a decision from the Supreme Council of Health. Ships carrying fruit and vegetables from Europe must have documents proving they are free of E. coli, the news agency said.

Spanish fruit and vegetable producers are losing 225 million euros ($329 million) a week because of the outbreak as demand falls and prices slump, said Jose Maria Pozancos, director general of trade group FEPEX.

Usually E. coli is transmitted when feces, often from an animal source, are ingested. In a 2006 California outbreak, spinach was contaminated with E. coli, killing 3 people and sickening 200. Cow feces had contaminated the water where the vegetables were growing.


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