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Home News centre National Press Releases 2011 Press Releases ›  Update on large outbreak of haemolytic uraemic syndrome caused by E. coli in Germany – important advice for travellers

Update on large outbreak of haemolytic uraemic syndrome caused by E. coli in Germany – important advice for travellers

2 June 2011

10:00hrs

Cases of HUS in Germany have risen to 470, with nine reported deaths. German authorities have also reported 1,064 cases of bloody diarrhoea (VTEC or EHEC infection, caused by E. coli O104) related to the outbreak, with 4 deaths – bringing the total number of official reported deaths in Germany to 13.


The HPA can confirm one new case of HUS and three new cases of bloody diarrhoea in England. All are suspected to be related to this outbreak. Three of the four new cases, including the HUS case, are in UK residents with a recent travel history to Germany and one new case is in a German national on holiday in England. This brings the total number of cases in England to seven – three HUS and four bloody diarrhoea. There are no reports of any secondary infections in England. 

To date the exact source of the contamination has not been determined. The Food Standards Agency has confirmed that they are working closely with industry trade bodies, wholesalers and retailers, and have found no evidence that produce from possible sources identified so far has been distributed to the UK.

The HPA is reminding people travelling to Germany to follow the advice of the authorities and avoid eating raw tomatoes, cucumbers and leafy salad including lettuce, especially in the north of the country, until further notice. In addition anyone returning from Germany with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention their recent travel history.

Dr Dilys Morgan, head of the gastrointestinal, emerging and zoonotic infections department at the HPA, said: "The HPA continues to actively monitor the situation very carefully and we are working with the authorities in Germany and with our counterparts across Europe as to the cause of the outbreak. We have alerted health professionals to the situation and advised them to urgently investigate and report suspected cases with a travel history to Germany."

ENDS

Q&A on HUS and this outbreak.

For media enquiries please contact the national HPA press office at Colindale on 020 8327 7901 or email cfipressoffice@hpa.org.uk. Out of hours the duty press office can be contacted on 020 8200 4400.

 

31 May 2011

17:15hrs

The Health Protection Agency (HPA) can confirm that the German authorities have now reported 373 cases of haemolytic uraemic syndrome (HUS) in Germany and six deaths. It has been found that the outbreak has been caused by a rare organism called verocytotoxin-producing E. coli (VTEC) O104 infection.

The HPA can also confirm that to date, no new cases have been reported in the UK since our last update on Friday. England has so far seen three cases in German nationals, two with HUS and one with bloody diarrhoea. Other countries are continuing to see cases of HUS and bloody diarrhoea but only among returning travellers from Germany. As a result England may see more cases in people returning from Germany.

Investigations into the cause of the outbreak are ongoing and the German authorities are pursuing a number of leads. Initial reports that Spanish cucumbers were the source of the outbreak have not been substantiated and extensive sampling of various food sources is underway.

Until the sources of the outbreak are known, the advice from the German authorities remains the same - that people in Germany should avoid eating raw tomatoes, cucumbers and leafy salad including lettuce, especially in the north of the country, until further notice. The HPA recommends travellers follow this advice. In addition anyone returning from Germany with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention their recent travel history.

ENDS

 

Update on large outbreak of haemolytic uraemic syndrome caused by E. coli in Germany – important advice for travellers

27 May 2011

15.30hrs

The outbreak of haemolytic uraemic syndrome (HUS), a serious complication from verocytotoxin-producing E. coli (VTEC) infection, continues in Germany. The Health Protection Agency (HPA) can confirm that there reports of approximately 276 cases of HUS in Germany with two deaths.

The German authorities have confirmed that they have identified organic cucumbers from two provinces of Spain (Almeria and Malaga) as one of the sources of the outbreak. Investigations are ongoing in Germany to identify other potential sources, while a third suspect batch of cucumbers originating in the Netherlands and traded in Germany is also under investigation. Some food products have also been withdrawn from the German market.

The Food Standards Agency is monitoring the situation closely and stress there is currently no evidence that any affected organic cucumbers from the sources identified have been distributed to the UK.

The European Commission report that the Spanish authorities are focusing their efforts on pinpointing the exact site of production of the organic cucumbers in question.

Until all sources of the outbreak are known, the German authorities are advising people in Germany to avoid eating raw tomatoes, cucumbers and lettuce, especially in the north of the country, until further notice. The HPA recommends travellers follow the advice of the German authorities. In addition anyone returning from Germany with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention any recent travel history.

England has so far seen three cases in German nationals, two with HUS and one with bloody diarrhoea. One of the HUS cases has been confirmed as having VTEC O104 infection which is causing this outbreak. There are no reports of any secondary infection in the UK. Other European countries are continuing to see cases of HUS and bloody diarrhoea among returning travellers.

ENDS

Q&A on HUS and the current outbreak in Germany.

For media enquiries please contact the national HPA press office at Colindale on 020 8327 7901 or email cfipressoffice@hpa.org.uk. Out of hours the duty press office can be contacted on 020 8200 4400.                                                                   

 

Large outbreak of haemolytic uraemic syndrome caused by E. coli in Germany – important advice for travellers

26 May 2011

14:00hrs

The Health Protection Agency (HPA) is aware that Germany is currently experiencing a large outbreak of haemolytic uraemic syndrome (HUS), which is a serious complication from verocytotoxin-producing E. coli (VTEC) infection that requires hospitalisation. Since the second week of May, there have been reports of approximately 214 cases of HUS and two people are reported to have died.

The outbreak is mainly affecting adults - almost 70 per cent of who are female. The cases are occurring mainly in northern Germany, but there are also reports from southern and eastern Germany.

This strain of VTEC infection suspected in this outbreak is O104 which is a rare strain of the infection and seldom seen in the UK.

England has so far seen two cases in German nationals with compatible symptoms. Other European countries have also seen cases of HUS and bloody diarrhoea among returning travellers.

The German authorities believe that a food source of infection is likely, and, early studies implicate raw tomatoes, cucumbers and lettuce. Although it is not clear whether one or more of these food items are associated with the outbreak, as a precaution they are advising people in Germany against eating raw tomatoes, cucumbers and lettuce, especially in the north of the country, until further notice.

The HPA and the National Travel Health Network and Centre (NaTHNaC) advises anyone travelling to Germany to follow the advice from the German authorities. In addition, returning travellers with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention any recent travel history.

The public health organisation in Germany investigating the outbreak also recommend following the standard food and water hygiene advice.

Dr Dilys Morgan, head of the gastrointestinal, emerging and zoonotic infections department at the HPA, said: "The HPA is actively monitoring the situation very carefully and liaising with the authorities in Germany, the European Centre for Disease Control (ECDC) and the World Health Organization (WHO) as to the cause of the outbreak.

"We are keeping a close watch for potential cases reported in England and are working with colleagues in the devolved administrations to recommend they do the same. In addition we are in the process of alerting health professionals to the situation and advising them to urgently investigate potential cases with a travel history to Germany."

The HPA is also working closely with the Department of Health and the Food Standards Agency. The FSA is monitoring the situation closely and if there are any implications for food distributed in the UK they will provide an update.

ENDS

Notes to editors:

1. In this outbreak many more people are suspected to have bloody diarrhoea, which can be serious, or milder forms of the infection which are usually self limiting and clears within seven days. The public health organisation investigating the outbreak in Germany is the Robert Koch Institute http://www.rki.de/

2. Haemolytic Uraemic Syndrome (HUS) is a serious complication from verocytotoxin-producing E. coli (VTEC) infection that affects the blood, kidneys and in severe cases, the central nervous system. It is a serious illness that requires treatment in hospital and can be fatal.

3. The number of severe cases of HUS in a short period is very unusual and the affected age groups in this outbreak are not typical – HUS is a more common complication from E. coli infection in children.

4. Escherichia coli (commonly referred to as E coli) bacteria usually cause diarrhoea which settles within seven days without treatment. There are many strains of the infection. Occasionally, serious kidney and blood complications can occur, such as HUS.

5. Most people normally carry harmless strains of E. coli in their intestine. Both the harmless strains and the strains that cause diarrhoea are acquired primarily through ingestion of contaminated food or water. Person-to-person and animal-to-human transmission is through the oral-faecal route.

6. Good hygiene is very important in preventing person-to person spread and small children should be supervised with hand washing after using the toilet and before eating. Advice on food safety can be found on the NHS Choices website: http://www.nhs.uk/Livewell/homehygiene/Pages/Homehygienehub.aspx

7. Verocytotoxin- producing E. coli (VTEC) O104 is a rare serogroup and further testing of samples is needed to confirm this as the cause of the outbreak. Reports from Germany refer to the VTEC cases as cases of Shiga-toxin producing E. coli (STEC). VTEC is also sometimes called Entrohaemorrhagic E. coli (EHEC).

8. Healthcare professionals and members of the public can find more information about travel health (including country specific advice) by logging onto the National Travel Health Network and Centre (NaTHNaC) website www.nathnac.org

9. The Health Protection Agency is an independent UK organisation that was set up by the government in 2003 to protect the public from threats to their health from infectious diseases and environmental hazards.  It does this by providing advice and information to the general public, to health professionals such as doctors and nurses, and to national and local government. In 2012 the HPA will become part of Public Health England. To find out more, visit our website: www.hpa.org.uk

10. For media enquiries please contact the national HPA press office at Colindale on 020 8327 7901 or email cfipressoffice@hpa.org.uk. Out of hours the duty press office can be contacted on 020 8200 4400.


 

Last reviewed: 2 June 2011