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Outbreak of Shiga toxin-producing E. coli in Germany (10 June 2011, 11:00)

10 Jun 2011

Outbreak of Shiga toxin-producing E. coli in Germany (10 June 2011, 11:00)
Epidemiological update, 10 June 2011, 11:00

Since 8 June, Member States have started reporting cases according to a new EU case-definition. This resulted with marginal adjustments of figures compared to previous reports in five Member States, Finland (that is not reporting cases anymore), France, the Netherlands, Sweden and the United Kingdom.

On 22 May, Germany reported a significant increase in the number of patients with haemolytic uremic syndrome (HUS) and bloody diarrhoea caused by Shiga toxin-producing E. coli (STEC). Since 2 May 2011, 795 cases of HUS and 2287 non-HUS STEC cases have been reported from European Union Member States, including 759 HUS cases and 2229 non-HUS STEC cases in Germany. 22 of the HUS cases and 9 non-HUS STEC cases in EU Member states have died. See table below.

While HUS, caused by STEC infections, is usually observed in children under 5 years of age, in this outbreak the great majority of cases are adults, with around two thirds being women.

Laboratory results indicate that STEC serogroup O104:H4 (Stx2-positve, eae-negative, hly-negative, ESBL, aat, aggR, aap) is the causative agent. PFGE results shows indistinguishable pattern of 7 human O104:H4 outbreak strains in Germany and 2 strains of O104:H4 in Denmark.

Although the source of the outbreak is still under investigation, food items originating from a specific farm in northern Germany have been indicated by the German Authorities as the most likely vehicle of infection.

Most cases are from, or have a history of travel to the North of Germany (mainly Schleswig-Holstein, Lower Saxony, North-Rhine-Westphalia and Hamburg). In the EU/EEA, Austria, Denmark, Germany, the Netherlands, Poland, Spain, Sweden and the United Kingdom have reported cases of HUS, while 5 other Member States have reported only non-HUS STEC cases.

Number of HUS and non-HUS STEC cases and associated deaths per EU/EEA Member States as of 10 June 11:00

EU Member States

reporting cases

Number of HUS cases (deaths)

Number of non-HUS STEC cases (deaths)

Austria

1 (0)

3 (0)

Czech Republic

0 (0)

1 (0)

Denmark

8 (0)

12 (0)

France

0 (0)

2 (0)

Germany

759 (21)

2229 (9)

Greece

0 (0)

1 (0)

Luxembourg

0 (0)

1 (0)

The Netherlands

4 (0)

4 (0)

Norway

0 (0)

1 (0)

Poland

2 (0)

0 (0)

Spain

1 (0)

1 (0)

Sweden

17 (1)

30 (0)

The United Kingdom

3 (0)

2 (0)

Total

795 (22)

2 287 (9)

Cases are associated with an exposure in Germany, mainly northern parts. The German Authorities have indicated food originating from a specific farm in Northern Germany as the most likely vehicle of infection. Further investigations are ongoing to identify the original source of the infection. The German Authorities are declaring a decrease of the number of new cases.

STEC is a group of pathogenic Escherichia coli (E. coli) strains capable of producing Shiga toxins, with the potential to cause severe enteric and systemic disease in humans.

Read more

Escherichia coli (E. coli) health topic site
Case definition

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