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New Discovery: E. Coli Mystery Deepens as Deadly Strain Found on Cucumber

Confusion over the source of the deadly E. coli bacteria grew on Wednesday when health officials detected it on a discarded cucumber in the eastern city of Magdeburg. Meanwhile, German authorities said they had found two new clues pointing to a sprout farm that may have been a source of the germ.

Suspicion has fallen on cucumbers again following the discovery of an infected cucumber in a garbage can in Magdeburg. Zoom
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Suspicion has fallen on cucumbers again following the discovery of an infected cucumber in a garbage can in Magdeburg.

Investigators in Germany on Wednesday discovered the deadly EHEC strain of E. coli on food for the first time since the outbreak -- on a piece of cucumber retrieved from the garbage of a family infected with the bacterium.

A spokesman for the Health Ministry of the eastern state of Saxony-Anhalt said the pathogen was the same as the one that has caused 26 deaths and infected more than 2,600 people, most of them in northern Germany, since early May.

However, as the cucumber had been in the garbage bin for two weeks, it was impossible to determine conclusively where the bacteria came from and how it got into the trash, the spokesman said. He added that a member of the family of three had mentioned eating cucumbers before falling ill. The family had not visited northern Germany.

Health officials have warned against eating cucumbers, tomatoes, lettuce or sprouts. A warning last month that cucumbers from Spain might be the source of the outbreak was disproved.

Growing Indications Sprouts Were Tainted

Earlier on Wednesday, German authorities had said there were growing indications that bean sprouts delivered by an organic farm in Bienenbüttel first identified as a possible source on Sunday may indeed be a cause of the outbreak.

Health officials found two fresh clues that point to the farm near the town of Uelzen in northern Germany, the regional Consumer Protection Ministry of Lower Saxony said.

Ministry spokesman Gert Hahne said a total of 18 people infected with EHEC, the deadly strain of the bacteria, around the northern port city of Cuxhaven ate sprouts from the farm in a company cafeteria.

In addition, three female workers at the farm suffered from diarrhea in the first half of May, and one of them is known to have been contaminated with EHEC. Their work included packaging the sprouts.

The ministry spokesman said it was possible that one of the women accidentally "fed the pathogen into the operations of the company." Or they might have been infected with EHEC at the farm.

Reuters reported that a local doctor said a worker at the farm had become severely ill with E. coli and had part of her intestine removed. The 54-year-old woman developed bloody diarrhea followed by serious blood disorders.

Anton Schafmayer, a doctor who operated on her, said she had eaten the sprouts. "It went very fast. Such a pace is very rare," he told Reuters. "The surgery probably saved her. We removed a large part of the lower intestine."

The Lower Saxony ministry spokesman said that despite the additional clues pointing to the sprout farm, it was still possible that the nationwide epidemic stemmed from several sources.

Four company canteens and three restaurants where people caught EHEC are now known to have been supplied by the Bienenbüttel farm -- infecting about 100 of the more than 2,600 EHEC patients in Germany. So far, no EHEC bacteria have been found at the farm.

'The Worst May be Over'

German Health Minister Daniel Bahr said the number of new infections had declined, but that there was no reason to sound the all clear. The death toll in Germany rose by one to 25 on Wednesday. One other patient has died in Sweden.

There is cause for optimism "that we're over the worst," Bahr told a news conference after a meeting of health officials in Berlin on Wednesday. But he added: "Sadly we can't rule out that there will be further deaths."

Hamburg's state health minister, Cornelia Prüfer-Storcks said: "We are seeing the first patients discharged, others are getting much better, so the first glimmers of hope are on the horizon".

Consumers remain deeply cautious and are shunning a wide range of fruit and vegetables -- not just the sprouts, raw tomatoes, lettuce and cucumbers mentioned by health officials as possible sources.

Sales of strawberries, radishes, carrots and broccoli are down sharply. Tomato sales fell by almost 50 percent in the second half of May, with a 60 percent slump in lettuces, the Agricultural Market Information service said. Radishes and strawberries were down by a third.

Consumer Protection Minister Ilse Aigner again defended the government's handling of the crisis on Wednesday in the face of growing criticism in Germany and abroad that the disease control system is too slow and too fragmented.

"The system is working," she said. "The national government and regional states are pulling together."

cro -- with wire reports

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Photo Gallery: Germany Still Hunting the Source of Deadly E.Coli Strain

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Unleashed Aggressor: How the E. coli serotype O104:H4 attacks the body
What to Know about E. Coli
Which E. coli strain is causing the outbreak?
There are hundreds of different types of Escherichia Coli, E. Coli, strains, most of which are harmless for humans. Strains are differentiated by their so-called serotypes -- variations within a subspecies of bacteria -- usually with the designations "O" and "H". "O" indicates the lipopolysaccharides, a type of sugar-fat molecule, found on the outer surface of the bacteria; "H" stands for the type of flagella found on the bacteria (flagella are the hairs the bacteria uses to move itself). E. coli bacteria are designated as enterohemorrhagic when they lead to bloody diarrhea in humans. This occurs because some subtypes, like the one currently causing panic in Germany, produce a certain poison, so-called Shiga toxins. The E. coli strain linked to the outbreak in Germany is being identified as E. Coli serotype 0104:H4. Experts have been especially surprised by the strain's aggressive nature and rapid spread. They first thought the strain to be a mutation of serotype 0104:H4. But initial genetic analysis suggests that the bacterium in question is actually a unique variant of the strain: According to the World Health Organization, this type of Enterohemmorhagic E. Coli (EHEC) has been seen in humans before but has never before been linked to an outbreak.
How can the risk of disease be reduced?
There is no vaccine currently available and treatment with antibiotics can be problematic. The reason: the E. coli bacteria in question release a dangerous (Shiga) toxin into the human body, and antibiotics can actually increase the amount of poison released. Good hygiene is one way to significantly decrease the risk of E. coli infection. Facial contact should be avoided after having handled animals or touched the floor. Raw meat and easily-spoiled foodstuffs should be stored at appropriate temperatures in a refrigerator or freezer. When cooking, foodstuffs should be cooked through in order to kill bacteria (at least 10 minutes at 70 degrees Celsius, 158 Fahrenheit). Wash hands regularly. Cutting boards, dishes and utensils should all be washed thoroughly. Avoid unpasteurized milk and unpasteurized milk products.
How can I tell if I've been infected by the E. coli bacteria?
The most common symptom of E. coli infection is heavy, and possibly bloody, diarrhea. Other possible symptoms include nausea, vomiting and, in rare cases, fever.
What can doctors do in the case of 0104:H4 infection?
The incubation period of O104:H4 is 10 to 13 days. Characteristic symptoms of the strain include bloody diarrhea, kidney failure and anemia. Experts have linked O104:H4 to haemolytic uraemic syndrome (HUS), which can lead to kidney failure and even death. With current knowledge, experts do not yet have the means necessary to effectively combat the O104:H4 pathogen. They are therefore treating the typical complications and symptoms as a whole, for instance through plasmapheresis, essentially a blood plasma transfusion. Some of those who are currently infected are also undergoing an experimental therapy of antibody treatment.
What should be done if symptoms arise?
In the case of serious diarrhea, saline- and fluid-loss need to be compensated for. If serious symptoms appear, medical treatment should be sought. In order to counteract potential complications as quickly as possible, those who are in extreme danger -- infants, small children or the elderly -- should be treated in a hospital.
What are other causes of gastrointestinal illnesses?
Gastrointestinal illnesses are among the most common infectious diseases in the world, and can be caused by germs other than E. coli. The norovirus circulates throughout the year and reaches its peak during the winter months. Its incubation period, at least six hours, is short. The norovirus also causes abdominal pains and fatigue, and is primarily spread via humans. During peak periods of illness, the victims are highly contagious.
The rotavirus is the most common cause of viral gastrointestinal disease in children. Ninety percent of children catch the virus before age three. Life-threatening dehydration is a possible effect. Other causes for gastrointestinal illnesses are salmonella and staphylococci.


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