2011 E. coli O104:H4 outbreak

2011 E. coli O104:H4 outbreak
File:E. coli O104-H4.png Electron micrograph of E. coli O104:H4
Disease	Hemolytic-uremic syndrome
Location	Germany, Europe
Date	May 2011 – July 2011
Deaths	53

The 2011 E. coli O104:H4 outbreak was a significant public health event that occurred primarily in Germany and affected several other countries in Europe. The outbreak was caused by a rare strain of Escherichia coli known as O104:H4, which led to severe illness and numerous fatalities.

Background

Escherichia coli (E. coli) is a bacterium commonly found in the intestines of humans and animals. While most strains are harmless, some can cause severe foodborne illness. The O104:H4 strain is particularly virulent and is known to produce Shiga toxin, which can lead to hemolytic-uremic syndrome (HUS), a condition characterized by kidney failure, hemolytic anemia, and low platelet count.

Outbreak Details

The outbreak began in May 2011, with the first cases reported in northern Germany. It quickly spread, with the majority of cases occurring in Germany, but also affecting people in other European countries, including Sweden, Denmark, and the Netherlands. The outbreak was linked to the consumption of contaminated fenugreek sprouts.

Symptoms and Diagnosis

Patients infected with the E. coli O104:H4 strain typically presented with severe gastroenteritis, bloody diarrhea, and in some cases, progressed to hemolytic-uremic syndrome. Diagnosis was confirmed through stool cultures and identification of the specific strain using molecular techniques.

Response and Control Measures

The outbreak prompted a swift response from public health authorities. The Robert Koch Institute in Germany, along with the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO), coordinated efforts to identify the source and contain the outbreak. Public health advisories were issued, warning against the consumption of raw sprouts.

Epidemiology

The outbreak resulted in 3,950 confirmed cases and 53 deaths. The majority of cases were reported in adults, with a higher incidence in women. The unusual demographic pattern was attributed to dietary habits, as women were more likely to consume raw vegetables and sprouts.

Investigation and Source Identification

Initial investigations struggled to pinpoint the source of the outbreak. After extensive epidemiological studies, the source was traced to a farm in Lower Saxony, Germany, which produced fenugreek sprouts. The contamination was believed to have originated from imported seeds.

Impact and Lessons Learned

The 2011 E. coli O104:H4 outbreak highlighted the challenges in tracing foodborne pathogens and the importance of rapid response and international collaboration. It led to increased scrutiny of food safety practices and regulations, particularly concerning the production and distribution of sprouts.

Also see

• Escherichia coli
• Foodborne illness
• Hemolytic-uremic syndrome
• Shiga toxin
• Public health