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Sprouts Are the Cause, Who’s to Blame?

So the mystery of Germany’s sproutbreak is finally solved.  Let the finger-pointing begin.

Nearly six weeks into the European epidemic of toxic E. coli O104:H4, German authorities Friday confirmed what had been suspected for days – that it was locally grown sprouts from an organic farm in Lower Saxony that sickened more than 3,000 people.

But that announcement only intensified public criticism targeting public health officials at the Robert Koch Institute (RKI) and other German agencies responsible for food safety.

First detected in the first few days of May, the outbreak has raged unabated for nearly six weeks, with the toll mounting daily – 3,086 sick, 789 with hemolytic uremic syndrome, 31 dead.  Critics pointed out that hundreds, even thousands of illnesses might have been prevented had the source been identified sooner and pulled from regional markets and restaurants.

To make matters worse, public attention was drawn for more than a week to other vegetables, especially cucumbers from Spain, which were wrongly fingered as a possible source.

The German establishment newspaper Der Spiegel compiled criticisms from all points in the the political spectrum. 

The conservative Die Welt:  “Why did authorities look at Spanish cucumbers so long and so intensely in their search for the E. coli source when a closer look revealed them to be innocent?  Why did the E. coli hunters not focus much sooner on the sprouts from Lower Saxony?”

That paper pointed out that another German agency, the Federal Institute for Risk Assessment, had warned consumers about “bacterial contamination of sprouts and kitchen-ready salad mixtures.” That warning was updated in early May, even as the outbreak was beginning. “Why didn’t the alarm bells go off at the agency?” the newspaper asked.

The leftist Frankfurter Rundschau sees a paralyzing conflict between federal and regional authorities. The RKI “isn’t allowed to question patients (because) that’s the domain of regional authorities,” the paper said.

That critique reinforced the observations of U.S. epidemiologists, who have wondered from the outset why German officials were so slow to interview victims about what they had eaten in previous days and weeks.

“You don’t have to interview everybody, just a statistical sample,” said Dr. Kirk Smith, foodborne illness director at the Minnesota Department of Health.  But tracing outbreaks to their source depends on quick and thorough interviews, using people trained to conduct such interviews, he said.

He and others pointed out that the concentration of illnesses in northern Germany should have made the investigation much easier – and quicker. With hundreds of illnesses in a relatively small area, the source is likely to be local — which should have cast serious doubt on the Spanish cucumber theory.

In another critique compiled by Der Spiegel, the Berlin daily Tagesspiegel commented; “Organic is good, chemicals (are) bad.  We get this message drummed into us every day.  It is a macabre irony that evil chemistry … is now saving people whose lives have been endangered by organic food.”

Other critics focused on the nature of German political authority, which places substantial responsibility with regional health officials. They suggest that a stronger federal authority might have been able to detect and respond more quickly to the epidemic.

That analysis is similar to the continuing debate over public health in the U.S., where some state health departments are consistently more successful than others at dealing with foodborne illness.

 

© Food Safety News
  • Gabrielle Meunier

    I know that authorities believe that a human to human interview needs to happen in a foodborne illness outbreak, but I believe that is much too slow especially in an epidemic where lives are at risk (of course you don’t know this in the beginning). From my first hand experience of being involved in a National Outbreak, I believe that any individual diagnosed with a foodborne illness should be directed either at the Doctor’s office or the hospital where the diagnoses was made, to a website to take a food intake survey. This survey should be correlated daily on a national level (for Europe, I would suggest the European union level). I believe the survey should be in a critical pathogen order. We’ve all known for years that sprouts are dangerous. This survey should have the foods most susceptible to pathogens first for submittal and correlation, then the second part can be all other foods. It isn’t rocket scientry. Local authorities will benefit from the speed of data availability (i.e. Rhode Island Bakery — results even sooner to warn people not to eat at the Bakery.) and national outbreaks will benefit enormously.

  • José M. Carré

    I believe that discussing about at which administration level should foodborne illnesses should be followed-up is missing the point.
    Much more important is that German and European health authorities should thoroughly review their procedures and come up with a more effective way.
    At this particular case, it seems that they totally ignored the data available from the beginning. All cases originated at Northern Germany. Even if the problem came from Spanish cucumbers, it was clear that these were not contaminated at source. So, they should have been looking at wholesalers and transportation withing Germany.
    Moreover, pointing the finger at a particular problem, without having data that confirms that it was the same E.coli strain is a terrible mistake. This issue alone should be reason enough to some kind of fine or reprimand. It is causing severe economical damages on farmers across Europe.

  • hhamil

    Why does Food Safety News unequivocally state, “Sprouts Are the Cause”?
    The most recent joint press release (http://www.ecdc.europa.eu/en/press/news/Documents/1106_Joint_Press_Release_German_authorities_issue_a_joint_statement.pdf) from the German regulators says only the following of its 3 studies:
    1. “In these, only 3 of 12 patients reported having eaten sprouts.”
    2. “Overall, 16 (30%) of 54 patients who could answer questions on the consumption of sprouts in the context of these extensive interviews stated having eaten sprouts within the time frame consistent with the period of acquisition of the infection.”
    3. “In this study, 6 (25%) of 24 cases stated having eaten sprouts in the incriminated period of infection, compared to 7 (9%) of 80 healthy controls.”
    4. “Distribution supply chains of sprouts originating from the Lower Saxony producer can explain 26 of 55 EHEC O104:H4 disease clusters or isolated cases in 5 German states.”
    As the German regulators state their 3 epidemiological cases studies have dietary correlations of only 25, 30 and 25% and they have only accounted for less than half of the disease clusters, it is clear to me that Food Safety News has joined the mainstream media in jumping to the conclusion that this is a single outbreak AND that it has been solved. The data does not support either conclusion.
    Furthermore, many of the 3086 illnesses are NOT being investigated by the German authorities.
    This premature closure is occurring in exactly the same way as occurred during the FDA/CDC’s incompetent handling of 2008 tomato/pepper salmonella enteritidis cases.
    This might be excusable in mainstream media but Food Safety News states that it “is about using the Web to put as much available food safety information in one place as is possible.” MeatingPlace.com and CICRAP (e.g., http://www.cidrap.umn.edu/cidrap/content/fs/food-disease/news/jun1011sprouts-br.html) have included important details that are NOT in FSN’s reports.

  • I do agree that this German cucumber/sprout outbreak will likely look a lot like the tomato/pepper outbreak in the end – http://www.nejm.org/doi/full/10.1056/NEJMoa1005741

  • Harry Hamil

    Why does Food Safety News unequivocally state, “Sprouts Are the Cause”?
    The most recent joint press release (http://www.ecdc.europa.eu/en/press/news/Documents/1106_Joint_Press_Release_German_authorities_issue_a_joint_statement.pdf) from the German regulators says only the following of its 3 studies:
    1. “In these, only 3 of 12 patients reported having eaten sprouts.”
    2. “Overall, 16 (30%) of 54 patients who could answer questions on the consumption of sprouts in the context of these extensive interviews stated having eaten sprouts within the time frame consistent with the period of acquisition of the infection.”
    3. “In this study, 6 (25%) of 24 cases stated having eaten sprouts in the incriminated period of infection, compared to 7 (9%) of 80 healthy controls.”
    4. “Distribution supply chains of sprouts originating from the Lower Saxony producer can explain 26 of 55 EHEC O104:H4 disease clusters or isolated cases in 5 German states.”
    As the German regulators state their 3 epidemiological cases studies have dietary correlations of only 25, 30 and 25% and they have only accounted for less than half of the disease clusters, it is clear to me that Food Safety News has joined the mainstream media in jumping to the conclusion that this is a single outbreak AND that it has been solved. The data does not support either conclusion.
    Furthermore, many of the 3086 illnesses are NOT being investigated by the German authorities.
    This premature closure is occurring in exactly the same way as occurred during the FDA/CDC’s incompetent handling of 2008 tomato/pepper salmonella enteritidis cases.
    This might be excusable in mainstream media but Food Safety News states that it “is about using the Web to put as much available food safety information in one place as is possible.” MeatingPlace.com and CICRAP (e.g., http://www.cidrap.umn.edu/cidrap/content/fs/food-disease/news/jun1011sprouts-br.html) have included important details that are NOT in FSN’s reports.

  • Ray James

    I like Gabrielle Meuniers suggestion on the web based online food questionar.

  • Pain is one that now not in the first page for the news.
    It seems that they do not like the good news of Spain.
    Been they have never infected cucumbers of Spain
    I hope that the compensation is so clay as the caused damage, to the economy and the image.

  • Doc Mudd

    Let’s not conveniently forget the organic Spanish cucumbers were proven contaminated with E. coli. It just didn’t happen to be the exact genetic strain from the food poisoning victims.
    http://www.euronews.net/2011/05/27/german-e-coli-linked-to-spanish-cucumbers/
    The contaminated organic cukes were poised to eventually initiate their own food poisoning outbreak if the organic sprouts hadn’t been faster on the draw…this time.