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Asymptomatic E. coli Infections Pose New EU Threat

After four students in Germany were sickened by E. coli O104:H4 infections, preliminary tests indicated that 22 out of 30 children at the same school were also infected with the outbreak strain but had no symptoms, health officials reported this week.

Asymptomatic E. coli O104:H4 infection was also found in three kitchen workers at the school in Kreis Paderborn, four child care employees at four different day-care centers in the district and three workers at the catering company that supplied school food, the European Centre for Disease Prevention and Control (ECDC) said in its latest risk-assessment report  on the massive outbreak that began in Germany in May.

The children’s infections “resulted most likely from foodborne” transmission rather than from person-to-person transmission, the ECDC said, but such a “significant proportion of asymptomatic carriers” of the pathogen “represent a risk for new foodborne outbreaks,” in particular if those carriers are food handlers.

“Considering the large number of summer festivals and mass gatherings in the EU, with sometimes inadequate food hygiene standards, targeted public health measures for such events could be of value to prevent further spread,” the ECDC suggested, adding ” … information to the public should stress the need for proper hand washing.”

European health authorities have previously noted that the estimated eight-day incubation period for the O104:H4 strain is longer than the typical three to eight days for most Shiga toxin-producing E. coli infections, and that “may indicate a low infectious dose, which may influence the likelihood of person-to-person and foodborne transmissions by infected persons.” 

However, so far person-to-person transmission does not appear to have been a major factor in the spread of the epidemic, the ECDC report stated. While some secondary infections have been confirmed, there isn’t much evidence of a large occurrence of secondary person-to-person exposure. In particular, no cases of O104:H4 illness in day-care centers, schools or nursing homes have been through secondary infection.

“Another important factor in monitoring the future epidemiology is whether or not the strain has established — or could establish — itself within an animal reservoir,” the ECDC said.

Although the ECDC reported “a dramatic decline” in the number of O104 cases in Germany in the last two weeks, it noted that new cases and clusters are continuing to be reported, despite the identification of sprouts as the most likely source of the outbreak that has caused more than 3,800 illnesses and at least 45 deaths.  

Since the European Food Safety Authority implicated contaminated fenugreek seeds imported from Egypt, the European Commission recalled and temporarily banned the import of certain types of seeds used for sprouting. It also has warned consumers not to grow their own sprouts for consumption or to eat sprouts unless they are cooked thoroughly.

While new cases may arise as the result of other contaminated foods or contaminated seeds   still in circulation, the “main reason for concern at this stage” in the outbreak, the ECDC wrote, is evidence from clusters like the one at the Kreis Paderborn school of “a substantial proportion of subclinical infections.”

© Food Safety News
  • Doc Mudd

    “Another important factor in monitoring the future epidemiology is whether or not the strain has established — or could establish — itself within an animal reservoir,” the ECDC said.
    Heh, looks like Germans make a pretty satisfactory reservoir, themselves. Who needs an animal reservoir when food service staff might keep over 70% of students subclinically infected?
    Damned fools were pre-occupied with anal-retentive hand-wringing over GMO and suchlike, but let meaningful routine food safety protocols slide to the extent that some little organic farmer could poison the entire freakin’ nation. There ought to be a lesson or two about priorities and risk management in there for sensible politicians everywhere to take note of.
    Where were all the self-important raging activists who should have been clamoring for strict legislation to prevent this sort of food poisoning outbreak? Where are they now? Crickets.

  • DM

    Ahem… there you go again, Mudd muddying up the facts with your own “anal-retentive hand-wringing” and your usual nasty and insulting spin. No wonder you have no credibility.
    FYI:
    — the major contamination outbreaks occurred separately in Germany and France — and both have been traced back to contaminated fenugreek seeds imported from Egypt as the most likely cause. No other sources have been held responsible.
    — what is known is this rare O104:H4 strain has recently evolved with much more virulence — but there’s little experience with how it manifests, how it is spread and even where it is able to reside. This report of subclinical infections via asymptomatic carriers adds a worrisome new dimension for potential secondary infections — and presents new difficulties in instituting effective risk management protocols…

  • My thanks to Food Safety News for bringing this important update to our attention. I know of no other news source that makes this type of information so readily available. The ECDC update raises several very important issues for all of us interested in improving the safety of the food available to all people.
    This article created a perfect opportunity for readers and FSN staff to further discuss the emerging issues outlined in the update as FSN appears to want by having entitled the space reserved for posts as “Discuss.” Unfortunately FSN has once again permitted the troll (as defined by the E-zine, Grist) “Doc Mudd” to make a post that probably will stop any chance for a meaningful discussion. That, of course, is a primary goal of trolls.
    This coupled with Bill Marler‚Äôs demonizing of the local food movement in his comments yesterday in ‚ÄúHawaii Might Ditch New Food Safety Law‚Äù (http://www.foodsafetynews.com/2011/07/hawaii-might-dish-new-food-safety-law/) are the straws that broke the camel’s back for me.
    I intend to not make another comment on any article on Food Safety News with the exception that I may choose to defend an unwarranted attack like that of Marler cited above. Simply put, I need to focus on growing, distributing and retailing local, healthy food. I can’t afford the time to try to set the record straight after foolish, know-it-all comments like Bill Marler’s in this article. He certainly has shown no evidence to being open to my opinions.
    Extending the simile of Dan Flynn about the John Adams’ and Thomas Jefferson’s relationship, I see Food Safety News as being like one of the newspapers of their period of history. FSN seems to me to be partisan because its publisher seems to find it nearly impossible to not be partisan. Bill Marler is an advocate to his core. I see no reason to believe that my further participation in Food Safety News is worth the effort. The FSN understanding of food safety, and the legislation and regulation about it, seems close to being written in stone and not open to new information or other points of view.
    In addition, FSN protects the identity of a person (“Doc Mudd”) who is clearly a troll in the blogging meaning of that word and has repeatedly viciously maligns people. And, it has allowed others to do so. FSN has never shown its readers that it has ever stopped clearly such false statements and personal attacks. Though FSN‚Äôs bully pulpit continues to get larger, I choose to ignore it because I don’t see it as any longer meriting my time and I choose to withdraw any appearance of supporting that type of journalism.
    As always, I will happily respond to personal e-mails about what I have written if addressed to me at healthyfoodcoalition@gmail.com.
    Goodbye.

  • Doc Mudd

    I wish your camel a speedy recovery, Harry.
    But my poor crickets may never be the same.

  • My thanks to Food Safety News for bringing this important update to our attention. I know of no other news source that makes this type of information so readily available. The ECDC update raises several very important issues for all of us interested in improving the safety of the food available to all people.
    This article created a perfect opportunity for readers and FSN staff to further discuss the emerging issues outlined in the update as FSN appears to want by having entitled the space reserved for posts as “Discuss.” Unfortunately FSN has once again permitted the troll (as defined by the E-zine, Grist) “Doc Mudd” to make a post that probably will stop any chance for a meaningful discussion. That, of course, is a primary goal of trolls.
    This coupled with Bill Marler‚Äôs demonizing of the local food movement in his comments yesterday in ‚ÄúHawaii Might Ditch New Food Safety Law‚Äù (http://www.foodsafetynews.com/2011/07/hawaii-might-dish-new-food-safety-law/) are the straws that broke the camel’s back for me.
    I intend to not make another comment on any article on Food Safety News with the exception that I may choose to defend an unwarranted attack like that of Marler cited above. Simply put, I need to focus on growing, distributing and retailing local, healthy food. I can’t afford the time to try to set the record straight after foolish, know-it-all comments like Bill Marler’s in this article. He certainly has shown no evidence to being open to my opinions.
    Extending the simile of Dan Flynn about the John Adams’ and Thomas Jefferson’s relationship, I see Food Safety News as being like one of the newspapers of their period of history. FSN seems to me to be partisan because its publisher seems to find it nearly impossible to not be partisan. Bill Marler is an advocate to his core. I see no reason to believe that my further participation in Food Safety News is worth the effort. The FSN understanding of food safety, and the legislation and regulation about it, seems close to being written in stone and not open to new information or other points of view.
    In addition, FSN protects the identity of a person (“Doc Mudd”) who is clearly a troll in the blogging meaning of that word and has repeatedly viciously maligns people. And, it has allowed others to do so. FSN has never shown its readers that it has ever stopped clearly such false statements and personal attacks. Though FSN‚Äôs bully pulpit continues to get larger, I choose to ignore it because I don’t see it as any longer meriting my time and I choose to withdraw any appearance of supporting that type of journalism.
    As always, I will happily respond to personal e-mails about what I have written if addressed to me at healthyfoodcoalition@gmail.com.
    Goodbye.

  • Harry,
    We’ll miss you! Your simple one-sided thinking structure was always an eye-opener. One of your last comments was very revealing, what you understand about food safety and traceback, telling us you have a fancy label on everything you sell in your store. What does it tell your customer? Is it made somewhere in a kitchen under which sanitation conditions and made out of what and where it comes from. Harry, start thinking! I can buy very cheap a pick-up load of produce from a pin-hooker he ‚Äútook‚Äù from a field where it was dumped as cattle feed. Process it somewhere, can it up and put some nice fancy labels on: homemade in Brunhilde‚Äôs Kitchen. Of course the price has to be higher than the stuff in the supermarket. Not many people will get sick and I‚Äôm sure they would blame it on a hamburger they ate at the same time.
    Do you get the issue, dear Harry?
    Maybe I’ll put you on our mailing list, so you get updates in Foodsafety and regulatory requirements.
    All The Best!
    Brunhilde