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‘Lessons Learned’ in European Outbreak

The outbreak of E. coli O104:H4 in Europe struck mostly women and men in their prime who thought they were eating healthy food, the director of the European Centre for Disease Prevention and Control (ECDC) noted in a speech July 5 in Sopot, Poland.

“Hundreds of them have been damaged for the rest of their lives, suffering kidney failure, brain damage and other long term disabilities,” Dr. Marc Sprenger said in a presentation to the Informal Health Council titled “Outbreak of EHEC/STEC in Germany: Lessons Learned.”

The most obvious lesson, he said regretfully, is that “the EU is still vulnerable to epidemics.” 

And while this E. coli outbreak linked to sprouts grown from fenugreek seeds was unprecedented — the ECDC’s Wednesday update on the outbreak put the latest toll at 4,236 illnesses, 898 cases of hemolytic uremic syndrome (HUS) and 50 deaths — Dr. Sprenger identified three key areas in which he thought public health authorities made a difference:

— ECDC’s Food and Water Borne Disease network, along with its microbiology team, reference laboratories and the World Health Organization’s collaborating labs, worked together to analyze the bacterium and publish guidance on lab tests to confirm infections. This “vital role of microbiology networks” helped to get an accurate picture of the developing outbreak, and eventually led to confirmation of contaminated sprouts as its likely source. 

— The EU’s Early Warning and Response System health-threats network and the European Commission agreed on a common case definition, produced a standard questionnaire and coordinated the EU-wide investigation.

— Reference materials describing best practices for treating patients were developed, discussed with doctors on the frontline and posted on the ECDC website, something that had never been done before on an EU-wide level. 

To prepare for and face future epidemics, Dr. Sprenger said the EU must keep investing in microbiology networks, use temporary platforms to exchange clinical information, foster cross-sector cooperation but keep “one voice” in giving information to policy makers and citizens and, finally, to remember that “what looks like a local outbreak can quickly become an EU-wide event.”

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