In what is becoming a haunting refrain of statistics connected to the E. coli outbreak in Germany, here are Tuesday’s updated figures: 24 dead (up 2 from the day before), more than 2,400 sick and 642 case patients with hemolytic uremic syndrome (HUS), a deadly complication of E. coli poisoning.

Germany reported 94 new patients on Tuesday alone, according to CBS News

And while the Robert Koch Institute (RKI) announced that the number of new cases in the outbreak of enterohemorrhagic E. coli (EHEC) is finally diminishing, hospitals in Germany remain stretched to their limits to accommodate the staggeringly high numbers of critical-care patients.

“The patients of UKSH Need Your Blood,” reads an announcement on the University Hospital of Schleswig-Holstein’s website.

The number of HUS cases generated by the epidemic (three times more than E. coli usually causes) has climbed so high that hospital’s blood supplies, needed for dialysis and tranfusions to treat patients, are running out.

In 2010, only two deaths from HUS were reported to the Robert Koch Institute. This year, HUS has been responsible for 15 deaths in this outbreak alone.

So far, more than 400 residents of Shleswig-Holstein, the region where 74 percent of the HUS cases are, have answered the call for more platelets. UKSH says 10 blood donors are needed per day for these patients. 

Hospitals are also being stretched financially.

The German Hospital Society estimates that hospitals in Northern Germany will have additional expenditures reaching into the 100 thousand euro range, according to Der Spiegel International.

In the Northern cities of Hamburg and Bremen, 17 hospitals are treating EHEC patients.
Insurance companies cannot yet estimate the total cost of extra claims filed in connection with E. coli cases from the outbreak.

Criticism Now Coming from Experts

Accusations that officials have botched the investigation into the source of the pathogen are growing louder, and are now coming from epidemiological experts as well as political critics.
“If you gave us 200 cases and five days, we should be able to solve this outbreak,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, according to CBS.

EU Health Chief John Dalli, according to the Telegraph, reproached German health officials for jumping to conclusions when they initially announced that contaminated Spanish cucumbers were the source of the outbreak bacteria, which later proved to be an error.

“It’s crucial that national authorities don’t rush to give information on the source of infection when it’s not justified by science,” he said. “That creates fears and problems for food producers. We must be careful not to make premature conclusions.”

However, Bill Keene, Senior Epidemiologist at Oregon’s Division of Public Health, cautions that it is risky to make accusations from the outside.

“All of us who do this professionally are following this outbreak as closely as we can, and we are gossiping about what is or isn’t happening  … commenting on the developments as they trickle out, just as you would with any spectacle of its kind,” he told Food Safety News in an emailed statement Tuesday. “First and foremost this is a human tragedy.”

And some fear that this trickle of new developments could soon slow to a halt. If the contaminated food was perishable, as is suspected, there is an increasingly remote chance that there will be any food to test. And as victim’s memories of what they ate become hazier, the trail grows cold.

“If we don’t know the likely source in a week’s time, there’s a chance we might never know the cause,” Dr. Guenael Rodier, WHO’s Director of Communicable Diseases, told the Associated Press Tuesday.

Keene says that if a source is indeed never found, commentators will be even less equipped to critique the way the investigation was handled.

“If the vehicle is identified, then we will be able to go back and assess how well the investigation was done,” he said.  “If no vehicle is identified (as has been the case in some large U.S. outbreaks), then you’re left with not much to say or learn.”

Criticism is also focused on a lack of organization among different agencies. While the Robert Koch Institute is in charge of the investigation, independent teams in different states are conducting their own investigations, making it difficult for these different sectors to share findings in an organized way.

“It would be especially important to cooperate more closely and in a more centralized way in situations with a nationwide germ,” said Chrsitin Claus, Saxony’s health minister, reported by Leipziger Volkszeitung.

Backlog of Vegetables

And as the search for the elusive origin of the epidemic goes on, European farmers continue to suffer as warnings against eating lettuce, tomatoes, cucumbers or sprouts have brought vegetable sales to a crashing halt.  

Economic damages to the agricultural sector have been devastating. German farms alone have lost an estimated 50 million euros in profits.

The European Union has said it will compensate farmers to the tune of 150 million euros, a figure that many say is inadequate.

“That isn’t enough,” said Spanish Ministry Chief Joaquina Rosa Aquilar Rivero. “We demand a compensation of 100 percent for all farmers,” according to Der Speigel. France has also demanded full reparations for its farmers’ losses.