French health authorities have confirmed what has been suspected for days, that the E. coli outbreak in Bordeaux is linked to the earlier German epidemic, and that contaminated sprouts may well still be available across Europe and the world.
Fifteen French citizens, most of them women, have been stricken with bloody diarrhea and other symptoms linked to E. coli O104:H4 — the same alarming microbial strain blamed for the May-June outbreak in northern Germany that has sickened more than 4,000 and killed 50.
A report Wednesday by the European Food Safety Authority suggested the possibility that fenugreek seeds imported from Egypt in 2009 and 2010 are responsible for both outbreaks.
On Thursday, the link between the outbreaks in Germany and France was further detailed by health authorities in the latest Eurosurveillance report from the European Centre for Disease Prevention and Control. It advances suspicions that contaminated sprout seeds have remained in distribution for weeks after the German outbreak, and are still a public hazard two months after the first German illnesses.
According to Eurosurveillance, French health investigators were alerted on June 22 of a cluster of eight cases of hemolytic uremic syndrome (HUS), or bloody diarrhea, in the Gironde region. Six of the case patients lived in the community of Begles, in Bordeaux – strongly suggesting a common source of contamination.
When interviewed by health officials, none of the victims recalled eating sprouts, so a second questionnaire was prepared “including an in-depth exploration of vegetable consumption” in the previous two weeks.
Meanwhile, the total number of sick grew to 15, and investigators learned that 11 of them had attended an open house at a children’s community center on June 8. That event included a cold luncheon buffet with raw vegetables, dips, gazpacho and a choice of two other cold soups — carrot and cumin and courgette, pasteurized fruit juices, cheese and fresh fruit. The soups and vegetables were garnished with fenugreek sprouts.
Of the 11 who attended the event, nine recalled eating sprouts, but two more were too sick to be questioned. Eight of the 11 are severely ill with HUS, and the majority are middle-aged women — a demographic pattern very similar to the German outbreak.
The sprouts had grown from seeds planted at the community center in early June. The fenugreek seeds were soaked in tap water for 24 hours, then placed in a jar topped with cotton gauze, then rinsed again. Mustard and rocket seeds were germinated on cotton wool moistened with tap water. Both kinds of seeds were harvested specifically for the buffet.
Eurosurveillance reports that the seeds were purchased from a garden store, and had been supplied by a distributor in the United Kingdom. Earlier, French authorities said a British seed company, Thompson & Morgan, had packaged the fenugreek seeds and sold them in France.
The Unused seeds are being tested, according to the latest report.
“Preliminary data indicate this outbreak shares the same novel epidemiological, clinical and microbiological features identified in the E. coli O104:H4 outbreak in Germany, including a predominance of adult women among the cases,” the report states.
Investigators concluded that the two outbreaks had the same source and “the possibility of similar outbreaks in France or elsewhere in Europe cannot be excluded.”
The second outbreak prompted the American CDC to reiterate its warning that any American who has travelled recently in Germany should be alert for any symptoms of foodborne illness — especially stomach cramps and bloody diarrhea.
Meanwhile, the U.S. Centers for Disease Control has reported the death of an unidentified American, an Arizona resident infected with the outbreak strain — one of five Americans who became infected while travelling in Germany.
The U.S. Food and Drug Administration said the United States has not received any seed imports from Thompson & Morgan since at least January 2010. The agency’s Office of Regulatory Affairs is working to determine whether any Egyptian fenugreek seeds have been imported into the country.
And U.S. health officials continued to question the European response to what has become the worst outbreak of food poisoning in recent memory.
Bill Keene, Oregon’s highly respected foodborne illness specialist, stressed that nobody should have been surprised to learn that contaminated sprouts had caused the European outbreaks.
“The unsolved mysteries are: Why did it take so long to figure out? And How can we better take advantage of all the advances in (epidemiology) for these kinds of outbreaks that have occurred in the US?” he said.
And Keene was worried that more contaminated seed is likely to remain in the marketplace, waiting to be sprouted and served to unsuspecting vicitims.