Published Date: 2011-06-28 21:28:13
Subject: PRO/AH/EDR> E. coli O104 - EU (26): update, Sweden, France
Archive Number: 20110628.1974
E. COLI O104 - EUROPEAN UNION (26): UPDATE, SWEDEN, FRANCE NON-LINKED
CASES
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A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] ECDC update with French cases without German link
[2] Possible Brazil ex Germany report
[3] Swedish case without Germany link
[4] German school cluster
*****
[1] ECDC update
Date: Tue 28 Jun 2011
Source: ECDC [edited]
http://www.ecdc.europa.eu/en/activities/sciadvice/Lists/ECDC%20Reviews/ECDC_DispForm.aspx?List=512ff74f%2D77d4%2D4ad8%2Db6d6%2Dbf0f23083f30&ID=1122&RootFolder=%2Fen%2Factivities%2Fsciadvice%2FLists%2FECDC%20Reviews
Update since 27 Jun 2011
------------------------
In the EU/EEA, 885 HUS [hemolytic uremic syndrome] cases, including
31 deaths, and 3138 non-HUS cases, including 17 deaths have so far
been reported. Germany reports 4 additional HUS cases since the last
update, as well as 96 non-HUS STEC [Shiga toxin producing _Escherichia
coli_] cases and 1 non-HUS STEC death. Sweden reports 1 new non-HUS
STEC cases. The latest known date of onset of diarrhea for cases is 22
Jun 2011.
On Fri 24 Jun 2011, France reported a cluster of patients with bloody
diarrhea, who had participated in an event in the commune of Begles
around Bordeaux on 8 Jun 2011. As of 27 Jun 2011, 9 people have been
hospitalized. 8 of these have developed HUS, a severe complication of
_E. coli_ infection. The 9th hospitalized case has bloody diarrhea but
not HUS, and epidemiological investigations have shown no link with
the event in Begles. An additional 4 cases of bloody diarrhoea, all
participants to the event, have been notified and are under clinical
follow-up. In 3 cases, infection with _E. coli_ O104:H4 has been
confirmed.
The French authorities are investigating this new cluster. 6 of the
cases reported having eaten sprouts at the event on 8 Jun 2011, and
leftovers are currently being analyzed. These suspected sprouts were
locally produced, and were not imported from the farm implicated in
the outbreak in Germany.
Thorough investigations are now being carried out to determine the
suspected vehicle of infection for the cases reported in the French
cluster, and whether there is any link between that cluster and the
large outbreak reported from Germany.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[By noting the EU number of daily cases of HUS and non-HUS cases and
their total as well as deaths reported, the daily trends of the
numbers can be seen:
Date (2011): New HUS / New non-HUS / New Total / Overall Total
Deaths
Mon 6 Jun: 3 / 67 / 70 / 22
Tue 7 Jun: 13 / 83 / 96 / 23
Wed 8 Jun: 48 / 266 / 314 / 25
Thu 9 Jun: 35 / 121 / 156 / 27
Fri 10 Jun: 38 / 115 / 153 / 31
Sat 11 Jun: 14 / 177 / 191 / 35
Sun 12 Jun: 0 / 40 / 40 / 35
Mon 13 Jun: 8 / 34 / 42 / 36
Tue 14 Jun: 1 / 6 / 7 / 36
Wed 15 Jun: 3 / 17 / 20 / 37
Thu 16 Jun: 2 / 48 / 50 / 39
Fri 17 Jun: 14 / 92 / 106 / 39
Mon 20 Jun: 12 / 74 / 96 / 40 (3 days)
Tue 21 Jun: 4 / 89 / 93 / 40
Wed 22 Jun: 8 / 79 / 87 / 43
Mon 27 Jun: 7 / 78 / 85 / 47 (4 days)
Tue 28 Jun: 4 / 97 / 101 / 48
Total cases: 4023 with 48 deaths -- 1.19 percent case fatality rate.
Cases have continued to occur as the last onset of symptoms to date is
only 6 days ago, 22 Jun 2011!
The cases do not necessarily reflect date of onset of disease but
rather when the diagnosis was made and reported. The number of newly
reported cases per day clearly decreased from the corresponding day in
the previous week. - Mod.LL]
*****
[2] Possible Brazil ex Germany report
Date: Sat 25 Jun 2011
Source: Prensa Latina [machine trans.] [edited]
http://www.prensa-latina.cu/index.php?option=com_content&task=view&id=300627&Itemid=1
Two persons from the city of Campinas, Sao Paulo state, were
suspected of infection by _E. coli_, Brazilian health authorities
reported today, 25 Jun 2011. These are 2 people who recently returned
from a stay in Germany, where since May 2011 reported an outbreak of
infection with _E. coli_ O104.
However, the Ministry of Health of Brazil, recently disclosed in a
footnote, dismissed the possibility of epidemic risk and said that one
of the travelers was hospitalized, but both are in good health.
--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>
[These are not yet confirmed but are likely to be the first cases of
this outbreak imported to the South American continent. - Mod. LL]
*****
[3] Swedish case without Germany link
Date: Tue 28 Jun 2011
Source: Agence France-Presse (AFP) [edited]
http://www.expatica.com/de/news/german-news/sweden-detects-e-coli-case-not-linked-to-germany_159505.html
Swedish health authorities said Tuesday, 28 Jun 2011, they had
detected a case of infection with the _E. coli_ strain that caused a
deadly outbreak in Germany, in a man who had not been to that country.
It is the 1st time that a case has turned up in Sweden in a person
with no direct link to Germany, Doctor Karin Tegmark Wisell of the
Swedish Institute for Communicable Disease Control told AFP.
The patient, a middle-aged man from the south of Sweden, "has not
been to Germany and there is no obvious link to Germany. He's not been
abroad at all and he has not been close to anyone who has been to
Germany or has been sick related to the German cases," Tegmark Wisell
said.
"We've had several cases (of the same type of bacteria as in the
German outbreak) in Sweden, but all of these cases have been visitors
in Germany or closely related family members. This is the 1st case
where we see no obvious link to the German cases," she added.
In a statement, the institute said "an EHEC (enterohemorrhagic _E.
coli_) case of the same specific type as the outbreak in Germany has
been identified in Sweden."
It added an investigation was under way to find the source of
contamination and that it was "still unclear if the contamination
comes from food in Sweden or if there is some other connection to the
German outbreak." The man became ill with bloody diarrhea in mid-June
2011 but was feeling better, it added.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Like the French cases discussed above, this case has had no link to
Germany, either directly or indirectly. It would be surprising if
additional countries find such cases. There may well be a link via the
sprout seeds but time will tell. No additional epidemiological
information is given in this report. - Mod.LL]
*****
[4] German school cluster
Date: Tue 28 Jun 2011
Source: Reuters [edited]
http://af.reuters.com/article/cameroonNews/idAFLDE75R1NQ20110628?pageNumber=2&virtualBrandChannel=0&sp=true
German officials closed a primary school in the west of the country
on Tuesday, 28 Jun 2011, after students fell ill with the rare strain
of _E. coli_ responsible for an outbreak that has killed 48 people.
The school in the town of Altenbeken will be shut for a week, about
the length of the _E. coli_ incubation period, to prevent a possible
spread of the bacteria, local officials said.
In Germany, health officials responsible for Altenbeken believed poor
hygiene by students and school canteen workers caused the spread of
the bacteria, rather than contaminated bean sprouts. "It could be
quite possible that the children were infected from contaminated
food," county health chief Georg Alles said, adding the germ could
also have been spread by people who failed to wash their hands after
using the toilet.
3 male students have been infected and 4 workers who prepare food for
the students at the school appeared to have been infected and are
undergoing further testing, the county said.
[Byline: Eric Kelsey]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[It is not clear if the students were secondary cases infected by a
food preparer or if all the cases are primary. - Mod.LL]
See Also
E. coli O104 - EU (25): updates 20110628.1969E. coli O104 - EU (24): France, sprouts 20110626.1956
E. coli O104 - EU (23): updates 20110624.1940
E. coli O104 - EU (22): case update 20110622.1902
E. coli O104 - EU (21): case update 20110619.1877
E. coli O104 - EU (20): secondary cases 20110618.1862
E. coli O104 - EU (10): USA commentary 20110605.1718
E. coli O104 - EU: (Germany, Denmark, Sweden) Spanish cucumbers
20110526.1611
E. coli VTEC - Germany (04): O104, poss. salad source 20110526.1600
E. coli VTEC - Germany (03): O104, spread South 20110525.1587
E. coli VTEC - Germany (02): increased case burden 20110524.1578
E. coli VTEC - Germany: RFI 20110523.1566
E. coli VTEC non-O157 - Japan: O111, raw beef, alert 20110504.1378
2010
----
E. coli VTEC non-O157 - USA (07): O26, ground beef, alert, recall
20100831.3097
E. coli VTEC non-O157 - USA (06): O145, lettuce 20100528.1777
E. coli VTEC non-O157 - USA (03): O145, lettuce, recall
20100507.1483
E. coli VTEC non-O157 - USA (02): (OH, MI, NY) O145 20100505.1460
E. coli VTEC non-O157 - USA: (MI, OH) 20100427.1358
2008
----
E. coli VTEC non-O157, restaurant - USA (04): (OK), O111
20081201.3779
E. coli VTEC non-O157, restaurant - USA: (OK), O111 20080902.2748
E. coli VTEC non-O157, past. ice cream, 2007 - Belgium: Antwerp
20080218.0655
2007
----
E. coli VTEC non-O157, beef sausage - Denmark 20070602.1784
E. coli VTEC non-O157, 2000-2005 - USA (CT) 20070118.0240
2006
----
E. coli VTEC non-O157, lettuce - USA (UT)(02): background
20060905.2523
E. coli VTEC non-O157, lettuce - USA (UT) 20060904.2521
E. coli VTEC non-O157 - Norway (03) 20060416.1133
E. coli VTEC non-O157 - Norway 20060329.0947
E. coli VTEC non-O157, minced beef - Norway 20060304.0680
2005
----
E. coli O145, fatal - Slovenia 20050916.2739
2003
----
E. coli, VTEC non-O157 - UK (Scotland): correction 20030828.2166
E. coli, VTEC non-O157 - UK (Scotland) 20030825.2144
2001
----
E. coli O26 - South Korea 20010509.0896
1999
----
E. coli O111, diarrhea - USA (Texas) 19990707.1134
1997
----
E. coli, non-0157 - Belgium 19970610.1215
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