In recent days, European health authorities are engaged in a real police investigation and a race against time to trace the trail of a new epidemic. Prime suspect: a bacterium Escherichia coli, accused of causing bloody diarrhea and kidney complications. Yesterday, Europe accounted for 1 000 patients in Germany, England, the Netherlands, Switzerland, Austria. In France, six suspects, three of which the Germans are under investigation. All had lived in Germany. Fifteen deaths are regrettable in Germany, one in Sweden.
Where is the health survey? Is this really the cucumber?
At first, the deadly bacteria was traced to imported Spanish cucumbers in Germany. But the German authorities admitted Tuesday that the latest tests showed that the vegetable was not the offending bacteria.
Only the stool of patients contain Escherichia coli enterohaemorrhagic (EHEC). The hypothesis of a contamination plant is however maintained. Tomatoes and salad greens are suspected. The question remains: the vegetables have been infected in Spain, Germany, during transport?
Next Monday, all European health ministers meet in Luxembourg for an update. Francois Grossetete MEP, said "the need to label products to determine their origin."
What is hemolytic uremic syndrome (HUS)?
HUS is a severe complication, sometimes fatal, infections of the digestive bacteria Escherichia coli enterohaemorrhagic (EHEC) types of E. coli that produce Shiga toxin. After 3-7 days of incubation, these infections are revealed by diarrhea, which may be bloody.Nine out of ten patients recover within ten days. HUS occurs in 10% of cases, linked to the spread of the toxin. It is characterized by acute renal failure, anemia and thrombocytopenia (low platelets). This complication is fatal in 3-5% of cases, a patient care on two renal sequelae. One hundred cases are reported each year in France, mainly in children under 15 years.
How to transmit these infections?
Cattle that are healthy carriers, are the main natural reservoir. Transmission to humans is most often through ingestion of undercooked beef (hamburgers, for example) or products containing raw milk. Water and other foods like vegetables contaminated by feces, can also be a source of infection. A direct human transmission is possible.Many serotypes of EHEC are identified, the most common is O157: H7.
What previous epidemics?
The first two outbreaks due to these producers shigatoxin coli were reported in 1982 in the United States. In total, about fifty people were infected with E. coli O157: H7 via hamburgers. In 1996, Scotland, over 500 people who were victims of the same serotype, also by eating beef. The largest epidemic was recorded in Japan in 1996. More than 9400 cases and 12 deaths had been identified, contaminated radish sprouts. In 2000, Canada, 2000 cases of infection were identified among the 4600 inhabitants of the town of Walkerton.In this area of intensive farming of cattle, the infection was transmitted by drinking water.
What precautions should I take?
In general, these bacteria are destroyed by heat, "two minutes at 70 degrees or 100 degrees a minute," says Professor Patrick Berche, microbiologist (Necker Hospital, Paris). Currently, there is, in his view, no reason not to eat raw vegetables. "The only precaution is to wash your hands before and after preparing raw vegetables, and wash vegetables and fruit, possibly with hot water," he insists.
What is special about the current epidemic?
The first is the serotype in question, O104. "It's fantastic, I have not had a case several years ago, said Professor Edouard Bingen (Hôpital Robert Debré, Paris), whose laboratory is associated with the National Reference Center for E.coli-Shigella. This serotype O104 has been the source of an epidemic in the United States in 1994. "It's odd to have a highly virulent strain and immediately resistant to powerful antibiotics such as cephalosporins," adds Dr Berche. Moreover, the current epidemic affects mostly women, while the hemolytic uremic syndrome usually involves children. A difference that, according to Professor Bingen, may be related to the origin of infection: the hamburger more often, raw vegetables in this case.