On 22 May Germany informed the European Commission's Early Warning and Response System (EWRS) of a significant increase in the number of patients with hemolytic uremic sysndrome (HUS) and bloody diarrhea caused by enterohemorrhagic Escherichia coli (EHEC). Investigations have now concluded that a Shiga toxin-producing Escherichia coli bacteria is responsible for this outbreak.
Shiga toxin-producing Escherichia coli (E. coli) is a type of enterohemorrhagic E. coli (EHEC) bacteria that can cause illness ranging from mild intestinal disease to severe kidney complications. Other types of enterohemorrhagic E. coli include the relatively important serotype E. coli O157:H7, and more than 100 other non-O157 strains such as O111 and O26.
A number of people with STEC developed the haemolytic uremic syndrome (HUS), a serious form of the disease.
Public health advice on prevention of diarrhoeal illness with special focus on Shiga toxin - producing E. coli (STEC), also called verotoxin - producing E. coli (VTEC) or enterohaemorrhagic E. coli (EHEC).
Pdf versions of the advice in different languages:
A joint statement by the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA), 3 June 2011
The Commission has been following the outbreak closely since it became known on Sunday, May 22. It activated immediately all existing networks created to manage this kind of incidents the moment the outbreak was confirmed. This includes the Rapid Alert System for Food and Feed (RASFF) and the Early Warning and Response System (EWRS) ensuring rapid distribution of information throughout the EU on findings in, and distribution of, possible food sources, and human cases respectively.
On Sunday June 5, a team of seven experts from the Commission, ECDC and EFSA arrived in Berlin after the German authorities accepted a Commission proposal to that end. The EU experts' goal is to provide assistance with the ongoing epidemiology, verify the results and contribute to the ongoing investigations to identify the source of contamination.
An announcement made on the afternoon of 11 June 2011 by the German authorities confirms the fact that various types of sprouts produced by one farm south of the city of Hamburg are responsible for the E. coli outbreak in Germany. Epidemiological investigations will continue in order to complete the picture of the links between people who fell ill, food establishments and the farm in Germany. Investigations will also focus on how the specific E. coli strain (O104) got into the food chain.
Good hygiene practices should be applied when preparing food and, in particular, when handling vegetables. Fruit and vegetables need to be washed thoroughly. The same applies for hands before preparing food or eating, and after using the bathroom or changing diapers. Finally, washing thoroughly knives, plates and other utensils used to prepare fruit or vegetables helps avoid the risk of cross-contamination.
Commission press releases
Commission's press release dated 05 July 2011
Commission's press release dated 22 June 2011
Commission's press release dated 11 June 2011
Statement made by the Commission during the midday press briefing on 10 June 2011
Commission's press release dated 04.06.2011
Commission's press release dated 02.06.2011
Commission's press release dated 01.06.2011
Commission's press release dated 31.05.2011
Commission's press release dated 27.05.2011
Commission's press release dated 26.05.2011
Statement by the Commission during the midday press briefing on 30.05.2011
Commissioner Dalli has been following closely the Escherichia coli outbreak in Germany. He has participated in different meetings on this subject in the European Parliament, in the Council and in Germany, and has made several statements and speeches in relation to this event. An overview of his activities can be found below.
Statement by Commissioner Dalli on the E. Coli outbreak in Germany - 31 May 2011
"This issue is an absolute priority. The European Commission is coordinating with Member States and is working with the German authorities, in particular, to ensure that the source of the problem is identified in order to be able to propose relevant solutions. The agreed statement of all Member States demonstrates the joint commitment to cooperation, vigilance and solidarity on this matter. It is positive that the number of new infection cases seems to be declining but all authorities must ensure continuous surveillance, which is crucial at this stage, as we are still working to pin down the possible source of contamination and eliminate risks for public health."
Statement by Commissioner Dalli on the E. Coli outbreak in Germany - 1 June 2011
The statement made by the Commissioner and the question and answer session with the press that followed it can be found on the Commission's audiovisual website.
The E-coli outbreak was also discussed at the Employment, Social Policy, Health and Consumer Affairs Council (EPSCO) held on 6 June 2011. An extract of the press conference with Commissioner Dalli following the Council meeting can be found on the Commission's audiovisual website
Commmissioner Dalli participated to the Extraordinary Agriculture Council dedicated to the E-coli crisis on 7 June 2011 in Luxembourg. An extract of the press conference can be found here. The full text of his intervention during the press conference can be found here.
Commissioner Dalli gave a speech and participated in the discussion on E-coli during the European Parliament plenary meeting on 7 June 2011. The video of his speech can be found here.
Commissioner Dalli visited the EU Reference Laboratory for Escherichia coli in Rome, Italy on 9 June 2011, to support and congratulate the whole team of the EU Reference laboratory for their excellent work during this crisis.
Commissioner Dalli led an EU Delegation that travelled to Moscow on Tuesday 21 June to discuss with the Russian authorities the disproportionate EU-wide ban on the imports of all vegetables into the Russian Federation. On the morning of Wednesday 22 June, Russia and the EU came to an agreement that effectively lifts this ban on EU vegetable exports. Please see the press release for further details on this issue. Immediately after the agreement was signed, the Commission started transmitting to Rospotrebnadzor (Russia's Health authority) the names of the competent national authorities entitled to sign the certificate, which is to be stamped on lots exported to Russia, and the names of the national laboratories accredited to perform monitoring of vegetables. This rapid transmission of information to the Russian authorities allows exports to resume immediately. This certification system will be temporary, as it will be applied until the 10th day after no new human case linked to E. coli O104 is reported by EU Member State authorities.
Reports of EWRS audio-conferences
Flash report Tuesday 7 June 2011
Flash report Friday 3 June 2011
Flash report Thursday 2 June 2011
Flash report Wednesday 1 June 2011
Flash report Tuesday 31 may 2011
Flash report Monday 30 may 2011
Flash report Friday 27 May 2011
Flash report Thursday 26 May 2011
Flash report Wednesday 25 May 2011
An update of the outbreak was provided by the Member State authorities during meetings of the Standing Committee on the Food Chain and Animal Health (SCoFCAH):
Germany provided information on the state of play regarding the results of the samples taken from cucumbers, tomatoes and lettuce. All Member States acknowledged the efforts of the German Authorities. Spain and other Member States provided more details regarding the actions taken following the RASFF notifications. Following the discussion the Member States endorsed unanimously a statement on the E. coli outbreak. All Member States confirmed that no unilateral measures have been taken against cucumbers from Spain. A table on the human cases and a table on results of the samples taken by all Member States will be kept updated at daily basis and circulated through the RASFF.
The official report of the meeting and the presentation given by the German representative in the SCoFCAH meeting can be found here.
An update of the situation was given by the German authorities during the SCoFCAH meeting Section Biological Safety of 21 June 2011.
An update of the situation was given by the German authorities during the SCoFCAH meeting Section Biological Safety of 12 July 2011. The presentation given by the German representative in the SCoFCAH meeting can be found here .
Information on EU legislation on food safety and the Shiga toxin-producing Escherichia coli .
EU case definition for diarrhoea and Haemolytic Uremy Syndrome (HUS) caused by the epidemic strain Shiga Toxin 2 producing Escherichia Coli (STEC) 0140:H4
The European Food Safety Authority (EFSA) has published on 9 June 2011 its fast track risk assessment on consumer exposure to STEC/VTEC (Shiga toxin or verotoxin producing E.coli) through the consumption of raw vegetables and provided advice on options to mitigate the risks of possible food contamination and human infection. More information on this can be found here.
Following a request from the Commission, the ECDC conducted a risk assessment which was communicated to the Commission and the Member States on 25 May and updated on May 27. The risk assessment can be found here.
The Robert Koch Institute with further useful information
Article on the outbreak in Eurosurveillance, Europe's journal on infectious disease epidemiology, prevention and control
Page on EU reference laboratories in the area of biological risks
German Federal Institute for Risk Assessment (BfR) in the field of consumer health protection