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that has so far left 17 dead and more than 1,500 sick
has baffled experts who warn the outbreak is more
severe than anything they've ever seen from the
bacteria.
The strain has hit eight countries in Europe, but has
been concentrated in Germany.
Two cases have surfaced in the United States, said
Lola Russell, a spokesperson for the Centers for
Disease Control and Prevention. Russell did not
disclose the victims' names or states where they
reside, but she did say their illnesses are associated
with recent travel to Germany. Both are expected to
survive.
"This strain of E. Coli seems to be particularly
virulent and also antibiotic resistant," said Dr. Ann
Marie Kimball, professor of epidemiology and health
sciences at the University of Washington School of
Public Health. "It is a toxin producing strain which
causes kidney shut down and apparently higher
mortality."
Despite a massive medical dragnet, the culprit for the
outbreak has not yet been determined. The initial
suspect was cucumbers from Spain, but tests have
discounted that the vegetable was responsible for
carrying the bacteria. Tomatoes and lettuce are also
being tested.
Because the source of the outbreak is still unknown,
it is possible that tainted products could be
unknowingly transported into the U.S., warned Dr.
William Schaffner, chair of the department of
preventive medicine at Vanderbilt University School of
Medicine.
"Bacteria do not need a passport," said Schaffner.
"There already have been a couple of cases in the U.S.
The patients had traveled to Hamburg, returned to the
U.S. where they became ill. This could happen again
and the E. Coli could be transmitted to family, friends
and others in the U.S."
Doctors say proposed budget cuts to the Food and
Drug Administration's food surveillance may make
outbreaks in the U.S. even more likely.
able to police imported food," said ABC News' senior
health and medical editor Dr. Richard Besser. "This is
so important for preventing the introduction of
products that could be harmful."
E. Coli Outbreak Resistant to Antibiotics
But Schaffner said that it is not likely that this
outbreak will spread to the U.S. because there is not a
lot of fresh produce that is imported into the U.S.
food supply from Europe.
Most E. Coli strains are harmless, but those that do
cause sickness usually trigger bouts of diarrhea,
fever and vomiting. In the bacteria's most serious and
severe form, the infection causes hemolytic uremic
syndrome, or HUS, a condition which attacks the
kidneys and can cause stroke, seizure, coma and
death.
German officials said this particular strain is a
common bacteria found the digestive systems of
mammals, including cows and humans.
In a typical outbreak, about 1 to 2 percent of those
affected suffer from HUS. Dr. Michael Osterholm,
director of the Center for Infectious Disease Research
and Policy at the University of Minnesota, said that it
something unusual about this particular agent which
is causing a higher percentage of people to suffer
from HUS or the outbreak is just extremely
widespread.
Germany first accused cucumbers imported from
Spain as the source of the outbreak. After experts
tested the vegetables and they came up negative for
carrying the bacteria, Spain threatened to sue
Germany over the cucumber charge.
But Osterholm said Spain may not be in the clear.
"Spain has no basis to say the cucumbers weren't
involved because this is such a difficult organism to
find," said Osterholm. "Right now, there is a lot of
misinformation out there because, even if a food item
is tested, there can be such a low level of
contamination that nothing ever comes up in testing."
Osterholm continued to say that experts need to look
epidemiologically at these cases to compare what E.
Coli sufferers ate versus what the non-E. Coli
sufferers consumed.
"Once you identify products, you do the trace and it
almost universally comes back to one source," said
Osterholm.
Kimball noted that strain "seems to be affecting a
different age group."
Usually, young children and elderly people are most
at risk of severe E. Coli symptoms, but women of
various ages seem to be hit hardest by the outbreak.
"If you look at the primary group that eats salads in
the U.S. and around the world, it's young to older
women," he said. "The profile of the outbreak hit
perfectly. It wasn't a surprise to see that vegetables
were implicated.
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