Health Protection Agency
http://www.hpa.org.uk/
Update on E.coli O104 outbreak in Germany and cluster of cases
News / 30 June 2011
http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2011PressReleases/110630GermanEcoliupdate/
Update on E. coli O104 outbreak in Germany and cluster of cases in France
30 June 2011New cases of Haemolytic Uraemic Syndrome (HUS) and bloody diarrhoea (VTEC or EHEC infection, caused by E. coli O104) in Germany are continuing to decrease this week.
Since our last update on Thursday 23 June, the German authorities have reported 18 new cases of HUS, bringing the total to 841. A further 245 new cases of bloody diarrhoea were reported, bringing the total to 3,110. Five more deaths have been reported in Germany since last Thursday – one from HUS and four from bloody diarrhoea. The total number of deaths from the outbreak now stands at 48 – 31 from HUS (30 in Germany, one in Sweden) and 17 from bloody diarrhoea (all in Germany).
No new cases of bloody diarrhoea in the UK, potentially linked to the outbreak in Germany, have been reported to the HPA in the past two weeks. The total number of cases in the UK therefore remains at 17 – three HUS (all in England) and 14 bloody diarrhoea (13 cases in England, one in Scotland). To date, six of these have been microbiologically confirmed. All 17 cases are related to travel to Germany.
The German authorities reported that a mix of locally grown sprouted seeds containing were implicated as the cause of infection.
As reported by the HPA on Monday 27 June, a cluster of cases of E. coli O104 have been reported in France, with no recent travel to Germany. To date the French authorities have reported eight cases of HUS and eight cases of bloody diarrhoea, with no deaths. Four of these cases are confirmed E.coli O104 – the same strain that was seen in the outbreak in Germany. Nine of the cases reported having eaten sprouted seeds (fenugreek, mustard and rocket) at an event in the commune of Bègles near Bordeaux on 8 June. The seeds, which were sprouted for the event, had been purchased from a local garden centre, which had sourced them from a British company.
A joint statement between the European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC) states that preliminary information on the French HUS cluster and detailed information from the German outbreak investigations suggest that the consumption of sprouting seeds is the source of infection of E. coli O104 in Germany and France.
The Food Standards Agency is working with EFSA who is coordinating trace-back and trace-forward investigations at national and EU level to identify what commonalities exist between the sprouting seed production chains (distributor chains, distributors, retail outlets and suppliers) in Germany and France, So far, the consumption of sprouted fenugreek seeds has been implicated as a possible source of the outbreaks in Germany and France.
Until the investigation has been finalised, the FSA has advised that as a precaution, all sprouted seeds – such as alfalfa, mung beans (usually known as beansprouts) and fenugreek – should only be eaten if they have been cooked thoroughly until steaming hot throughout; they should not be eaten raw.
In addition, ECDC and EFSA strongly recommend consumers across Europe should not grow sprouted seeds for their own consumption.
The FSA has also advised that there is no evidence that seeds contaminated with this strain of E. coli which caused the outbreak in France or Germany are on sale in the UK.
To avoid infection with E. coli, the HPA recommends that, as always, people should follow normal hand hygiene procedures and anyone suffering from symptoms of bloody diarrhoea and vomiting should immediately contact their GP.
ENDS
Notes to editors:For information on food safety, visit the Food Standards Agency website: http://www.food.gov.uk/news/newsarchive/2011/june/ecoli
To view the joint rapid risk assessment on the E. coli outbreak, visit: http://www.ecdc.europa.eu/en/publications/Publications/2011June29_RA_JOINT_
EFSA_STEC_France.pdf
The HPA carries out surveillance of E. coli in England. Its guidance on avoiding E. coli infections is as follows:
- Wash your hand thoroughly after using the toilet (or helping others including changing nappies), handling raw meat, before meals and after contact with animals.
- Cooking all minced meat products (i.e. burgers, meatloaf, meat balls etc.) thoroughly, until the colour is the same all the way through, and no blood runs from them;
- Ensure that refrigerators are working correctly, bacteria grow more quickly at temperatures over 4°C;
- Only leave cooked foods, meat and dairy products out at room temperature for a short time;
- Store uncooked meats below cooked meats and salad vegetables to avoid dripping juices onto ready to eat food;
- Store uncooked and cooked meats on different plates, avoid all contact between raw and cooked meats;
- Thoroughly wash all salad vegetables that will be eaten raw, do not prepare them with utensils that have also been used for raw meat;
- Children and the elderly who are particularly susceptible to the severe effects of VTEC should avoid eating or drinking unpasteurised dairy products;
- People who have been ill should not prepare food for others for at least 48 hours after they have recovered;
- Boil any drinking water if you are unsure of it's source;
- Do not swim in water that you think may be contaminated by cattle and sheep in nearby fields.
For more information about the situation in Germany, visit the Robert Koch Institute's website http://www.rki.de/
For an updated Q&A on this topic, visit: http://www.hpa.org.uk/web/HPAweb&Page&HPAwebAutoListName/Page/1296687744200
For media enquiries please contact the national HPA press office at Colindale on 020 8327 7901 or email colindale-pressoffice@hpa.org.uk.. Out of hours the duty press office can be contacted on 020 8200 4400.
Last reviewed: 30 June 2011
E.coli cluster in France
News / 29 June 2011
http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2011PressReleases/110629EcoliinFrance/
E. coli cluster in France
29 June 2011The HPA is aware of an E. coli incident involving seeds in France and so far no cases have been reported in the UK associated with this cluster.
The Food Standards Agency (FSA) is leading on the investigation of this incident in the UK and has advised that as a precaution all sprouted seeds should only be eaten if they have been cooked thoroughly until steaming hot throughout; they should not be eaten raw. We will continue to work closely with the FSA to assist with this investigation.
In the meantime and as always people should follow normal hand hygiene procedures and if you suffer any symptoms of bloody diarrhoea and vomiting immediately contact your GP.
http://www.food.gov.uk/news/newsarchive/2011/june/ecoli
The HPA carries out surveillance of E. coli in England. Its guidance on avoiding E. coli infections are below but if you are experiencing vomiting and bloody diarrhoea consult your GP immediately.
HPA Guidance on avoiding E. coli infections:
- Wash your hand thoroughly after using the toilet (or helping others including changing nappies), handling raw meat, before meals and after contact with animals.
- Cooking all minced meat products (i.e. burgers, meatloaf, meat balls etc.) thoroughly, until the colour is the same all the way through, and no blood runs from them;
- Ensure that refrigerators are working correctly, bacteria grow more quickly at temperatures over 4°C;
- Only leave cooked foods, meat and dairy products out at room temperature for a short time;
- Store uncooked meats below cooked meats and salad vegetables to avoid dripping juices onto ready to eat food;
- Store uncooked and cooked meats on different plates, avoid all contact between raw and cooked meats;
- Thoroughly wash all salad vegetables that will be eaten raw, do not prepare them with utensils that have also been used for raw meat;
- Children and the elderly who are particularly susceptible to the severe effects of VTEC should avoid eating or drinking unpasteurised dairy products;
- People who have been ill should not prepare food for others for at least 48 hours after they have recovered;
- Boil any drinking water if you are unsure of it's source;
- Do not swim in water that you think may be contaminated by cattle and sheep in nearby fields.
Last reviewed: 29 June 2011
Update on E.coli outbreak in Germany
News / 23 June 2011
http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2011PressReleases/110623Germanecoliupdate/
Update on E. coli outbreak in Germany
23 June 2011New cases of Haemolytic Uraemic Syndrome (HUS) and bloody diarrhoea (VTEC or EHEC infection, caused by E. coli O104) in Germany are continuing to decrease this week.
Since our last update on Thursday 16 June, the German authorities have reported 37 new cases of HUS, bringing the total to 823. A further 347 new cases of bloody diarrhoea were reported, bringing the total to 2,865. Four more deaths have been reported in Germany since last Thursday - all from HUS. The total number of deaths from the outbreak now stands at 43 – 30 from HUS (29 in Germany, one in Sweden) and 13 from bloody diarrhoea (all in Germany).
No new cases of bloody diarrhoea possibly linked to the outbreak have been reported to the HPA since last Thursday. An alternative diagnosis has been found for one case of bloody diarrhoea previously linked to the outbreak and has subsequently been eliminated from the UK figures. The total number of cases in the UK therefore stands at 17 – three HUS (all in England) and 14 bloody diarrhoea (13 cases in England, one in Scotland). To date, six of these have been microbiologically confirmed. All 17 cases are related to travel to Germany.
The German authorities have reported that locally grown sprouted seeds such as lentils, alfalfa seeds, fenugreek and adzuki beans were implicated as the vehicle of infection and the current advice is to avoid eating these in Germany. They are also advising that people no longer need to avoid eating raw tomato, lettuce and cucumber.
The HPA advises travellers to Germany to follow the advice from the German authorities and avoid eating locally grown sprouted seeds until further notice.
The next HPA update will be on Thursday 30 June 2011.
ENDS
Notes to editors:The National Travel Health Network and Centre (NaTHNaC) is funded by the HPA and healthcare professionals and members of the public can find more information about travel health, including country specific advice, by logging onto their website: http://www.nathnac.org/
For more information about the situation in Germany, visit the Robert Koch Institute's website http://www.rki.de/
Updated Q&A on this topic
For information on food safety, visit the Food Standards Agency website:
http://www.food.gov.uk/news/newsarchive/2011/june/outbreak
For media enquiries please contact the national HPA press office at Colindale on 020 8327 7901 or email colindale-pressoffice@hpa.org.uk.. Out of hours the duty press office can be contacted on 020 8200 4400.
16 June 201117:30hrs
New cases of Haemolytic Uraemic Syndrome (HUS) and bloody diarrhoea (VTEC or EHEC infection, caused by E. coli O104) in Germany have decreased significantly this week.
Since Monday, the German authorities have reported 5 new cases of HUS, bringing the total to 786. A further 71 new cases of bloody diarrhoea were reported, bringing the total to 2518. Three more deaths have been reported in Germany since Monday – all from HUS. The total number of deaths from the outbreak now stands at 39 – 26 from HUS (25 in Germany, one in Sweden) and 13 from bloody diarrhoea (all in Germany).
3 new cases of bloody diarrhoea in England possibly linked to the German outbreak have been reported to the HPA since Monday, bringing the total number of cases in the UK to 18. Three had HUS (all in England) and 15 bloody diarrhoea (14 cases in England, one in Scotland). To date, 6 of these have been microbiologically confirmed. All 18 cases are related to recent travel to Germany.
The German authorities reported last week that locally grown sprouted seeds such as lentils, alfalfa seeds, fenugreek and adzuki beans were implicated as the vehicle of infection and the current advice is to avoid eating these in Germany. They are also advising that people no longer need to avoid eating raw tomato, lettuce and cucumber.
The HPA advises travellers to Germany to follow the advice from the German authorities and avoid eating locally grown sprouted seeds until further notice.
The next HPA update will be on Thursday 23 June 2011.
ENDS
13 June 2011
17:00
Since Friday, the German authorities have today reported 22 new cases of Haemolytic Uraemic Syndrome (HUS), bringing the total to 781. In addition, a further 218 cases of bloody diarrhoea (VTEC or EHEC infection, caused by E. coli O104) were recorded, bringing the total to 2,447. Five more people are reported to have died in Germany since Friday – one from HUS and four from bloody diarrhoea. The total number of deaths from the outbreak now stands at 36 – 23 from HUS (22 in Germany, one in Sweden) and 13 from bloody diarrhoea (all in Germany).
One new case of bloody diarrhoea in England possibly linked to the German outbreak has been reported to the HPA today, bringing the total number of cases in the UK to 15 – three HUS (all England) and 12 bloody diarrhoea (11 cases in England, one in Scotland). To date, six of these have been microbiologically confirmed. All 15 cases are related to recent travel to Germany.
The German authorities reported on Friday that sprouted seeds such as lentils, alfalfa seeds, fenugreek and adzuki beans, were implicated as the vehicle of infection and the current advice is to avoid eating these in Germany. They are also advising that people no longer need to avoid eating raw tomato, lettuce and cucumber.
The HPA advises travellers to Germany to follow the advice from the German authorities and avoid eating sprouting seeds until further notice. Anyone returning from Germany with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention their recent travel history.
The next HPA update will be on Thursday 16 May.
ENDS
10 June 2011
18:00hrs
The German authorities have today reported 37 new cases of Haemolytic Uraemic Syndrome (HUS), bringing the total number of cases to 759. In addition, a further 143 cases of bloody diarrhoea (VTEC or EHEC infection, caused by E. coli O104) were recorded, bringing the total to 2,229. Four more people are reported to have died in Germany today, bringing the total number of deaths from the outbreak to 31 – 22 with HUS (21 in Germany, one in Sweden) and nine with bloody diarrhoea (all in Germany).
One new case of bloody diarrhoea in Scotland has been reported to the HPA today, bringing the total number of cases in the UK linked to the German outbreak to 14 – three HUS and 11 bloody diarrhoea. To date, six of these have been microbiologically confirmed. All 14 cases are related to recent travel to Germany.
The German authorities have today reported that sprouting seeds such as lentils, alfalfa seeds, fenugreek and adzuki beans, have now been implicated as the vehicle of infection and the current advice is to avoid eating these raw in Germany. The German authorities are now advising that people no longer need to avoid eating raw tomato, lettuce and cucumber.
The Food Standards Agency has confirmed that there is no evidence that any affected food products have been distributed to any country other than Germany.
The HPA advises travellers to Germany to follow this advice from the German authorities and avoid eating sprouting seeds until further notice. Anyone returning from Germany with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention their recent travel history.
09 June 2011
17:00hrs
The German authorities have today reported 33 new cases of Haemolytic Uraemic Syndrome (HUS), bringing the total number of cases to 722. In addition, a further 127 cases of bloody diarrhoea (VTEC or EHEC infection, caused by E. coli O104) were recorded, bringing the total to 2,086. A total of 27 people are now reported to have died – 19 with HUS (18 in Germany, one in Sweden) and eight with bloody diarrhoea (all in Germany).
One new case of bloody diarrhoea has been reported to the HPA today, bringing the total number of confirmed cases in England linked to the German outbreak to 13 – three HUS and 10 bloody diarrhoea. To date, five of these have been microbiologically confirmed. All 13 cases are related to recent travel to Germany.
As investigations into the cause of the outbreak continue, the public health advice from the HPA remains the same – travellers to Germany should to follow the advice of the German authorities and avoid eating raw tomatoes, cucumbers and leafy salad including lettuce, especially in the north of the country, until further notice. Anyone returning from Germany with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention their recent travel history.
ENDS
08 June 2011
16:45hrs
The German authorities have reported 47 further cases of Haemolytic Uraemic Syndrome (HUS) today, bringing the total number of cases to 689. In addition, 276 more cases of bloody diarrhoea (VTEC or EHEC infection, caused by E. coli O104) have been reported, bringing the total to 1,959. 25 people are now reported to have died – 19 with HUS (18 in Germany, one in Sweden) and six with bloody diarrhoea (all in Germany).
One new case of bloody diarrhoea has been reported to the HPA today. One case of bloody diarrhoea previously linked to the outbreak has subsequently tested positive for Salmonella infection and been eliminated from this outbreak. Therefore the total number of confirmed cases linked to the outbreak in England remains 12 – three HUS and nine bloody diarrhoea. To date, five of these have been microbiologically confirmed. All 12 cases are related to recent travel to Germany.
As investigations into the cause of the outbreak continue, the public health advice from the HPA remains the same – travellers to Germany should to follow the advice of the German authorities and avoid eating raw tomatoes, cucumbers and leafy salad including lettuce, especially in the north of the country, until further notice. In addition anyone returning from Germany with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention their recent travel history.
ENDS
07 June 2011
17:30hrs
A further 12 cases of Haemolytic Uraemic Syndrome (HUS) have been reported by Germany today, bringing the total number of cases to 642. In addition, the German authorities report 82 more cases of bloody diarrhoea (VTEC or EHEC infection, caused by E. coli O104), bringing the total to 1,683. Twenty-three people are now reported to have died – 16 with HUS (15 in Germany, one in Sweden) and seven with bloody diarrhoea (all in Germany).
One new case of bloody diarrhoea has been reported to the HPA today, bringing the total number of confirmed cases linked to the outbreak in England to 12 – three HUS and nine bloody diarrhoea. All 12 cases are related to recent travel to Germany.
As investigations into the cause of the outbreak continue, the public health advice from the HPA remains the same – travellers to Germany should to follow the advice of the German authorities and avoid eating raw tomatoes, cucumbers and leafy salad including lettuce, especially in the north of the country, until further notice. In addition anyone returning from Germany with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention their recent travel history.
ENDS.
06 June 2011
17:30hrs
According to Robert Koch Institute in Germany (www.rki.de), cases of HUS in the country have risen to 630 since Friday, with 16 reported deaths. A further 1,601 people are reported to be suffering from bloody diarrhoea (VTEC or EHEC infection, caused by E. coli O104) with six deaths - bringing the total number of official reported deaths in Germany to 22.
Eleven cases have so far been linked to this outbreak in England – three HUS and eight bloody diarrhoea. All eleven cases are related to recent travel to Germany. No further cases of HUS or bloody diarrhoea have been reported to the HPA since Friday.
Although the German authorities have reported that a mix of sprouted seeds, which are used in salads and includes lentils, alfalfa seeds, fenugreek and adzuki beans, could be the cause of the E. coli outbreak, there is currently no laboratory evidence to support this link.
The Food Standards Agency reports that there is no evidence that any of these potentially affected products have entered the UK. As a precaution, the German authorities have withdrawn the potentially affected produce from the market.
As investigations into the cause of the outbreak continue, the public health advice from the HPA remains the same – travellers to Germany should to follow the advice of the German authorities and avoid eating raw tomatoes, cucumbers and leafy salad including lettuce, especially in the north of the country, until further notice. In addition anyone returning from Germany with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention their recent travel history.
ENDS
03 June 201117:30hrs
The Robert Koch Institute in Germany (www.rki.de) have confirmed that the number of cases of HUS in Germany has risen to 520, with 11 reported deaths. They have also confirmed 1,213 cases of bloody diarrhoea (VTEC or EHEC infection), related to the outbreak of E. coli O104), with 6 deaths – bringing the total number of official reported deaths in Germany to 17.
The HPA can confirm four new cases of bloody diarrhoea in England suspected to be related to this outbreak. All new cases are related to recent travel to Germany.
This brings the total number of cases in England to eleven – three HUS and eight bloody diarrhoea.
There are no reports of any secondary infections in England. To limit the infection being transmitted from person to person, practicing good hand hygiene is very important.
The public health advice from the HPA remains the same – travellers to Germany should to follow the advice of the German authorities and avoid eating raw tomatoes, cucumbers and leafy salad including lettuce, especially in the north of the country, until further notice. In addition anyone returning from Germany with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention their recent travel history.
ENDS
02 June 2011
10:00hrs
Cases of HUS in Germany have risen to 470, with nine reported deaths. German authorities have also reported 1,064 cases of bloody diarrhoea (VTEC or EHEC infection, caused by E. coli O104) related to the outbreak, with 4 deaths – bringing the total number of official reported deaths in Germany to 13.
The HPA can confirm one new case of HUS and three new cases of bloody diarrhoea in England. All are suspected to be related to this outbreak. Three of the four new cases, including the HUS case, are in UK residents with a recent travel history to Germany and one new case is in a German national on holiday in England. This brings the total number of cases in England to seven – three HUS and four bloody diarrhoea. There are no reports of any secondary infections in England.
To date the exact source of the contamination has not been determined. The Food Standards Agency has confirmed that they are working closely with industry trade bodies, wholesalers and retailers, and have found no evidence that produce from possible sources identified so far has been distributed to the UK.
The HPA is reminding people travelling to Germany to follow the advice of the authorities and avoid eating raw tomatoes, cucumbers and leafy salad including lettuce, especially in the north of the country, until further notice. In addition anyone returning from Germany with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention their recent travel history.
Dr Dilys Morgan, head of the gastrointestinal, emerging and zoonotic infections department at the HPA, said: "The HPA continues to actively monitor the situation very carefully and we are working with the authorities in Germany and with our counterparts across Europe as to the cause of the outbreak. We have alerted health professionals to the situation and advised them to urgently investigate and report suspected cases with a travel history to Germany."
ENDS
31 May 2011
17:15hrs
The Health Protection Agency (HPA) can confirm that the German authorities have now reported 373 cases of haemolytic uraemic syndrome (HUS) in Germany and six deaths. It has been found that the outbreak has been caused by a rare organism called verocytotoxin-producing E. coli (VTEC) O104 infection.
The HPA can also confirm that to date, no new cases have been reported in the UK since our last update on Friday. England has so far seen three cases in German nationals, two with HUS and one with bloody diarrhoea. Other countries are continuing to see cases of HUS and bloody diarrhoea but only among returning travellers from Germany. As a result England may see more cases in people returning from Germany.
Investigations into the cause of the outbreak are ongoing and the German authorities are pursuing a number of leads. Initial reports that Spanish cucumbers were the source of the outbreak have not been substantiated and extensive sampling of various food sources is underway.
Until the sources of the outbreak are known, the advice from the German authorities remains the same - that people in Germany should avoid eating raw tomatoes, cucumbers and leafy salad including lettuce, especially in the north of the country, until further notice. The HPA recommends travellers follow this advice. In addition anyone returning from Germany with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention their recent travel history.
ENDS
27 May 2011
15.30hrs
The outbreak of haemolytic uraemic syndrome (HUS), a serious complication from verocytotoxin-producing E. coli (VTEC) infection, continues in Germany. The Health Protection Agency (HPA) can confirm that there reports of approximately 276 cases of HUS in Germany with two deaths.
The German authorities have confirmed that they have identified organic cucumbers from two provinces of Spain (Almeria and Malaga) as one of the sources of the outbreak. Investigations are ongoing in Germany to identify other potential sources, while a third suspect batch of cucumbers originating in the Netherlands and traded in Germany is also under investigation. Some food products have also been withdrawn from the German market.
The Food Standards Agency is monitoring the situation closely and stress there is currently no evidence that any affected organic cucumbers from the sources identified have been distributed to the UK.
The European Commission report that the Spanish authorities are focusing their efforts on pinpointing the exact site of production of the organic cucumbers in question.
Until all sources of the outbreak are known, the German authorities are advising people in Germany to avoid eating raw tomatoes, cucumbers and lettuce, especially in the north of the country, until further notice. The HPA recommends travellers follow the advice of the German authorities. In addition anyone returning from Germany with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention any recent travel history.
England has so far seen three cases in German nationals, two with HUS and one with bloody diarrhoea. One of the HUS cases has been confirmed as having VTEC O104 infection which is causing this outbreak. There are no reports of any secondary infection in the UK. Other European countries are continuing to see cases of HUS and bloody diarrhoea among returning travellers.
ENDS
26 May 2011
14:00hrs
The Health Protection Agency (HPA) is aware that Germany is currently experiencing a large outbreak of haemolytic uraemic syndrome (HUS), which is a serious complication from verocytotoxin-producing E. coli (VTEC) infection that requires hospitalisation. Since the second week of May, there have been reports of approximately 214 cases of HUS and two people are reported to have died.
The outbreak is mainly affecting adults - almost 70 per cent of who are female. The cases are occurring mainly in northern Germany, but there are also reports from southern and eastern Germany.
This strain of VTEC infection suspected in this outbreak is O104 which is a rare strain of the infection and seldom seen in the UK.
England has so far seen two cases in German nationals with compatible symptoms. Other European countries have also seen cases of HUS and bloody diarrhoea among returning travellers.
The German authorities believe that a food source of infection is likely, and, early studies implicate raw tomatoes, cucumbers and lettuce. Although it is not clear whether one or more of these food items are associated with the outbreak, as a precaution they are advising people in Germany against eating raw tomatoes, cucumbers and lettuce, especially in the north of the country, until further notice.
The HPA and the National Travel Health Network and Centre (NaTHNaC) advises anyone travelling to Germany to follow the advice from the German authorities. In addition, returning travellers with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention any recent travel history.
The public health organisation in Germany investigating the outbreak also recommend following the standard food and water hygiene advice.
Dr Dilys Morgan, head of the gastrointestinal, emerging and zoonotic infections department at the HPA, said: "The HPA is actively monitoring the situation very carefully and liaising with the authorities in Germany, the European Centre for Disease Control (ECDC) and the World Health Organization (WHO) as to the cause of the outbreak.
"We are keeping a close watch for potential cases reported in England and are working with colleagues in the devolved administrations to recommend they do the same. In addition we are in the process of alerting health professionals to the situation and advising them to urgently investigate potential cases with a travel history to Germany."
The HPA is also working closely with the Department of Health and the Food Standards Agency. The FSA is monitoring the situation closely and if there are any implications for food distributed in the UK they will provide an update.
ENDS
Notes to editors:
1. In this outbreak many more people are suspected to have bloody diarrhoea, which can be serious, or milder forms of the infection which are usually self limiting and clears within seven days. The public health organisation investigating the outbreak in Germany is the Robert Koch Institute http://www.rki.de/
2. Haemolytic Uraemic Syndrome (HUS) is a serious complication from verocytotoxin-producing E. coli (VTEC) infection that affects the blood, kidneys and in severe cases, the central nervous system. It is a serious illness that requires treatment in hospital and can be fatal.
3. The number of severe cases of HUS in a short period is very unusual and the affected age groups in this outbreak are not typical – HUS is a more common complication from E. coli infection in children.
4. Escherichia coli (commonly referred to as E coli) bacteria usually cause diarrhoea which settles within seven days without treatment. There are many strains of the infection. Occasionally, serious kidney and blood complications can occur, such as HUS.
5. Most people normally carry harmless strains of E. coli in their intestine. Both the harmless strains and the strains that cause diarrhoea are acquired primarily through ingestion of contaminated food or water. Person-to-person and animal-to-human transmission is through the oral-faecal route.
6. Good hygiene is very important in preventing person-to person spread and small children should be supervised with hand washing after using the toilet and before eating. Advice on food safety can be found on the NHS Choices website: http://www.nhs.uk/Livewell/homehygiene/Pages/Homehygienehub.aspx
7. Verocytotoxin- producing E. coli (VTEC) O104 is a rare serogroup and further testing of samples is needed to confirm this as the cause of the outbreak. Reports from Germany refer to the VTEC cases as cases of Shiga-toxin producing E. coli (STEC). VTEC is also sometimes called Entrohaemorrhagic E. coli (EHEC).
8. Healthcare professionals and members of the public can find more information about travel health (including country specific advice) by logging onto the National Travel Health Network and Centre (NaTHNaC) website http://www.nathnac.org/
9. The Health Protection Agency is an independent UK organisation that was set up by the government in 2003 to protect the public from threats to their health from infectious diseases and environmental hazards. It does this by providing advice and information to the general public, to health professionals such as doctors and nurses, and to national and local government. In 2012 the HPA will become part of Public Health England. To find out more, visit our website: http://www.hpa.org.uk/
10. For media enquiries please contact the national HPA press office at Colindale on 020 8327 7901 or email cfipressoffice@hpa.org.uk. Out of hours the duty press office can be contacted on 020 8200 4400.
Last reviewed: 23 June 2011
