Global food poisoning scare

A potentially fatal strain of an organism called E. coli has caused a severe outbreak of food poisoning in Germany and has spread to 12 other European countries. DietDoc comments.

During the past week, newspapers and other media reports have been tracking the spread of a potentially fatal strain of an organism called Escherichia coli. The organism has caused a severe outbreak of food poisoning in Germany and has spread to twelve other European countries (News24, 2011B). New cases are being reported daily and by now the E. coli infection has migrated to America (Randall & Larkin, 2011).



In view of modern travel and the inter-connectedness of the world, there is a danger that this outbreak of food poisoning may spread throughout the Global Village. What makes this outbreak of E. coli so threatening, is that it is a new and virulent strain which has caused a condition known as haemolytic-uraemic syndrome (HUS) in approximately 25% of infected patients. The incidence of this complication is 5 times higher than usually found in E. coli infections (Randall & Larkin, 2011). Haemolytic-uraemic syndrome can cause permanent damage to the kidneys and nervous system and can be fatal (Kennedy, 2011).

What is E. coli?

Escherichia coli is a so-called ubiquitous microorganism, in other words one that is with us at all times and is found everywhere. Both humans and animals carry E. coli in their intestines and waste products generated by man and beast can have high E. coli counts. Normally, E. coli organisms are harmless, but some strains produce toxins and can cause infections varying in severity from mild nausea and diarrhoea to the potentially fatal haemolytic-uraemic syndrome.

Many tourists have experienced the unpleasant symptoms of cramps, nausea and diarrhoea, when visiting foreign countries. These bouts of illness are usually due to eating foods or consuming water or ice cubes infected with E. coli, among other pathogens. In general, patients recover within a few days provided that they do not become severely dehydrated or develop haemolytic-uraemic syndrome. Treatment with anti-diarrhoea medications such as loperamide and rehydrating electrolyte solutions, usually allow less seriously affected patients to continue their holidays after a day or two. However, the more severe manifestations of this illness may have to be treated with antibiotics and/or hospitalisation where dialysis may be required (News24, 2011B).

Severity of this outbreak

The present outbreak is much more serious than traveller’s diarrhoea. According to the World Health Organisation more than 2000 persons in 12 or more countries have been affected and so far 22 deaths have been recorded (News24, 2011B). Because of the high incidence of kidney involvement (470 cases in Germany alone) caused by this virulent strain of E. coli, which is know as an enterohaemorrhagic E. coli (EHEC) the US Centres for Disease Control and Prevention have classified this outbreak as “A new public health problem”.

Researchers attempting to identify the strain have stated that this is “an entirely new super-toxic E. coli strain” (Health24, 2001B; Randall & Larkin, 2011), caused by mutation of the microorganism. In addition, the new strain appears to be highly resistant to standard antibiotics.

Where did this epidemic originate?

At present, no one is sure where this E. coli outbreak originated. Originally cucumbers imported to Germany from Spain were blamed. But now that the disease is spreading, other fresh vegetables such as tomatoes and lettuce are also under suspicion (Dunmore & Busemann, 2011). Russia has announced a ban on the import of fresh plant produce from the EU and if this outbreak continues to spread, it will have a serious effect on the trade in foodstuffs between countries (Kennedy, 2011). The latest reports have stated that fresh bean sprouts may have been the source of the killer organism (News24, 2011B).

E. coli in South Africa

E. coli infections also occur in South Africa and researchers regularly detect high levels of this organism in our water systems (Müller et al, 2001). Participants in the Duzi Canoe Race take precautions to avoid ‘Duzi Gut’, as it is know. The press also keep canoeists updated on the E. coli counts of the river water before and during the race. However, large-scale outbreaks of infection via our water supply have so far been avoided.

Most foods that we export to other countries or consume in South Africa are screened for E. coli contamination and if necessary, such food products are treated to reduce or eliminate this organism. For example, a study of fermented, dried rooibos tea, showed that the tea contained “a high incidence of coliform bacteria including E. coli type 1 and Salmonella spp..”. However treatment of the fermented tea with steam before marketing “effectively reduced bacterial numbers.” (Du Plessis et al, 1987).

The two example I have cited, are not intended to scare readers off an excellent and healthy product such as rooibos tea or to discourage your participation in water sports, but are used to illustrate that E. coli bacteria are indeed ubiquitous and occur all over the world, including in our own country.

Preventive measures

Hygienic food handling which stretches from the farm to the plate is important and most South African food manufacturers take strict precautions to prevent our food from being contaminated by E. coli and other microorganisms.

If you live in an area where the water supply may be contaminated, then it is also a good idea to apply some simple hygienic measures at home. Always wash your hands and all kitchen utensils with water and a mild antibacterial soap before preparing or serving food. If necessary boil all water that you drink or use for making ice cubes. Wash all raw fruit and vegetables in cooled, boiled water or add a small amount of a disinfectant such as ordinary table salt (1 teaspoon per litre) or Milton or Jik (1/2 teaspoon per litre) to unboiled water, to ensure that you do not contaminate fresh foods with suspect tap water.

If you intend travelling to foreign countries, apply the usual safety precautions: 

• don’t drink tap water or use ice cubes in your drinks
• don’t eat raw fruits that you have not peeled yourself
• avoid raw fruits and vegetables, rather eat them cooked
• take along a supply of anti-diarrhoea medications and some oral rehydration solution for emergencies

Travellers who intend, or are currently visiting the countries in Europe that have been affected by the E. coli outbreak (Germany, Austria, Denmark, France, the Netherlands, Norway, Spain, Sweden, Switzerland, the UK and others), as well as the USA, should report to a medical doctor immediately if they feel nauseous, have stomach cramps or develop diarrhoea, particularly if the latter is bloody (Randall & Larkin, 2011).

Being part of the Global Village has many advantages, but in some instances, it can also be risky, so be aware and take the necessary precautions.

 - (Dr IV van Heerden, DietDoc, June 2011)   

References:
(Dunmore C, Busemann H-E (2011). Germany: sharp rise in E. coli cases, source unknown. Reuters 1 June 2011. http://www.reuters.com ; Du Plessis HJ et al, 1987. Recovery of coliforms, Escherichia coli type I and Salmonella species from rooibos tea (Aspalathus linearis) and decontamination by steam. Phytophylactica, Vol 18 (4): 177-181; Kennedy M & agencies (2011). E. coli outbreak: WHO says bacterium is a new strain. Guardian 2 June 2011.http://www.guardian.co.uk./world/2011; Müller EE et al, (2011). The occurrence of E. coli O157:H7 in South African water sources intended for direct and indirect consumption. Water Research, Vol 35(13): 3085-3088; News24 (2011A). German probe fixes on restaurant. News24 5 June 2011. http://www.news24.com ; News24 (2011B). Germany now says it’s bean sprouts. News24 5 June 2011. http://www.news24.com ; Randall T, Larkin C (2011). Europe E. coli outbreak is deadliest on record. Bloomberg 2 June 2011.http://bloomberg.com)          

Any questions? Ask DietDoc 

Read more:

EU trade blame over E.coli outbreak
Main food poisoning culprits
Food poisoning
E.coli linked to longterm problems
Slideshow: Bacteria