Four U.S. residents are believed to have contracted a virulent E. Coli strain that has killed at least 22 individuals in Europe and sickened another roughly 1,800.
Three of the patients are hospitalized with hemolytic urinary syndrome, which suggests that the bacteria's toxins have caused organ damage, while the fourth patient is experiencing bloody diarrhea. Two U.S. military members serving in Germany also may be infected, according to CDC's Chris Braden.
Few other details about the possible U.S. cases have been released because of patient confidentiality concerns; however, Milwaukee Health Commissioner Bevan Baker confirmed that one of the patients was in a local hospital. According to Robert Tauxe, deputy director of foodborne illness at CDC, patients may need to undergo dialysis or a blood transfusion after the bacteria dissolves red blood cells.
The E. Coli strain sweeping through Europe has been identified as enterohemorrhagic E. coli (EHEC) serotype O104, MedPage Today reports. The strain is one of a handful that can cause severe illness in humans by producing Shiga toxins, which may damage kidneys. German officials say sprouts grown by an Uelzen-based company may be a "significant" source of the bacteria, Bloomberg/San Francisco Chronicle reports.
U.S. health officials issue E. Coli alerts
CDC on Friday issued a travel notice about the E. Coli outbreak, advising U.S. residents who visit Germany to avoid raw tomatoes, fresh cucumbers, and leafy salads. The agency also is encouraging all travelers who visited Germany and now show symptoms of E. Coli, including bloody diarrhea and stomach cramps, to see a physician immediately.
Meanwhile, FDA has reassured U.S. residents that the country's food supply remains safe. "To date, FDA believes that this outbreak has not affected the U.S. food supply," the agency said in a statement. "The FDA is constantly vigilant and consistently takes steps to increase monitoring, as appropriate, in situations such as this, to protect the U.S. food supply."
FDA inspectors are targeting all cucumber, lettuce, and tomato shipments from Germany and Spain, which also has been a suspected epicenter for the bacteria. The United States imports less than 0.2% of its produce from those two countries, according to David Elder, FDA's director of regional operations.
U.S. companies react
The outbreak also has prompted American Airlines to exclude salads from menus for European flights and its lounge facilities, according to a notice on the company's website. "We are replacing the salad menu items with other menu options to preempt any risk and alleviate concerns," the online notice said (Fox, National Journal, 6/3 [subscription required]; Kaiser, MedPage Today, 6/3; AP/CBS, 6/4; Forgione,Los Angeles Times, 6/3; Bloomberg/Chronicle, 6/5).