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CDC Issues a Travel Advisory for Germany due to Escherichia coli (STEC) Bacteria Outbreak…At Least 18 Have Died, Thousands Sickened

June 3, 2011

Today, CDC issued a travel advisory for travel to Germany due to the Escherichia coli (STEC) bacteria outbreak that began May 2, 2011. This outbreak is being caused by an infection with a Shiga toxin-producing Escherichia coli (STEC) bacteria. Many people have been hospitalized, several requiring intensive care, and at least 18 people have died. New cases are still being reported although today the New York Times reported that the outbreak “appeared to be stabilizing.”

The mutant form of the food poisoning bug is the deadliest E.coli outbreak for decades, and has spread to 11 countries in Europe and to the U.S.

The organism causing the outbreak has been identified as E. coli O104:H4, producing Shiga toxin. This strain of E. coli causes an illness similar to infection with E. coli O157:H7. Most infections have been reported in people in northern Germany (mainly Bremen, Hamburg, Lower Saxony, and Schleswig-Holstein) or in people who have recently traveled to these areas. Virtually all of them have been traced to northern Germany. Cases in travelers to northern Germany have been reported in Denmark, the Netherlands, Spain, Sweden, and the United Kingdom. The origins of the outbreak still remain cloaked in mystery however the consistent theme is Germany.

German health authorities are investigating the outbreak but have not confirmed a source. They suspect that the source is contaminated food, possibly raw vegetables.

 Advice for US Travelers to Germany

German health authorities recommend that people in Germany, especially in the northern part of the country, avoid eating raw tomatoes, fresh cucumbers, and leafy salads, until further notice. Travelers should also follow regular food safety measures when handling fruit and vegetables.

If you have traveled to Germany and have bloody diarrhea and stomach cramps or symptoms of HUS, go to a doctor right away and tell him or her about your recent travel.  STEC infections can cause different gastrointestinal symptoms, which often include severe stomach cramps, diarrhea (often bloody), and vomiting. If there is fever, it is generally not very high (less than 101°F [38.3°C]). HUS is a disorder that usually occurs when an infection in the digestive system (such as STEC) produces toxic substances that destroy red blood cells and cause kidney injury. Early symptoms of HUS include decreased frequency or volume of urination, feeling very tired, and losing pink color in the cheeks and inside the lower eyelids. Signs of HUS typically start 5–7 days after the start of diarrhea, and diarrhea or bloody stools may no longer be present when HUS develops.

http://wwwnc.cdc.gov/travel/notices/outbreak-notice/2011-germany-europe-e-coli.htm

http://www.cdc.gov/ecoli/2011/ecolio104/

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