Another 100 sick people have been added to a major German E. coli outbreak as officials continue to battle to find the source.
The outbreak of E. coli O45 affecting more than 350 people has been ongoing since mid-August.
The focus is in northern and western Germany. Children younger than 10 years of age are mainly affected, some with hemolytic uremic syndrome (HUS). HUS is a clinical syndrome related to E. coli, which can lead to kidney failure, brain damage and death.
A total of 183 confirmed cases are involved in the outbreak and 48 people have developed HUS. There are also eight probable and 160 possible cases that may be part of the outbreak. This means 351 cases can be linked to the outbreak.
The previous total was 255 cases with 137 confirmed infections and 38 HUS cases.
Two confirmed cases have died: a 5-to 10-year-old patient with HUS and a 70- to 80-year-old female infected by E. coli. One probable case: a female patient older than 90 with HUS has also died.
The median age of confirmed cases is 4, with an age range of less than 1 to 94 years old. All HUS cases are children.
Different affected areas
The federal state with the most confirmed cases is Mecklenburg-Vorpommern. In the first few weeks, affected people had almost exclusively been to this region in the days before their illness onset, either on vacation or as residents. However, there are now cases in Nordrhein Westfalen, and other areas with seven of 16 states affected.
The Robert Koch Institute (RKI) has received information via EU networks on four travel-related outbreak cases. A U.S. woman had been in Mecklenburg-Vorpommern before falling sick, a child from the Netherlands had been shopping for food in Germany, a child living in Germany became ill in Italy, and a child from Luxembourg became ill with no evidence of exposure in Germany.
The current incident is the largest since the E. coli O104 outbreak in 2011, which was associated with the consumption of fenugreek sprouts. The final case count was 4,075, including 908 HUS cases and 50 deaths in 16 countries.
RKI said investigations into the causes and sources of infection of the current outbreak are continuing. This includes interviews with patients and their parents, a case-control study and analyzing shopping receipts. No single food product has been identified so far.
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