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Arizona Death: Possible Connection to Massive E.Coli Outbreak

More deadly than previous outbreaks, doctors say

The death of an Arizona patient could be linked to the deadly German E. coli epidemic that caused 29 deaths and sickened thousands, the Centers for Disease Control and Prevention reported on Thursday. The outbreak has alarmed doctors, who have never seen such an aggressive intestinal bacteria before.

U.S. health officials say the epidemic was more deadly than previous outbreaks because it combined dangerous characteristics of two different strains of the bacteria. The unusual combination of traits makes it more likely for infected people to develop a potentially fatal kidney complication called hemolytic uremic syndrome, or HUS, researchers said.

There are already five confirmed cases in the U.S., but the Arizona man would be the first death directly linked to the outbreak in Europe.

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It has been confirmed that the man had recently visited Germany, according to a statement by the CDC.

His death is currently under investigation but health officials say he did have hemolytic uremic syndrome (kidney failure) similar to the hundreds of afflicted people in Europe.

The massive outbreak has sickened 3,601 people, including 815 with HUS, and killed 39, according to the Robert Koch Institute.

Recent studies conclude that the "STEC O104:H4 outbreak in Germany and other European countries “is so far one the largest reported outbreaks in the world."

According to new findings published in The Lancet Infectious Diseases “kidney complications are usually observed in children under age 5; however, in this outbreak the great majority of cases are adults, with more than two-thirds being women."

“Although we lack an explanation for increased virulence, this outbreak tragically shows that blended virulence profiles in enteric pathogens introduced into susceptible populations can have serious consequences for infected people,” researchers in the Lancet Infectious Diseases journal said.

The bacteria produced a poisonous by-product called Shiga toxin and had the ability to stack together and stick to the gut, researchers led by Helge Karch, director of the Hygiene Institute at the University of Muenster, said in an article published in the journal.

The CDC says any person with recent travel to Germany with signs or symptoms of STEC infection or HUS, should seek medical care and let the medical provider know about the outbreak of STEC infections in Germany and the importance of being tested.

Symptoms of STEC infection include severe stomach cramps, diarrhea, which is often bloody, and vomiting. If there is fever, it usually is not very high.

Most people get better within 5-7 days, but some patients go on to develop HUS-usually about a week after the diarrhea starts. Symptoms of HUS include decreased frequency of urination, feeling very tired, and losing pink color to skin and membranes due to anemia.

Health officials announced earlier this month that contaminated raw sprouts from one farm in Germany are the likely source of the outbreak, after incorrectly blaming Spanish cucumbers at first.

German health officials said the farm has been closed and the sprouts produced there are no longer in restaurants or store shelves in Germany.

In 1997, E. coli detected in alfalfa sprouts infected 108 people in Michigan and Virginia. Health department specialists and epidemiologists in both states quickly isolated the specific strain of E. coli found in victims and conducted interviews to determine the source of the sprouts, finding that the alfalfa fields at the four suspect farms were possibly contaminated by cattle manure, run-off water or deer feces.

Sprouts have been a common culprit in such outbreaks, having been linked to 30 outbreaks over the past 15 years, according to the CDC.

In the previous worst case, which occurred in Japan in 1996, 12 people died and more than 9,000 fell ill from tainted radish sprouts.

Sprouts are grown in hot, humid conditions -- ideal breeding grounds for E. coli bacteria.

On the web: http://www.cdc.gov/

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