You may not need to be quite this careful

On June 7th CDC officials were quoted as saying an unusual strain of E. coli, similar to that that has caused the on-going epidemic in Germany, had also, in the US in 2010, caused even more illness than the more common form of the bacteria. In this country, however, the national tracking and monitoring system for food-bourne diseases, revealed considerably less serious problems, with fewer of those affected requiring hospitalization.

So what actually happened here vs. in Europe? Let's start with what E. coli is and how we determine its variants (or strains as they are usually termed). In 1885 a German physician/bacteriologist discovered the most common bowel bacterium. His name was Theodor Escherich and the organism was found in the colon, so its name became Escherichia coli, E. coli for short. Several types of E. coli are part of the normal flora of the human gut, are not a threat to our health, help keep more dangerous bacteria from colonizing the bowel and can actually produce, in some instances, forms of vitamin K.

Laboratories test for E. coli strains by determining which form of the bacterium's antigens are found in its various structural components layer. The ones that form the major surface antigens are the O antigens, and the H and K antigens. The O157:H7 variety is more virulent than most others and causes diarrheal disease by producing a toxin harmful to the lining of the intestine.

Even that nasty "bug," which can be found in undercooked beef, but also other foods, is not lethal to most affected by it. Most healthy adults recover from a O157:H7 infection  in 5 to 7 days. Roughly 6% of those affected, usually young children, elderly adults and people of all ages with weakened immune systems, can develop much more serious complications such as hemolytic uremic syndrome  (HUS) in which red blood cells break down (hemolysis), blood platelets (responsible for clotting) clump up in small blood vessels in the kidneys and acute kidney failure occurs.

The most common problem bacterium, E. coli O157:H7, has for some time been a focal point for eradication from food products. The others, commonly called the "non-O157s" haven't routinely been tested for. Now the debate is whether US meat packers will be forced to check for rarer forms of E. coli making the selling of ground beef that contains it illegal.

Why is ground beef the focus?

It often contains meat from a number of cows (sometimes a large number) and has to be thoroughly cooked to break down the toxin. The day of the safe rare hamburger (I used to love them) may well be over. Other cuts of beef would come from just one animal and cooking the surface is usually felt to be relatively safe.

Meanwhile in Europe the number affected by the epidemic is up to almost 3,000 in 12 countries with over 700 developing HUS and 30 deaths. The lab tests on sprout samples were negative, but people who ate bean sprouts were nine times more likely to become infected than those who hadn't.

This week the focus appears to have shifted. I saw a photo in The Wall Street Journal of the German Health Minister and the local Hamburg Health Minister donning surgical gloves and wearing masks and gowns while they plan to visit an isolation ward.

Are these the culprits?

Now the most likely culprit appears to be bean sprouts in the food-borne illness that has affected well over 1,500 in Germany alone with 627 developing Hemolytic Uremic Syndrome (HUS). The article I read said that's an abnormally high percentage for this dire complication which has killed 22 people thus far.

Hamburg was the epicenter of the epidemic, i.e., most cases of the illness and of HUS-related complications have occurred relatively close to that city. There's lots more epidemiological work to be done, but a farm in the German state of Lower Saxony has been implicated, closed, and its produce is under a general recall.

The World Health Organization (WHO) has an online fact sheet that mentions people in 12 other countries have developed the disease termed hemorrhagic colitis (so you may see the unusual strain of E. coli called EHEC for Enterohemorrhagic E. coli). All but one person in that cohort had travel links to, or residence in, Germany.

The E. coli strain, called O104:H4, is rare, but has been seen in humans before. This is the first time its been linked to an EHEC outbreaks, this time with more than 2,200 people affected. There have been EHEC outbreaks every year, in varying parts of the globe, but almost always those have been small (the largest was in Japan in 1996 and affected more than 10,000 people).

The most recent update I found said that the first 23 samples (of 40) from the farm in question, tested negative, but more tests and more samples are pending.

Of course the economic impact on farmers has already been huge with estimates of $44 million in loses per week in Germany alone. Spain, whose cucumbers were initially blamed for the EHEC outbreak, is thinking of suing.

As of May 7th the European agriculture commissioner proposed paying farmers 30%of the cost of the vegetables they've been unable to sell, 150 million Euros. The source is still unclear and may never be known, but bean sprouts are still felt the most likely culprit, even if the ongoing tests come back negative. They've been implicated in previous US and Japanese outbreaks and are grown in heated water setting up an ideal culture media.

US scientists suggest that children, the elderly and those with weakened immune systems should not consume them raw.

This is what I'm buying

And it may be unfair, but yesterday when I shopped for groceries, I looked for "grown in the US" labels.