Northern Arizona death from E. coli outbreak likely brings new strain of e Coli to Flagstaff
Jul 8, 2011 (CIDRAP News) – The US Centers for Disease Control and Prevention (CDC) today confirmed that the death of an Arizona resident who had traveled to Germany is linked to Europe's sprout-related Escherichia coli O104:H4 outbreak.
The CDC had previously said it was investigating if the fatality was related to the outbreak. In today's update, the CDC said it has now confirmed all six of the US cases that have links to the outbreak. Four of the US patients had hemolytic uremic syndrome (HUS), including the Arizona patient who died.
Five of the US patients had traveled to Germany before they got sick, and one was a close contact of a Michigan patient who had HUS, a serious kidney disorder.
The Arizona case is the first fatality in the outbreak outside Europe. The Arizona Department of Health Services had previously said that the patient is a man older than 65 who died in mid June after he was hospitalized for HUS, according to a Jun 24 report from the Arizona Republic.
So far monitoring of personnel at US military bases in Germany has turned up no cases in staff or dependents, the CDC said.
The CDC acknowledged a report from European investigators that a single lot of fenugreek seeds from an Egyptian exporter is the likely source of sprout seeds in Germany's outbreak, as well as the illness cluster in Bordeaux, France. It warned that all lots of fenugreek seeds from the exporter, which has not been named, should be considered suspect. On Jul 5 the European Union ordered a recall and temporary ban of fenugreek seeds.
In other outbreak developments, two new Danish cases have been traced to the outbreak, one of which involves HUS, the European Centre for Disease Prevention and Control (ECDC) said today in an update. Both are contacts of relatives who were previously infected in Germany. Also, seven more German infections were reported. The new cases push Europe's outbreak total to 3,774 cases, including 750 with HUS and 44 deaths.
The World Health Organization (WHO), in its outbreak update yesterday, said no more E coli O104:H4 cases from France or Sweden have been reported since Jul 1, the date of the agency's last update. The WHO's total includes the US cases and death. So far the United States and Canada, which reported one case, are the only countries outside of the European Union reporting outbreak cases.
Jul 8 CDC outbreak update
Jun 24 Arizona Republic story
Jul 8 ECDC report
Jul 8 WHO update
[Editors note: People infected with Escherichia coli O104:H4 are likely flushing their feces to a wastewater treatement plant where this extremely pathogenic strain will reproduce several times an hour in the digesters. The wastewater will become populated with this antibiotic resistant strain, which will be released into water with the effluent and will be present in sewage sludge. The sewage treatment plant will become a reservoir for this pathogen. Public Health officials must consider that the sewage sludge from these plants may create future outbreaks. It now resides in some sewage treatment plants in the US (Possibly here in Flagstaff, since this is probably where the person died - no Daily Sun coverage, but a crappy story in the Phoenix Republic was noted). Do we want to risk introducing this pathogen widely throughout North America through the use of sewage sludge 'biosolids' as fertilizer or recreating on reclaimed water?]