Germany Struggles to Strengthen Food Safety after Deadly E. coli Crisis

Chicory ice cream, Bavarian steam beer, and wine of the latest vintage of organic Riesling or pinot noir. During the annual International Green Week in Berlin, Germany’s largest trade exhibition for food and agricultural goods, producers and retailers gather to showcase their latest culinary creations for German and European customers.

Over the past few years, the meeting has been overshadowed by food safety issues that have included eggs tainted by dioxin-contaminated animal feed. Although industry figures indicate that the latest crisis, which involved a rare and deadly strain of E. coli, has resulted in sales losses comparable to the Chernobyl nuclear accident in 1986, only a handful of exhibitors and farmers are willing to talk about the disaster openly. Nearly a year after the devastating outbreak, which killed more than 40 and sickened more than 4,000 people in Germany and other parts of Europe, it is business as usual.

A few hundred miles northeast at the University Medical Center Hamburg-Eppendorf, the deadly strain is still a grim reality. At one of the epicenters of the crisis that kept doctors and German health authorities on their toes last summer, almost 120 patients who suffered from symptoms of the hemolytic-uremic syndrome caused by the infection are still receiving assisted outpatient treatment.

At the height of the outbreak in June, the center treated almost one out of 10 HUS patients in Germany. Data gathered by doctors is expected to reveal clues about the long-term effects of the disease and help develop new therapies to handle crises more effectively. The study has received 1.23 million euros ($1.62 million) in funding from the German Ministry of Health for the next two years and is supported by the Robert Koch Institute, whose EHEC consulting lab experts deciphered the O104:H4 strain. The research will also include data from clinics in other parts of northern Germany, such as the University Medical Center Schleswig-Holstein in nearby Lübeck, where 117 HUS patients are still under medical observation.

Professor Andreas Hensel, president of the Federal Institute of Risk Assessment, says it is only a mattter of time until an outbreak with similar consequences occurs.

“We are closely cooperating with these and other working groups in Germany and the U.S. in order to find markers that could help us to find more information about the severity of the disease and when is the right time to begin treatment,” said Professor Rolf Stahl, MD, chair of the department of nephrology and clinical director of the University Medical Center Hamburg-Eppendorf. “The care that these patients require, however, will probably have to continue for years. Five to 10 percent still suffer from HUS-related health problems like limited renal functions, arterial pressure, and neurological disorders.”

The new E. coli strain did not find the country completely unprepared. Only a few days before the first pediatric cases of HUS were reported by health authorities on May 19, the Federal Institute for Risk Assessment, a governmental body responsible for consumer health protection, released a warning on sprouts and prepared salads that they had found to be partially contaminated with different kinds of bacteria. Though epidemiological studies of infected patients indicated that the source of the contamination was most likely raw tomatoes, cucumbers, or leafy salad greens, investigators were finally able to trace it back to fenugreek seeds that had been imported from Egypt by a horticultural farm in northern Germany for the purpose of growing sprouts. By this point, the disaster had already claimed dozens of lives and a significant number of financial resources as well as hours dedicated by scientists, local administrators, and clinical personnel.