Germany’s E. coli Nightmare

THE GERMAN OUTBREAK day by day

• MAY 1-2: German and European authorities indicate the outbreak begins.
• MAY 19: Germany’s public health authority, the Robert Koch Institute (RKI), learns that three children suffering from hemolytic uremic syndrome (HUS) have been admitted to a Hamburg hospital.
• MAY 20: RKI investigators arrive in Hamburg.
• MAY 22: German officials report that Shiga toxin-producing E. coli is responsible for the uptick in HUS cases, according to The Lancet.
• MAY 25: The BBC reports at least 80 people had ingested enterohemorraghic E. coli-tainted foods over the prior two weeks, with 350 more cases suspected.
• MAY 26: The RKI points to cucumbers, tomatoes, and lettuce as source, with cucumbers from Spain specifically cited by the Hamburg Senate.
• MAY 30: German officials confirm six E. coli deaths. Spanish authorities, upset over millions of dollars in losses by its farmers, consider action over claims that cucumbers from Spain are the primary cause of the outbreak.JUNE 2: The BBC reports 17 deaths, 16 in Germany and one in Sweden, as well as more than 1,500 sick. RKI President Reinhard Burger says the outbreak might last months and acknowledges losses by Spanish farmers over the now-discounted theory that cucumbers from that country were at the root of the outbreak.
• JUNE 8: The focus of the investigation briefly turns back to cucumbers, found in the garbage/compost of a family sickened by E. coli in eastern Germany. In Bègles, France, an event held at a children’s center eventually results in an outbreak of E. coli among attendees who reported eating fenugreek, mustard, and arugula sprouts.
• JUNE 9: German officials in theeastern state of Saxony-Anhalt downplay previous day’s speculation about tainted cucumber, according to Agence France-Presse.
• JUNE 10: Bean sprouts named as likely source of outbreak by German health officials; warning against eating raw cucumbers, tomatoes, and lettuce is canceled.
• JUNE 12: Estimates of the outbreak’s toll reach about 35 dead, more than 3,200 ill.
  35 Dead
  3,200+ Illnesses
• JUNE 15: The European Union (EU) agrees to pay more than $300 million in assistance to farmers hit hard by the E. coli outbreak, according to Der Spiegel.
• JUNE 22: The Lancet Infectious Diseases publishes analysis of 0104:H4, researched by a team led by Dr. Helge Karch, head of RKI’s EHEC consulting lab at the University of Munich. The New England Journal of Medicine publishes a profile of the epidemic written by a team led by Drs. Christina Frank and Dirk Werber.
• JUNE 24: First reports emerge of eight people sickened by sprouts served at the June 8 event in Bègles.
• JUNE 28: France identifies 15 cases of HUS in southwest France. France’s Institut de veille sanitaire says the 0104:H4 strains that sickened residents in France and Germany are genetically related, according to the World Health Organization.
• JULY 5: Fenugreek sprouts from Egypt emerge as the leading connection between the outbreaks in Germany and France, according to the European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC). The agencies’ report cites sprouts imported by a German company in 2009 or 2010. The EU bans import of some Egyptian seeds after the EFSA says fenugreek seeds from that country were distributed to at least 12 European nations.
• JULY 6: Death toll stands at 50, according to the ECDC, with more than 4,236 ill and 898 cases of HUS.
  50 Dead
  4,236+ Illnesses
  898 hemolytic uremic syndrome (HUS)
• JULY 8: Arizona man dies from O104:H4 E. coli infection after visit to Germany, CDC confirms.
  First U.S. fatality