EHEC outbreak: update 18

Over the last week, the number of reported cases of haemolytic uraemic syndrome (HUS)/enterohaemorrhagic Escherichia coli (EHEC) has declined significantly. In Germany, the daily numbers of reported cases have steadily decreased since they peaked, on 21 May for HUS and on 22 and 23 May for EHEC. Nevertheless, the cumulative numbers of cases from Germany continue to rise, primarily owing to delays in notification.

Investigations by the German authorities indicate that the vehicle of the bacterium responsible for the outbreak, enteroaggregative verocytotoxin-producing Escherichia coli (EAggEC VTEC) O104:H4, is bean and seed sprouts, and the Robert Koch Institute has warned people in Germany not to eat raw bean and seed sprouts of any origin.

The table shows the reported cases of and deaths from HUS and EHEC infection as of 16 June at 15:00 CET.

Country
HUS
EHEC
Comments
 Cases Deaths
 Cases  Deaths  
Austria 1
 0 3
0
 
Canada  0 0
 1  0  
Czech Republic 0
 0 1
 0 A tourist from the United States who had travelled in Germany
Denmark 8
0
12
 0  
France 0
0
2
0

Germany
 798  25  2610 13  
Greece 0
 0  1 0
A German tourist
Luxembourg 1
 0 1
0
 
Netherlands 4
 0 4
0
 
Norway 0
0
1
0
Contact with a German in Norway
Poland 2
0
1  0  
Spain 1
 0 1
0
 
Sweden 18
1
30
0
 
Switzerland 0
0
5
0
 
United Kingdom 3
0
3 0

United States of America  3 0
 2 0
3 HUS cases (all confirmed) and 2 EHEC cases (one confirmed and one suspected)
 Total  839  26  2678  13  

Note: There are 3517 HUS and EHEC cases in total, including 39 fatalities.

The latest date of onset of diarrhoea for a HUS case is 10 June and for an EHEC case, 13 June. All but 5 of the above HUS and EHEC cases were in people who had travelled to or lived in Germany during the incubation period for infection, typically 3–4 days after exposure (range: 2–10 days). The remaining 5 cases can also be linked to the outbreak in Germany.

Note

EHEC and HUS have exclusive notification categories, so case numbers should not overlap. The figures in any rapidly evolving outbreak, however, are provisional and subject to change for a variety of reasons.

In providing the above information, WHO wishes to recognize the contribution of its Member States, and technical partners such as the European Commission, the European Centre for Disease Prevention and Control and a number of WHO collaborating centres.