EHEC outbreak: update 23

Since week 23/2011, 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 22 May. 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 E. coli (EAggEC VTEC) O104:H4, is bean and seed sprouts, and the Robert Koch Institute has warned people in Germany not to eat raw sprouts of any origin.

The table shows the reported cases of and deaths from HUS and EHEC infection as of 23 June at 15:00 CET.

Country
HUS
EHEC
Comments
 Cases Deaths
 Cases  Deaths  
Austria 1
 0 4
0
 
Canada  0 0
 1  0  
Czech Republic 0
 0 1
 0 A tourist from the United States who had travelled in Germany
Denmark 9
0
13
 0  
France 0
0
2
0

Germany
 827  29  2890 14  
Greece 0
 0  1 0
A German tourist
Luxembourg 1
 0 1
0
 
Netherlands 4
 0 7
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
33
0
 
Switzerland 0
0
5
0
 
United Kingdom 3
0
3 0

United States of America  4 1
 2 0
3 HUS cases and 2 EHEC cases – all confirmed; in addition, 1 fatal HUS case with travel history to Germany reported by the state of Arizona (not yet confirmed as O104:H4)
 Total  870  31  2966  14  

Note. There are 3836 HUS and EHEC cases in total, including 45 fatalities.

In Germany, the latest date of onset of diarrhoea is 16 June for both HUS and EHEC cases. 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.