REVIEW PAPER
Public health hazards in Poland posed by foodstuffs contaminated with E.Coli O104:H4 bacterium from the recent European out break
 
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1
Chief Sanitary Inspectorate, Warsaw, Poland
 
2
Institute of Haematology and Transfusion Medicine, Warsaw, Poland
 
3
Independent Laboratory of Molecular Biology, Institute of Rural Health, Lublin, Poland
 
4
Department of Public Health, University of Information Technology and Management, Rzeszow, Poland
 
5
Independent Laboratory of Streptomyces and Fungi Imperfecti, National Institute of Public Health – National Institute of Hygiene, Warsaw, Poland
 
6
Department of Health Promotion, Food and Nutrition, Institute of Rural Health, Lublin, Poland
 
 
Corresponding author
Lucyna Kapka-Skrzypczak   

Independent Laboratory of Molecular Biology, Institute of Rural Health, Lublin, Poland
 
 
Ann Agric Environ Med. 2012;19(1):3-10
 
KEYWORDS
ABSTRACT
Shiga toxin producing Escherichia coli (STEC) are the most virulent diarrhoeagenic E. coli known to date. They can spread with alarming ease via the food chain, as recently demonstrated by the large outbreak of STEC O104:H4 borne by sprouted seeds in 2011, clustered in northern Germany, and subsequently affecting other countries. Indeed, a significant number of infections to verocytotoxin producing Escherichia coli O104:H4 have been reported from the WHO European Region resulting in many cases of bloody diarrhoea and haemolytic uraemic syndrome in Germany, 15 other European countries and North America. Eventually, the European Food Standards Agency, (EFSA), identified the likely source to a single consignment of fenugreek seeds from an Egyptian exporter as being linked to the two outbreaks in Germany and France. The situation was closely monitored by the Chief Sanitary Inspectorate public health authority in Poland where actions undertaken ensured that the public was well informed about the dangers of STEC contamination of food, how to avoid infection, and what to do if infected. Tracing the fenugreek distributors also enabled the identification of suspected batches and their isolation. As a result, there were very few reported cases of STEC infection in Poland. Effective control over such outbreaks is therefore a vital public health task. This should include early detection and rapid identification of the contagion mode, followed by removing the foodstuff(s) from the market, providing consumer advice, and preventing secondary spreading. As a mitigation measure, screening/monitoring those involved in food handling is also warranted to exclude carriers who can be asymptomatic.
REFERENCES (62)
1.
WHO – Regional Office For Europe: Public health review of the enterohaemorrhagic Escherichia Coli outbreak in Germany, June 2011. http://www.euro.who.int/__data... (access: 2012.01.10).
 
2.
Brzuszkiewicz E, Thürmer A, Schuldes J, Leimbach A, Liesegang H, Meyer FD et al. Genome sequence analyses of two isolates from the recent Escherichia coli outbreak in Germany reveal the emergence of a new pathotype: Entero-Aggregative-Haemorrhagic Escherichia coli (EAHEC). Arch Microbiol. 2011; 93(12): 883-91.
 
3.
Rey J, Sanchez S, Blanco JE, Hermoso de Mendoza J, Hermoso de Mendoza M, Garcia A, et al. Prevalence, serotypes and virulence genes of Shiga toxin-producing Escherichia coli isolated from ovine and caprine milk and other dairy products in Spain. Int J Food Microbiol. 2006; 107: 212-217.
 
4.
Zweifela C, Schumachera S, Blancob M, Blancob JE, Tasaraa T, Blancob J et al. Phenotypic and genotypic characteristics of non-O157 Shiga toxin-producing Escherichia coli (STEC) from Swiss cattle. Vet Microbiol. 2005; 105: 37-45.
 
5.
ECDC/EFSA JOINT TECHNICAL REPORT, Shiga toxin/verotoxin-producing Escherichia coli in humans, food and animals in the EU/EEA, with special reference to the German outbreak strain STEC O104, Stockholm, June 2011. http://ecdc.europa.eu/en/publi... (access: 2012.01.10).
 
6.
Łoś JM, Węgrzyn G. Enterokrwotoczne szczepy Escherichia coli (EHEC) i bakteriofagi kodujące toksyny Shiga [Enterohemorrhagic strains of Escherichia coli (EHEC) and shiga toxin-encoding bacteriophages]. Post Mikrobiol. 2011; 50(3): 175-190.
 
7.
Jinneman KC, Waite-Cusic JG, Yoshitomi KJ. Evaluation of shiga toxin-producing Escherichia coli(STEC) method for the detection and identification of STEC O104 strains from sprouts. Food Microbiol. 2012; 30: 321-328.
 
8.
Rangel JM, Sparling PH, Crowe C, Griffin PM, Swerdlow DL. Epidemiology of Escherichia coli O157:H7 Outbreaks, United States, 1982-2002. Emerg Infect Dis. 2005; 11(4): 603-9.
 
9.
Ścieżyńska H, Maka Ł, Grochowska A, Pawłowska K, Postupolski J. Escherichia coli w żywności, w tym E. coli O104 [Escherichia coli in food, including E. coli O104]. Przem Spożywczy. 2011; 65(10):8-12.
 
10.
Brooks JT, Sowers EG, Wells JG, Greene KD, Griffin PM, Hoekstra RM, Strockbine NA. Non-O157 Shiga Toxin–Producing Escherichia coli Infections in the United States, 1983–2002. J Infect Dis. 2005 Oct 15; 192(8): 1422-9.
 
11.
Ruggenenti P, Remuzzi G. A German outbreak of haemolytic uraemic syndrome. Lancet. 2011; 378(9796): 1057-8.
 
12.
Scheutz F, Moller Nielsen E, Frimodt-Moller J, Boisen N, Morabito S et al. Characteristics of the enteroaggregative Shiga toxin/verotoxin-producing Escherichia coli O104:H4 strain causing the outbreak of haemolytic uraemic syndrome in Germany, May to June 2011. Euro Surveill. 2011 Jun 16;16(24). pii: 19889.
 
13.
Shiga toxin-producing E. coli (STEC) O104:H4 2011 outbreaks in Europe –Taking Stock, EFSA Journal 2011;9(10):2390 http://www.efsa.europa.eu/en/e... (access: 2012.01.10).
 
14.
Mellmann A, Bielaszewska M, Kock R, Friedrich AW, Fruth A, Middendorf B, et al. Analysis of collection of hemolytic uremic syndrome-associated enterohemorrhagic Escherichia coli. Emerg Infect Dis. 2008; 14(8): 1287-90.
 
15.
Bae WK, Lee YK, Cho MS, Ma SK, Kim SW, Kim NH, et al. A case of hemolytic uremic syndrome caused by Escherichia coli O104:H4. Yonsei Med J. 2006; 47(3): 437-9.
 
16.
Wu CJ, Hsueh PR, Ko WC. A new health threat in Europe: Shiga toxin-producing Escherichia coli O104:H4 infections. J Microbiol Immunol Infect. 2011; 44(5): 390-393.
 
17.
Januszkiewicz A, Szych J, Rastawicki W, Wolkowicz T, Chróst A, Leszczynska B, et al. Molecular epidemiology of shiga-toxin producing Escherichia coli household outbreak in Poland due to secondary transmission of STEC O104:H4 from Germany. J Med Microbiol. 2011 Dec 1. [Epub ahead of print].
 
18.
Scavia G, Morabito S, Tozzoli R, Michelacci V, Marziano ML, Minelli F et al. Similarity of Shiga toxin-producing Escherichia coli O104:H4 strains from Italy and Germany. Emerg Infect Dis. 2011; 17(10): 1957-8.
 
19.
Wieler LH, Semmler T, Eichhorn I, Antao EM, Kinnemann B, Geue L et al. No evidence of the Shiga toxin-producing E. coli O104:H4 outbreak strain or enteroaggregative E. coli (EAEC) found in cattle faeces in northern Germany, the hotspot of the 2011 HUS outbreak area. Gut Pathog. 2011; 3(1): 17.
 
20.
Trachtman H. Escherichia coli O104:H4 outbreak in Germany. N Engl J Med. 2012; 366(8): 766; author reply 766-7.
 
21.
Aurass P, Prager R, Fliege A. EHEC/EAEC O104:H4 strain linked with the 2011 German outbreak of aemolytic uremic syndrome enters into the viable but non-culturable state in response to various stresses and resuscitates upon stress relief. Environ Microbiol. 2011; 13(12): 3139-3148.
 
22.
Jourdan-da Silva N, Watrin M, Weill F, King L, Gouali M, Mailles A et al. Outbreak of haemolytic uraemic syndrome due to Shiga toxin-producing Escherichia coli O104:H4 among French tourists returning from Turkey, September 2011. Euro Surveill 2012; 17(4). pii: 20065.
 
23.
Struelens MJ, Palm D, Takkinen J. Enteroaggregative, Shiga toxin-producing Escherichia coli O104:H4 outbreak: new microbiological findings boost coordinated investigations by European public health laboratories. Euro Surveill 2011; 16(24). pii: 19890.
 
24.
Künne C, Billion A, Mshana SE, Schmiedel J, Domann E, Hossain H et al. Complete sequences of plasmids from the hemolytic-uremicsyndrome-associated Escherichia coli strain HUSEC41. J Bacteriol. 2012; 194(2): 532-3.
 
25.
Mahajan A, Gally D. Escherichia coli and the mucosal immune system. Expert Rev Clin Immunol. 2011; 7(6): 743-5.
 
26.
Kim JJ. Immunoadsorption for haemolytic uraemic syndrome. Lancet. 2011; 378(9797): 1120-2.
 
27.
Gault G, Weill FX, Mariani-Kurkdjian P, Jourdan-da Silva N, King L, Aldabe B et al. Outbreak of haemolytic uraemic syndrome and bloody diarrhoea due to Escherichia coli O104:H4, south-west France, June 2011. Euro Surveill 2011; 16(26). pii: 19905.
 
28.
Marejková M, Roháčová H, Reisingerová M, Petráš P. An imported case of bloody diarrhea in the Czech Republic caused by a hybrid enteroaggregative hemorrhagic Escherichia coli (EAHEC) O104:H4 strain associated with the large outbreak in Germany, May 2011. Folia Microbiol (Praha). 2012 Jan 19. [Epub ahead of print].
 
29.
Tzschoppe M, Martin A, Beutin L. A rapid procedure for the detection and isolation of enterohaemorrhagic Escherichia coli (EHEC) serogroup O26, O103, O111, O118, O121, O145 and O157 strains and the aggregative EHEC O104:H4 strain from ready-to-eat vegetables. Int J Food Microbiol. 2012; 152(1-2): 19-30. Epub 2011 Oct 21.
 
30.
Hauri A, Gotsch U, Strotmann I, Krahn J, Bettge-Weller G, Westbrock H et al. Secondary transmissions during the outbreak of Shiga toxin-producing Escherichia coli O104 in Hesse, Germany, 2011. Euro Surveill 2011; 16(31). pii: 19937.
 
31.
Rump LV, Bodeis-Jones S, Abbott J, Zhao S, Kase J, Lorenz S et al. Genetic Characterization of Escherichia coli O104 Isolates from Different Sources in the United States. Appl Environ Microbiol. 2012; 78(5): 1615-8. Epub 2011 Dec 30.
 
32.
Mariani-Kurkdjian P, Bingen E, Gault G, Jourdan-Da Silva N, Weill FX. Escherichia coli O104:H4 south-west France, June 2011. Lancet Infect Dis. 2011; 11(10): 732-3.
 
33.
Kuijper EJ, Soonawala D, Vermont C, van Dissel JT. Household transmission of haemolytic uraemic syndrome associated with Escherichia coli O104:H4 in the Netherlands, May 2011. Euro Surveill. 2011 Jun 23; 16(25). pii: 19897.
 
34.
Cordesmeyer S, Peitz U, Gödde N, Kasper HU, Hoffmann MW, Allemeyer E. Colonic ischaemia as a severe Shiga toxin/verotoxin producing Escherichia coli O104:H4 complication in a patient without haemolytic uraemic syndrome, Germany, June 2011. Euro Surveill 2011; 16(25). pii: 19895.
 
35.
Roche Marti´nez A, P óo Arguelles P, Maristany Cucurella M, Jime´nez Llort A, Camacho JA, Campistol Plana J. Haemolytic-Uraemic Syndrome: Neurologic Symptoms, Neuroimaging and Neurocognitive Outcome, Neuroimaging for Clinicians – Combining Research and Practice, 2011, Julio F. P. Peres (Ed.), ISBN: 978-953-307-450-4, InTech, Available from: http://www.intechopen.com/sour... (access: 2012.01.10).
 
36.
Loirat C, Fre´meaux-Bacchi V. Atypical hemolytic uremic syndrome. Orphanet J Rare Dis. 2011; Sep 8(6): 60.
 
37.
Borgatta B, Kmet-Lunaček N, Rello J. E. coli O104:H4 outbreak and haemolytic-uraemic syndrome. Med Intensiva. 2012 Jan 11. [Epub ahead of print].
 
38.
Cheung MK, Li L, Nong W, Kwan HS. 2011 German Escherichia coli O104:H4 outbreak: whole-genome phylogeny without alignment. BMC Res Notes. 2011; 4: 533.
 
39.
Michael M, Elliott EJ, Ridley GF, Hodson EM, Craig JC. Interventions for haemolytic uraemic syndrome and thrombotic thrombocytopenic purpura. Cochrane Database Syst Rev. 2009 Jan 21; (1): CD003595.
 
40.
Tarr PI, Gordon CA, Chandler WL. Shiga-toxin-producing Escherichia coli and haemolytic uraemic syndrome. Lancet. 2005; 365(9464): 1073-86.
 
41.
Mörtzell M, Berlin G, Nilsson T, Axelsson CG, Efvergren M, Audzijoni J et al. Thrombotic microangiopathy. Transfus Apher Sci. 2011; 45(2): 119-23.
 
42.
Mehrazma M, Hooman N, Otukesh H. Prognostic value of renal pathological findings in children with atypical hemolytic uremic syndrome. Iran J Kidney Dis. 2011; 5(6): 380-5.
 
43.
Boyer O, Niaudet P. Hemolytic uremic syndrome: new developments in pathogenesis and treatment. Int J Nephrol. 2011; 2011: 908407.
 
44.
Kerr H, Richards A. Complement-mediated injury and protection of endothelium: lessons from atypical haemolytic uraemic syndrome. Immunobiology. 2012; 217(2): 195-203.
 
45.
German EHEC-HUS Registry. The German 2011 epidemic of Shiga toxin-producing E. coli-the nephrological view. Nephrol Dial Transplant. 2011; 26(9): 2723-6.
 
46.
Teramoto T, Fukao T, Hirayama K, Asano T, Aoki Y, Kondo N. Escherichia coli O-157-induced hemolytic uremic syndrome: Usefulness of SCWP score for the prediction of neurological complication. Pediatr Int. 2009; 51(1): 107-9.
 
47.
Kemper MJ. Outbreak of hemolytic uremic syndrome caused by E. coli O104:H4 in Germany: a pediatric perspective. Pediatr Nephrol. 2012; 27(2): 161-4.
 
48.
Colic E, Dieperink H, Titlestad K, Tepel M. Management of an acute outbreak of diarrhoea-associated haemolytic uraemic syndrome with early plasma exchange in adults from southern Denmark: an observational study. Lancet. 2011; 378(9796): 1089-93.
 
49.
Goldwater PN, Bettelheim KA. Treatment of Enterohemorrhagic E. coli (EHEC) infection and Hemolytic Uremic Syndrome (HUS). BMC Med. 2012; 10(1): 12.
 
50.
Ballal M, Martena S. First Case Report of Moraxella osloensis Diarrhea in a Hemolytic Uremic Syndrome/Acute Renal Failure Child from Rural Coastal India-Manipal, Karnataka. Indian J Pediatr. 2012 Jan 10. [Epub ahead of print].
 
51.
Ruggenenti P, Remuzzi G. A German outbreak of haemolytic uraemic syndrome. Lancet. 2011; 378(9796): 1057.
 
52.
Wong CS, Jelacic S, Habeeb RL, Watkins SL, Tarr PI. The risk of the hemolytic-uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 infections. N Engl J Med. 2000; 342(26): 1930-6.
 
53.
Hadaya K, Ferrari-Lacraz S, Fumeaux D, Boehlen F, Toso C, Moll S et al. Eculizumab in acute recurrence of thrombotic microangiopathy after renal transplantation. Am J Transplant. 2011; 11(11): 2523-7. doi: 10.1111/j.1600-6143.2011.03696.x.
 
54.
Jansen A. Highlights from the clinical symposium on Shiga toxin-producing Escherichia coli / haemolytic uremic syndrome, Berlin, September 2011. Euro Surveill. 2011; 16(39). pii: 19977.
 
55.
Macneil A, Nichol ST, Spiropoulou CF. Hantavirus pulmonary syndrome. Virus Res. 2011 Dec; 162(1-2): 138-47.
 
56.
Nowakowska A, Heyman P, Knap JP, Burzyński W, Witas M. The first established focus of hantavirus infection in Poland, 2007. Ann Agric Environ Med. 2009; 16: 79-85.
 
57.
Dutkiewicz J, Cisak E, Sroka J, Wójcik-Fatla A, Zając V. Biological agents as occupational hazards – selected issues Ann Agric Environ Med. 2011; 18(2): 286-293.
 
58.
Bartosik K, Lachowska-Kotowska P, Szymanska J, Pabis A, Buczek A. Lyme borreliosis in south-eastern Poland: relationships with environmental factors and medical attention standards. Ann Agric Environ Med. 2011; 18(1): 131-137.
 
59.
Kalinova Z, Halanova M, Cislakova L, Sulinova Z, Jarcuska P. Occurrence of IgG antibodies to Anaplasma phagocytophilum in humans suspected of Lyme borreliosis in eastern Slovakia. Ann Agric Environ Med. 2009; 16(2): 285-288.60. Stanek G, Wormser GP, Gray J, Strle F. Lyme borreliosis. Lancet. 2012 Feb 4; 379(9814): 461-73.
 
60.
Stanek G, Wormser GP, Gray J, Strle F. Lyme borreliosis. Lancet. 2012 Feb 4; 379(9814): 461.
 
61.
Goldwater PN, Bettelheim KA. Treatment of Enterohemorrhagic E. coli (EHEC) infection and Hemolytic Uremic Syndrome (HUS). BMC Med. 2012 Feb 2; 10(1): 12. [Epub ahead of print].
 
62.
STEC Workshop Reporting Group. Experiences from the Shiga toxin-producing Escherichia coli O104:H4 outbreak in Germany and research needs in the field, Berlin, 28–29 November 2011. Euro Surveill. 2012;17(7):pii=20091., http://www.eurosurveillance.or... (access: 2012.01.10).
 
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