Arizona E. coli related death triggers warning

By Dr. Ananya Mandal, MDJul 10 2011

The Center for Disease Control and Prevention (CDC) and the Arizona Department of Health announced last Friday that a man who recently traveled to Germany was infected by the German E. coli outbreak.  The man died from kidney complications. This death was the first U.S. fatality of the relentless epidemic.  According to the World Health Organization, 52 have been killed in the outbreak.

This strain of the bacteria - OO104:H4 strain was said to have originated on a farm in northern Germany in organic sprouts of Egyptian fenugreek seeds, said German health officials. This specific strain of the E. coli has not been diagnosed since it appeared in one German child ten years ago. The strain is extremely resilient because it is a fusion of E. coli O157, which produces the Shiga toxin, and enteroaggregative E. coli, which attaches itself to the gut and notoriously causes diarrhea in developing countries.  The toxin causes hemolytic-uremic syndrome followed by kidney failure. Common symptoms include stomach cramps, bloody diarrhea, nausea, and vomiting. Most healthy people infected recover in five to seven days.  The very young and the elderly are most vulnerable.

Five of the infected Americans, including the Arizona man, developed hemolytic uremic syndrome (HUS), a severe complication that can lead to death or permanent kidney damage. In Europe, 823 patients have developed HUS.

E. coli is typically spread by ingestion of contaminated food, and is difficult to spread person-to-person, although one of the Americans was infected in this manner. The Food and Drug Administration said that raw sprouts should be avoided; this strain is resistant to antibiotics and highly contagious.