Smoking gun elusive in deadly E. coli outbreak

BERLIN (AP) - European health officials tracking one of the worst E. coli outbreaks on record might never know where it came from. It’s a sad fact of life in food poisoning cases: There often is no smoking gun.

The germ has sickened more than 1,500 people, mostly in Germany. Most patients who have been interviewed said they ate lettuce, tomatoes or cucumbers, but officials testing produce across the continent have yet to find any vegetables with the particular strain involved.

Illnesses can occur days after tainted food is eaten and leftovers thrown out, so “the trail gets cold pretty quick,” said Bill Marler, a Seattle attorney who specializes in food poisoning cases.

“They might never find the cause of the outbreak,” said Paul Hunter, professor of health protection at England’s University of East Anglia. “In most foodborne outbreaks, we don’t know definitively where the contaminated food came from.”

Germany’s national health agency said Wednesday that more than 1,530 people there had been sickened by a dangerous E. coli germ, including 17 dead and 470 suffering from a kidney failure complication that was previously considered rare.

The outbreak has hit at least nine European countries, but virtually all the sick people either live in Germany or recently traveled there. Two people who were sickened are now in the U.S., and both had recently traveled to Hamburg, Germany, where many of the infections occurred.

The outbreak is already considered the third-largest involving E. coli in recent world history, and it may be the deadliest. Twelve people died in a 1996 Japanese outbreak that reportedly sickened more than 12,000, and seven died in a 2000 Canadian outbreak that also made thousands ill.

Nearly all cases are linked to northern Germany, “so it seems to be a common exposure there. But we don’t yet know what was this exposure,” said Dr. Hilde Kruse, the World Health Organization’s food safety program manager for Europe.

“It’s like a puzzle. But unfortunately the puzzle is not complete.”

Where the dangerous germ came from is just one of the questions health officials have. Another is why patients are suffering from life-threatening kidney complications in an unusually high percentage of cases. It might mean the strain is particularly virulent, but it’s also possible that thousands of less serious cases of food poisoning have gone unreported.

People with less severe symptoms may contact health authorities later, or not at all, Kruse said.

Kruse also said the outbreak is “different in that it mainly affects adults and predominantly women.” Some experts say that likely has to do with diet _ women tend to eat more fresh produce.

Experts are cautious about trying to explain what’s happening at the moment. “An epidemic is like a battle _ it’s not clear where everything is coming from and what is going on,” said Dr. Phillip Tarr, an E. coli expert at the Washington University School of Medicine.

The bacteria being investigated is one of the few dangerous types among the hundreds of different E. coli bugs. People and animals carry various E. coli in their intestines. But only a very small percentage are deadly. One of the most notorious was a strain that killed four U.S. children in 1993 and was linked to contaminated hamburgers at a fast-food chain.

Some experts said the sheer scope of the German outbreak may help eventually solve it. With more cases, there are better odds that the source can be found. That helped in the Japanese outbreak in 1996, which was blamed on radish sprouts, and the 2000 Canadian outbreak, which was traced to drinking water.

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