- Associated Press - Sunday, June 5, 2011

BERLIN (AP) - Nicoletta Pabst could not believe what she saw twelve days ago when she rushed to a Hamburg hospital with stomach cramps, diarrhea and blood in her stool.

The emergency room at the University Medical Center in Hamburg-Eppendorf was engulfed by chaos, she said, overwhelmed as it tried to treat hordes of E. coli victims.

“All patients suspected of E. coli were led to a separate location for examination,” Pabst told The Associated Press in an interview Saturday. “When I arrived, there were at least 20 other people and more and more kept coming in, many of them by ambulance.”

She said the emergency room’s sanitary conditions were horrendous.

“All of us had diarrhea and there was only one bathroom each for men and women _ it was a complete mess,” she said. “If I hadn’t been sick with E. coli by then, I probably would have picked it up over there.”

Hamburg is at the epicenter of the deadliest E. coli outbreak in modern history.

Germany’s national disease control center raised the death toll Sunday to 22 people _ 21 in Germany and one in Sweden _ and said another 2,153 people in Germany have been sickened since May 2. That figure included 627 people who have developed a rare, serious complication of the disease that can cause kidney failure. Ten other European nations and the U.S. have reported a total of 90 other victims.

“We’d all been reading the scary news about the E. coli outbreak in our region for days,” said Pabst, a 41-year-old homemaker. “(My husband) took me to the university hospital right away.”

After waiting three hours to be seen, Pabst was told to go home because her blood levels did not indicate that she had kidney failure.

Germany’s health minister has admitted that hospitals in Hamburg and other northern areas have been struggling to provide enough beds for all the infected patients. Several people have said they were initially turned down by hospitals only to return days later with much more severe symptoms. Doctors and nurses in the north have been working around the clock to handle the surge of patients.

Pabst’s stomach cramps and bloody stools got worse during the night. The next morning she was so weak that she couldn’t stand, and her husband called an ambulance.

She was hospitalized at Asklepios Hospital in Hamburg-Altona and taken to an isolation room that doctors and nurses were only allowed to enter while covered from head to toe in protective gowns, gloves and masks.

Health officials questioned her about the food she’d been eating, and as a precaution her children were blocked from going go to school.

Nobody else in Pabst’s family got sick “even though we all ate the same tomatoes, cucumbers and salads,” she remembered.

The cause of her infection seemed to point to home cooking at her house or a friend’s, unlike earlier suggestions that many people may have been infected while visiting a port festival in Hamburg or a restaurant in the northern German city of Luebeck.

Pabst had to stay at the hospital for a week.

“For the first two days, I was completely exhausted, nodding off, not aware at all of what was happening around me,” Pabst remembered. She was put on an intravenous drip and her doctor decided to treat her with antibiotics despite recommendations by the World Heath Organization and the German health ministry not to do so.

There have been frequent reports about German doctors treating patients with unconventional, non-approved therapies like antibody treatment or antibiotics, often simply because traditional treatments do not improve the patients’ health.

Friedrich Hagenmueller, the medical director of Asklepios Hospital, treated Pabst with antibiotics early on “because what we had been doing so far in this outbreak hasn’t been very successful.”

“Her quick recovery has encouraged me to try out antibiotics on other incoming patients as well,” Hagenmueller told the AP.

Hans-Joerg Epple, a gastroenterologist at Berlin’s Benjamin-Franklin-Hospital, said while antibiotics were normally not given to E. coli patients, some experts were looking into treating the current E. coli strain with specific kinds of antibiotics.

“It is quite unusual and we don’t have a lot of data on this, but there are indications that some kinds of antibiotics may be helpful here,” Epple said.

Bahr, the German health minister, made a surprise visit Sunday to the University Medical Center in Hamburg-Eppendorf only hours after the AP reported on the shocking conditions there.

Pabst’s recovery started 48 hours after she’d received her first dose of antibiotics and on Wednesday she was discharged from the hospital. Her children will be allowed to go back to school now and Pabst said she’s feeling healthy again herself.

“One thing’s for sure: as long as the cause of the E. coli outbreak has not been found, there’ll be no more vegetables or fruit in our house,” Pabst said. “We’re only eating deep-frozen meals and spaghetti these days.”

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