German E. Coli Outbreak Holds Lessons For U.S.

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Listen to Richard Knox's story on Morning Edition.

American public health officials are warning that the outbreak is a bellwether for what could be in store as E. coli strains evolve. For unknown reasons, some strains are releasing more toxins when attacked by antibiotics, and the toxins are causing more serious disease — and more deaths.

RENEE MONTAGNE, host:

And while the investigation into the E. coli outbreak continues in Europe, NPR's Richard Knox says U.S. experts worry this country could see something similar.

RICHARD KNOX: Some experts think the bug that's circulating mainly in Germany isn't really more dangerous than earlier strains. It's just that more people got exposed to it. After all, the U.S. Centers for Disease Control and Prevention discovered an almost identical E. coli germ two years ago in the Republic of Georgia in Eastern Europe. It didn't get much attention then. But Dr. Dennis Maki of the University of Wisconsin has treated lots of people with bad E. coli infections over the years. And he says this one is clearly different. Earlier strains were far less likely to put victims in the hospital with severe anemia and kidney failure.

Dr. DENNIS MAKI (University of Wisconsin): Rarely over 10 percent, and here it's about a third. That's extraordinary. This is an extraordinarily virulent strain of E. coli. I think it's becoming clear.

KNOX: Maki thinks the European strain has acquired the ability to crank out far more toxins than earlier forms. It's the toxin that destroys blood cells and causes kidney failure. The U.S. is no stranger to serious outbreaks of E. coli. Dr. Chris Braden is chief of food-borne diseases at the CDC.

Dr. CHRIS BRADEN (Chief of food-borne diseases, Center for Disease Control): Certainly we've seen our share of E. coli outbreaks, and we see quite a few infections every year.

KNOX: In fact, there are more than 100,000 U.S. cases of serious E. coli infection every year. Hundreds of people are hospitalized, and as many as 80 die. But most of them occur one-by-one, not in big outbreaks. Braden doesn't think the German outbreak will leapfrog the Atlantic and start spreading here, right away.

Dr. BRADEM: But I am concerned about something similar that could happen in the United States.

KNOX That's because a big change is going on in the type of E. coli that's causing serious illness here. The chief culprit used to be a notorious bug, called O-157-H-7. It caused a big outbreak in hamburger back in 1982, in raw spinach five years ago, and two dozen outbreaks in between. Dr. Michael Osterholm is an infectious disease expert at the University of Minnesota.

Dr. MICHAEL OSTERHOLM, (University of Minnesota): For a number of years, almost all of the strains of this kind of E. coli were that O-157-H-7. Over the past 15 years, we've seen a very sizable increase in the number of non-O157-H-7 strains.

KNOX: Many of these more recent strains are called O-1-zero-4. And that's the same type of strain causing the outbreak in Germany. It's just that the American version is far less dangerous, so far. But Osterholm predicts more mischief from the newer strain.

Dr. OSTERHOLM: Are there are going to be more outbreaks like we see in Germany right now occurring around the world? I bet there will be.

KNOX: Maki agrees.

Mr. MAKI: We will see U.S. cases. If enough people bring this strain back to the U.S., we could have big outbreak with this strain maybe in a year or two or three. It's not out of the question at all.

KNOX: That's why experts want to learn everything they can about the European bug - how it got there, why it's so deadly, and above all, how it gets into food.

Richard Knox, NPR News

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