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A farmer displays a cucumber cut in half in a greenhouse in Algarrobo, near Malaga, southern Spain May 29, 2011. (Jon Nazca/Reuters/Jon Nazca/Reuters)
A farmer displays a cucumber cut in half in a greenhouse in Algarrobo, near Malaga, southern Spain May 29, 2011. (Jon Nazca/Reuters/Jon Nazca/Reuters)

Toll climbs in European E. coli outbreak Add to ...

An E. coli outbreak that is ravaging Germany and other parts of Europe - and has prompted government officials there to issue a warning to consumers tempted by raw salad vegetables - is on pace to set a global record.

At least 14 people have died and more than 1,200 have been sickened - 329 seriously - by a rare strain of E. coli that has been linked, although not definitively, to cucumbers imported from Spain. The European Centre for Disease Prevention and Control has described the outbreak as "one of the largest worldwide and the largest ever reported in Germany."

Food safety officials have been struggling for more than two weeks to pin down the precise source of the adulterant, which first surfaced in Hamburg and has since hit people in Britain, Denmark, Sweden and the Netherlands, most of whom travelled recently in northern Germany.

The ambiguity, coupled with the continuing flood of fatalities, prompted Belgium and Russia to ban vegetable imports from Spain outright while Germany continues its investigation into the source. Fears have prompted the removal of Spanish cucumbers from shelves in the Czech Republic, France and Austria. The boycott prompted Spanish Agriculture Minister Rosa Aguilar to lash out in denial on Monday and to suggest her producers ought to be compensated.

"Our understanding is that the problem does not come from the [country of]origin," Ms. Aguilar told Agence France-Presse. "The image of Spain is being damaged, Spanish producers are being damaged and the Spanish government is not prepared to accept this situation," she said.

The bug

Unique to the outbreak is the rare strain of E. coli, called 0104. More common in cases of food-borne illness is E. coli 0157:H7, the culprit in recent cases of tainted hamburger, cookie dough and lettuce affecting the United States and Canada.

Both strains of E. coli produce Shiga toxins, one of the most potent toxins in existence known to cause full-blown haemolytic uraemic syndrome (HUS), a disease that causes bloody diarrhea, liver and kidney damage and in some cases, death. Doctors everywhere struggle to treat the illness.

E. coli has several characteristics that make the organisms dangerous. Present in the intestines of animals and humans, they can survive for long periods on non-sterile surfaces - think countertops, vegetable skins or anywhere from field to table. It takes only a small dose of them to wreak havoc on an immune system.

The carriers

Second to beef, leafy vegetables are the most common sources of E. coli-related illnesses. While beef is often contaminated during processing (manure-coated cowhide can come into contact with raw meat, providing a gateway for E. coli into the supply chain), the bacteria is usually killed during high-temperature cooking processes.

With raw vegetables, it's a different story. If grown outdoors, vegetables can become contaminated with E. coli carried by chicken, deer, sheep, cattle or pigs snacking in the spinach patch, or with water that has itself been contaminated by feces from one of those animals.

While washing vegetables well usually removes bacteria, sometimes it can grow right into the plant structure. In those rare cases, washing the lettuce or vegetable is a futile effort. The bacteria will remain unless the vegetables are cooked at a temperature hot enough to kill them off. Eaten raw, contaminated vegetables can be deadly. This can occur in any country, regardless of the rigour of its food-safety system.

A problem in need of a global solution

German food safety officials have yet to pinpoint where E. coli entered their food chain. Regardless of where the weak point lurks, food-safety experts say the solution is a more robust global recall system.

A 2008 study done by AMR Research found that, on average, it takes 18 days for large food manufacturers to sense the need for a recall and issue one. There is no question of the need to narrow that timeline - cutting it down would potentially reduce the number of sicknesses in a given outbreak. Robert Tauxe, the U.S. Centers for Disease Control and Prevention's deputy director of food-borne, bacterial and mycotic diseases, said during a talk last year that there is no consensus on how to do this.

Governments cannot force retailers or manufacturers to issue recalls. Establishing the need and scope of a recall hinges on how many cases of a particular illness have been recorded by public health authorities. But the system of collating records of those cases is imperfect: Not all doctors are aware of the importance of reporting food-related illnesses to regional health authorities; not all regional authorities that get the information send it on to the appropriate provincial, state or national officials given the task of identifying illness clusters that are less concentrated in our increasingly global food system.

When illness clusters are identified and recalls are issued, few proceed smoothly. There is no universal labelling system for food; a wholesaler might work with 10 different labelling or packaging systems customized to the likes of 10 different suppliers who may or may not repackage the product for an end customer. With unbranded fresh fruit and vegetables that come unmarked in large boxes and are mixed with other similar-sized vegetables from different suppliers before being loaded onto grocery shelves, recalls are extremely tough to manage.

John Keogh, senior vice-president responsible for product safety and recalls for GS1, a global non-profit industry standards group, said the solution is a global standard for product recalls.

Developed by GS1 over the past two years, the system is being implemented by Australia and New Zealand this year. The hope is that other countries, including Germany, where officials met with Mr. Keogh recently, will follow suit.

Without one, the international community will continue to struggle through outbreaks. "They're not all talking the same language," he said.

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