LONDON (AP) — An expert at the World Health Organization
says time is running out for German investigators to find the source of the
world's deadliest E. coli outbreak, which has spread fear across Europe and cost farmers millions in exports.
German officials are still seeking the cause of the outbreak
weeks after it began May 2. In the last week, they have wrongly accused Spanish
cucumbers and then German sprouts of sparking the crisis that has killed 22
people and infected over 2,400.
"If we don't know the likely culprit in a week's time,
we may never know the cause," Dr. Guenael Rodier, director of communicable
diseases expert at WHO, told The Associated Press on Tuesday.
He said the contaminated vegetables have likely disappeared
from the market and it would be difficult for German investigators to link
patients to contaminated produce weeks after they first became infected.
"Right now, (Germans) are interviewing people about
foods they ate about a month ago," he said. "It's very hard to know
how accurate that information is."
Without more details about what exact foods link sick patients,
Rodier said it would be very difficult to narrow down the cause.
"The final proof will come from the lab," he said.
"But first you need the epidemiological link to the suspected food."
Other experts issued harsher criticism of the German
investigation and wondered why it was taking so long to identify the source.
"If you gave us 200 cases and 5 days, we should be able
to solve this outbreak," said Michael Osterholm, director of the Center
for Infectious Disease Research and Policy at the University
of Minnesota, whose team has contained
numerous food-borne outbreaks in the United States.
Osterholm described the German effort as "erratic"
and "a disaster" and said officials should have done more detailed
patient interviews as soon as the epidemic began.
The medical director of Berlin's Charite Hospitals, Ulrich Frei,
said it took the national disease control center weeks to send his hospital
questionnaires for E.coli patients to fill out about their eating habits.
Osterholm said the Germans should have been able to trace
cases of illness to infected produce by now and that tests on current produce
won't be helpful.
"It's like looking at camera footage of a traffic
intersection today to see what caused an accident three weeks ago," he
said.
"This is an outbreak response that is not being led by
the data," he added. "Solving an outbreak like this is difficult, but
it's not an impossible task."
On Tuesday, the EU health chief warned Germany against
premature — and inaccurate — conclusions on the source of contaminated food.
The comments by EU health chief John Dalli came only a day after he had
defended the German investigators, saying they were under extreme pressure.
Dalli told the EU parliament in Strasbourg that information must be
scientifically sound and foolproof before it becomes public.
In outbreaks, it is not unusual for certain foods to be
suspected at first, then ruled out. In 2008 in the U.S., raw tomatoes were initially
implicated in a nationwide salmonella outbreak. Consumers shunned tomatoes,
costing the tomato industry millions. Weeks later, jalapeno peppers grown in Mexico were
determined to be the cause.
In the current E. coli outbreak, tests are continuing on
sprouts from an organic farm in northern Germany, but have so far come back
negative,
But Rodier said that doesn't necessarily exonerate the
vegetables.
"Just because tests are negative doesn't mean you can
rule them out," he said. "The bacteria could have been in just one
batch of contaminated food and by the time you collect specimens from the
samples that are left, it could be gone."
He said food-borne outbreaks are difficult to contain
because they involve multiple industries, government departments and in Germany's case,
several layers of bureaucracy to report numbers. That results in a slight
reporting delay, which makes it harder for experts to know whether an outbreak
is peaking or not.
The outbreak has killed 22 people — 21 in Germany and one in Sweden.
Germany's
national disease control center, the Robert Koch Institute, on Tuesday raised
the number of infections in Germany
to 2,325, with another 100 cases in 10 other European countries and the United States.
The number of victims hospitalized in intensive care with a rare, serious complication
that may lead to kidney failure rose by 12 to 642.
The institute said the number of new cases is declining — a
sign the epidemic might have reached its peak — but added it was not certain
whether that decrease will continue.
In a major difference from other E. coli outbreaks, women —
who tend to eat more fresh produce — are by far the most affected this time.
The majority of the victims in Germany
are between 20 and 50 years old and tend to be highly educated, very fit, and
lead healthy lifestyles, investigators said.
"What do they have in common? They are thin, clean
pictures of health," said Friedrich Hagenmueller of the Asklepios Hospital
in Hamburg, Germany.