E. Coli outbreak in Europe

I just returned the day before yesterday from Belgium, Netherlands and Czech Republic... my traveling partner and myself have been eating all these foods for two weeks! I can't find info on what to do. We are worried...any ideas where we can get information on how to know if you are infected?

If you develop diarrhea, go to see your doctor. Otherwise, don't worry.

If you are not sick yet, you are probably okay. You can also search internet and look up the CDC site to see what info they can give you.

Uk's supposed to be ok.
S :0)

The outbreak is confined mostly to northern Germany, so you should be fine. But just in case, don't eat raw cucumbers, tomatoes or lettuce. Those are the only foods so far linked to the outbreak. Even washing the vegetables is probably not sufficient.

If you're concerned, eat only cooked foods. If everything is cooked, the Ecoli will be killed in the process. Remember even a McDonald's Big Mac has uncooked lettuce. To completely avoid uncooked foods, you need to think through your food orders carefully. Meanwhile, keep an eye on the news. I don't think they've accurately pinpointed the source of the outbreak yet.

" don't think they've accurately pinpointed the source of the outbreak yet." As of the latest bulletins I'm getting, that is correct. So yes, caution is definately in order.

Don't forget some perspective - the USA is seemingly under a non-stop warning about one vegetable/fruit or another...tomatoes from California one month, jalapenos from New Mexico another...peanut butter from Texas...I was 'supposed' to throw out my peanut butter-and-crackers awhile back, after I'd eaten 1/3 of the package already (I survived after eating the entire package). Taco Bell stopped putting tomatoes (or was it lettuce? avocados?) in their foods. And I won't start on the beef recalls... Eat cooked foods, and get any diarrhea checked out by a doctor ASAP. Susan, the UK is OK in my book, anyway ;-)

I contracted a bad strain of E Coli two years ago and was hospitalized for four days. I was contacted by the health department for questioning. They asked me to trace back what I had eaten for the last three weeks, and then after I was home from the hospital I had blood tests every other day for two or three more weeks to make sure my health didn't go south. So, I guess you can get sick a couple weeks or more after the exposure. For me, I had very bad stomach cramps (almost like labor pains) that would come and go along with diarrhea, but the cramps where the primary thing that made me need to get to the hospital. I never did find out were I got it, so in this case I think I'd just stay away from uncooked food. We leave for Germany on Friday, and that is my plan. Can you believe that three weeks after my E Coli I was on a Mexican Cruise where then H1N1 broke out? Thankfully, I didn't get it!

@ Susan, "Uk's supposed to be ok." You might have a look at this: www.independent.co.uk/life-style/health-and-families/health-news/ecoli-warning-after-germany-outbreak-2289499.html As this particular strain appears to be transmittable from person-to-person, those returning from the affected areas could cause problems in the U.K. Hopefully any affected individuals will be quickly contained. This news report is almost a week old, so not sure whether there have been any further cases in the U.K.

Eileen, this actually is quite serious. EHEC outbreaks are thankfully rare, but they can cause serious illness and even death in otherwise healthy people. Most of the outbreaks of contaminated food in the US are of much less deadly bacteria, like Salmonella, which can make your life very unpleasant for a few days, but usually is only serious in people with pre-existing medical conditions. And even more concerning is that the source of the current EHEC outbreak has not yet been isolated. Now, nobody should cancel a trip to Europe, or even avoid the epicenter of the outbreak in northern Germany. But you should follow some basic precautions, and avoid the food that has so far been identified as contaminated.

There are quite a few of us still alive here, and I for one have not stopped eating raw vegetables! :-)
Roger

Latest is that it is a never-seen-before, mutant strain of e coli. And now Russia is refusing EU veggies and fruits. As previously stated, be aware of the symptoms and avoid the raw vegetables linked to the outbreak. Although serious, chances of getting sick are limited since you are not traveling to where it is concentrated. Maybe buy medical/travel insurance just in case. Also, avoid watching TV. We were in France for H1N1 outbreak and it is all they could talk about. Be informed, but you don't want to add unnecessary worry by being inundated with it. Have fun!

Here is a pretty detailed article about the outbreak from Time: http://healthland.time.com/2011/06/02/why-health-authorities-are-so-worried-about-europes-mutant-e-coli-outbreak/ I agree with the others, try to eat cooked food as much as possible -- although it looks like Spanish cucumbers have been un-blacklisted :)

"Eileen, this actually is quite serious." I never said it wasn't - it's extremely serious - just don't expect to contract a disease simply by crossing a border. The USA just 'finished' 2 E. coli multi-state outbreaks, but most people were probably unaware of that (no deaths this time, thankfully). Some people ( not commenting specifically on Charlanne) get disproportionally upset about an isolated train derailment in France or the mugging of one tourist in Madrid, when statistically it's far more dangerous to drive a car to the airport. Germany - and it's visitors - is suffering from a new super-toxic bug, but it's also apparently from fresh fruit and vegetable sources. This would be a great time to eat the wursts and cooked potatoes...and stay away from the great German salads :-( If you'd like, bring your own utensils that haven't been handled by anyone but yourself, wash-wash-wash those hands, and take care if self-treating - antidiarrheal medication may not be the best idea if you have reason to believe it's the new E. coli bug because they slow the bacteria from leaving the digestive tract...yet another reason to see a doctor ASAP for a proper diagnosis. This isn't the time to attempt self-treatment... FWIW, our own household just eliminated (no pun intended) a documented E. coli infection a few weeks ago...Bad stuff. As you said, Tom: "If you develop diarrhea, go to see your doctor. Otherwise, don't worry (italics mine)." Ditto, again. Charlanne, you and your family have a fantastic trip!

I appreciate all the good advice. It's good to be prepared.

Oh, and BUY TRAVEL INSURANCE!!

I returned from Europe on May 31st. I went to Spain, France, Italy, Germany and Austria. I didn't know about the problem until I got back but if you take the usual precautions, like washing your hands, and avoid uncooked vegetables, you should be fine.

When H1N1 hit, I had just returned from Mexico with what I thought was the worst chest cold of my life. It turned out the symptoms were identical to the flu virus but by the time the world started worrying about it, I was better.

A German Sunday newspaper reported that provided all vegetables were thoroughly washed first in lukewarm water then they should be safe. Can't really believe it's that simple because if it is then why on earth do we have this problem in the first place? The problem with this is that you cannot guarantee the hygiene in restaurant kitchens. If someone who had handled infected vegetables then touches meat without washing their hands then the infection is transferred. As others have suggested, eat only cooked food which is cooked for you at point of order. Another thing I have always done is to open the door to toilets in public buildings when I leave using a paper towel which I then throw away (I also use paper towels to turn off the tap). Many germs are contracted through toilet door handles,flush handles and taps. It is amazing how many people I see who do not wash their hands after going to the loo. You might find this anally retentive but I have never suffered with stomach related problems.

http://www.nytimes.com/2011/06/03/health/03treatment.html?_r=1&partner=rss&emc
Just picked this up from NYT. American sources feel that the European use of antibiotics to fight the bacteria is in error. Fluids should be administered to keep the kidneys flushed out. Apparently antibiotics are hard on the kidneys.

There is evidence that using antibiotics increases the risk of hemolytic-uremic syndrome (HUS). The German health bulletins I've received recommend against using antibiotics, so I'm not sure where the doctors they interviewed for this story are getting their sources.

The best source of facts about the E. Coli outbreak is the CDC. www.cdc.gov

"The best source of facts" Another good source of facts is Tom from Hüttenfeld, I believe he's a physician and now residing in Germany, and we appreciate him sharing his knowledge here.

Perspective, perspective. It's easy to forget just how large Germany really is, in spite of the fact that we live in a "global village." Avoiding Germany because there's an e coli outbreak based in northern Germany is like avoiding going to Biloxi, Mississippi because there's an e coli outbreak in Savannah, Georgia. We're going to be traveling through Belgium, France, Germany and Austria later this month. We plan to take the usual precautions - wash our hands often, for instance - as well as implementing a few more: 1. I like the idea of using a disposable paper towel to open bathroom doors and use sink and toilet handles in public bathrooms - will probably do that. 2. We will be carrying antibacterial gel and will use that more often than we normally would. 3. Sadly, we will order no "salat" with our meals! 4. No steak tartar either - but I can do without that anyway! We plan to forego our usual preference for medium rare meat as well. I think we'll be fine. It would take a lot more than this to get me to cancel this trip!

I'm traveling to Germany and Austria later this month. I'll be gone for 3 weeks, and am traveling alone. I had already decided I would just avoid raw produce, until friends in the medical field stressed (in addition) washing hands often and using hand sanitizer. I just watched ABC's news report (video available online) which has me concerned. I will not be traveling to Hamburg, but much of my travel is concentrated in central and southern Germany. I don't have travel medical insurance and not sure I'll be able to get it now. Also the symptoms often don't show up for 7 to 12 days, and now they are saying women are twice as likely to get this (and they are not sure why).

Susan, "they are saying women are twice as likely to get this (and they are not sure why)." From reports I've seen, the presumption is that women are more likely to eat salads, and that's the main reason they're affected to a greater degree. Regarding Medical Insurance, you should easily be able to obtain it on short notice. In my case, it only takes about 15-minutes at BCAA to obtain a travel medical policy. Having travel medical is a really GOOD idea at any time and I see no reason why you can't obtain a policy, since your trip won't be taking place for a few weeks. Cheers!

"I don't have travel medical insurance " - why not??? I would never travel without medical coverage, e coli or no e coli. I don't care how healthy you are, accidents happen, and are more likely to happen in unfamiliar environments. Besides standard medical coverage you should also have medical evacuation insurance. I don't buy trip interruption or cancellation insurance, but I make sure I have medical coverage.

We're leaving this Thursday, have got the Travel Insurance and have read that now they believe it's the locally-grown bean sprouts that are the culprit raw vegetable. Thanks for all the good advice.

"4. No steak tartar either - but I can do without that anyway! We plan to forego our usual preference for medium rare meat as well. " Medium rare steak is okay. As long as the outside is cooked the inside never has the e coli. Hamburgers must always be cooked "well done".

"they believe it's the locally-grown bean sprouts that are the culprit raw vegetable." I've seen some fairly lengthy news reports on that topic today, and based on those it appears that locally grown Bean Sprouts are most likely responsible in this case. The authorities traced the outbreak to a particular farm in the Lübeck area, and surprisingly to a single worker on that farm. That revelation would seem to exonerate the Spanish produce that was first blamed for the situation. I expect there will be some confirmation over the next few days. In the meantime, they're still recommending "caution" with lettuce and cucumbers. I suspect the Spanish will be pushing for some compensation for the produce that had to be thrown out.

The German government now thinks the common link is bean sprouts. I've never understood their appeal, even more so now. What a way to kill the veggie industry .

"I don't know anybody who eats raw Spargel. " My dog did while I wasn't looking.... 5 days later and she's still not sick ;)

We eat raw Spargel; I generally munch a stalk or two while preparing the rest for cooking. It is delicious.

Lola, I have eaten green asparagus raw but the white one that's widely sold in Germany is a different story. Never tried it raw.

Good point. The white asparagus is very different. It costs so much here (in the US) I never buy it. And the kind we eat is either homegrown or very local (it is a major crop here in Washington State.) I remember seeing the special "white asparagus" menus in Germany when it was available in the spring. Do they still do that?

All the spargel stands are still open, so it couldn't have killed the vegetable industry that much.

Wouldn't want to be a German tourist in Spain this morning!

Tom, I don't know anybody who eats raw Spargel. Once your food is cooked the e-coli danger is gone. Now the latest news is that the source most likely is NOT the bean sprouts from this Northern German farm. Not knowing where this outbreak is coming from is still the biggest issue right now. So stay away from raw veggies.

"The source most likely is not the bean sprouts." Unfortunately the negative tests do not prove anything. Negative test results on current batches of sprouts do not mean that previous sprout batches, several weeks ago, weren't contaminated. Sprouts are a common source of pathogenic bacteria, both E. coli and Salmonella, because of the way they are grown. The bacteria may be on the seed coat and they grow rapidly in the warm conditions in which the seeds are sprouted. There was a serious outbreak in Japan several years ago traced to radish sprouts. And there was a salmonella outbreak traced to alfalfa sprouts in the Western US. Remember when alfalfa and other sprouts were commonly available in bulk in grocery stores? It is now very hard to find raw sprouts in the markets in the US. I do not even grow my own any more, due to the chance that the seeds themselves are contaminated. Basically, they do not have an answer yet, but news reports saying that the sprouts have been exonerated are not looking at the results correctly.

We are in Spain right now, and one of the local papers a couple of days ago, reported that Spain was going to seek compensation for the "false charges."

Foodborne illness is tough to protect against. Went to Turkey and took all the precautions - only drank bottled water, ate no fruit or veggies that had not been peeled, no street vender food, used bottled water to brush my teeth, etc. - still most of our group came down with a norovirus. Turkish authorities arrived at our hotel afraid we had bird flu and were ready to quarantine us. When no one had a fever, they left us alone. I took Cipro on day five after only minor relief in my symptoms - things cleared up. Two weeks after my return to the USA, my symptoms returned five-fold and I ended up in the ER courtesy of a parasite (giardia) that returned with a me (an unusual souvenir) - a few others in the group had that parasite and another one as well. Turns out, one of the places we stayed did not boil water for coffee, tea or soup. I would not change my trip plans because of an outbreak however, even after that incident. Bring Cipro, immodium (already out of the little packet because it's very very difficult to get out of the package in an emergency), Pepto Bismal, a powder form of electrolyte replacement, toilet paper, toilet seat covers, and lots of exact change to tide you over. Medical insurance is a good idea. Last, seek medical help if the symptoms are severe.

It is late at night in Germany, or I am sure Tom would be quick to object to the suggestion that one should self-dose with Cipro without consulting a doctor. That antibiotic has no effect against Norovirus, and as you learned it is not effective against Giardia either.

FYI - I did not self dose, was given medical advice which I followed. But yes, I would agree that it is wise not to self dose; always check with a doctor first before taking an antibiotic.

My apologies. It sounded from your post as if you carried it "just in case" and then took it without testing to determine if your illness was viral or bacterial. You did not indicate that you had medical advice before taking it. So again, I apologize for taking your post the wrong way.

I visited the Travel Medicine Clinic prior to my trip to Greece last year, and the attending Physician suggested taking along some Cipro "just in case". His recommendations were based on the countries I'd be travelling in. I filled the prescription and packed along the Cipro, but fortunately didn't need it! After reading the potential side-effects in the information pamphlet, I was somewhat relieved that I didn't have to take it!

I, also, want to discourage anyone from "self-dosing" with any anti-biotic- especially Cipro- and especially for an intestinal problem. I was given Cipro for an asthma attack that had progressed into broncitis. Had taken it once, when I was younger. This time I had an allergic reaction. You DON'T want to go there!!! Also, like Ken I read the possible side effects- one of which is to kill off the "helpful" microbes in your gut- and several weeks later it can result in severe diahrreha and vomiting, usually requiring hospitialization. So always seek medical counsel for anthing that you think might require anti-biotics- and READ to info provided. Also, one poster mentioned that fruits should be peeled- that does not always remove all the bad "buggies"- espeically parasites (like the one mentioned).