Tuesday 20 February 2018

Ireland at risk from deadly E coli bug, says leading scientist

Diarmuid Doyle and Steven Swinford

The mutant E coli strain which has killed 18 people in Germany and Sweden will inevitably arrive in Ireland, according to one of the country's leading microbiologists.

Dr Eleanor McNamara, director of the HSE's public health laboratory said that because all the cases discovered so far had had been related to travel to Germany, "it is probably inevitable at some stage that we may well see some cases".

She urged anybody who return from a trip to Germany with evidence of gastroenteritis to seek medical help immediately.

The Centre for Disease Control and Prevention in the US yesterday said that three people there are suspected to have been affected by the E coli bacteria after returning from Germany. In Britain seven people have been infected, four German nationals and three British citizens who had recently visited Germany.

Dr McNamara told RTE's Morning Ireland that the HSE and other state bodies were monitoring the situation in Germany on a daily basis. The source of the bacteria had not been confirmed yet, she said, although the German authorities suspected that it was food-related.

She encouraged people in Ireland to be "scrupulous" with hygiene when preparing food, and said air passengers should use hand wipes before and after eating and using the bathroom.

The bacteria was "so virulent", she said, that people can catch it from somebody else even if they have not eaten the infected foods. The symptoms were mild diarrhoea, followed by bloody diarrhoea, then kidney failure and bleeding disorders. However, with proper medical treatment, the vast majority of people will recover, she said.

Agriculture Minister Simon Coveney told the same programme that the government takes advice on the issue from bodies like the HSE and the Food Safety Authority. "If we thought there was any threat from imported prodicts, we would act on that," he said. "But there is no evidence that exported food has caused the strain.” It was an infection that was sourced in a particular area of Germany, he said.

The British Health Protection Agency (HPA) warned last night that there is a high risk of the bug spreading form person to person.

More than 1,600 people have now been infected worldwide -- mainly in northern Germany -- and hundreds have been left seriously ill, with at least 18 having died.

The World Health Organisation (WHO) yesterday identified the bacteria as a "completely new" mutant strain, which was both more toxic and infectious than the usual varieties. It can cause the deadly haemolytic-uraemic syndrome (HUS), which affects the blood and kidneys.

Experts are still unable to say where the outbreak originated from, having ruled out the initial theory that it came from a consignment of Spanish cucumbers.

Dr Bob Adak, an expert in gastrointestinal infections at the HPA, said his organisation had interviewed the families of all of those involved and advised them to take precautions to avoid a secondary spread of the bacteria.

"We're extremely concerned by it," he said.

"We are on the lookout for secondary infections, because it is quite infectious you don't need many bacteria on your hand to spread it.

E coli is usually contracted by eating contaminated food, but it can spread from person to person if the strain is infectious enough.

People need to be particularly careful to wash their hands thoroughly after using the toilet.

Hilde Kruse, a food safety expert at the WHO, said the new strain had characteristics that made it "more virulent and toxin-producing".

Preliminary genetic sequencing suggests that the strain is a new, mutant form of two different E coli bacteria, according to the WHO.

"This is a unique strain that has never been isolated from patients before," Ms Kruse said.

It is resistant to antibiotics and has an eight-day incubation period, which means that the outbreak could be yet to peak.

Unlike previous outbreaks, the new strain of E coli mainly attacks women rather than children or elderly people.

More than three-quarters of the people suffering from serious kidney problems are adult women.

Dr Alexander Mellmann, the scientist who mapped the DNA of the bacteria at the University of Munster in Germany, said the new strain was one of the worst he had seen.

He said the bacteria had evolved to become both more toxic and also better at "sticking" to human cells, increasing the chance of infection.

He said: "This is a combination of two different groups of E coli which have led to increased pathogenicity. It can adhere very well to human cells, which makes it easier to transmit."

The HPA is advising people to wash salads and to avoid eating raw tomatoes, cucumbers and leafy salads if they are travelling to Germany.


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