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The Epidemic Detectives: The Hunt for the Source of Germany's E. Coli Outbreak

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The eeriest thing of all, according to Rolf Stahl, is the way patients change. "Their awareness becomes blurred, they have problems finding words and they don't quite know where they are," says Stahl. And then there is this surprising aggressiveness. "We are dealing with a completely new clinical picture," he notes.

Stahl, a 62-year-old kidney specialist, has been the head of the Third Medical Clinic and Polyclinic at the University Medical Center Hamburg-Eppendorf (UKE) for almost 18 years. "But none of us doctors has ever experienced anything quite like this," he says. His staff has been working around the clock for the last week or so. "We decide at short notice who can go and get some sleep."

The bacterium that is currently terrifying the country is an enterohemorrhagic strain of the bacterium Escherichia coli (EHEC), a close relative of harmless intestinal bacteria, but one that produces the dangerous Shiga toxin. All it takes is about 100 bacteria -- which isn't much in the world of bacteria, which are normally counted by the millions -- to become infected. After an incubation period of two to 10 days, patients experience watery or bloody diarrhea.

'The Situation Is Deteriorating Dramatically'

But Stahl only sees the most severe cases, those in which EHEC also attacks the blood, kidneys and brain. These patients suffer from a life-threatening complication known as hemolytic-uremic syndrome (HUS). About 10 days after the diarrhea begins, the red blood cells suddenly disintegrate, blood clotting stops working and the kidneys fail. In many cases patients need dialysis to stay alive.

"The situation is deteriorating dramatically for our patients," says Stahl. "And the worst thing is that we don't know what's causing it."

In Germany, about 60 people a year contract hemolytic-uremic syndrome after being infected with EHEC. Last week, there were as many cases in a single day. According to the Robert Koch Institute (RKI), the national German institution responsible for disease control and prevention, there were 276 HUS patients in German hospitals by Friday.

By Tuesday there were 373 confirmed cases of HUS across Germany. As many as 15 people may have died from EHEC in Germany so far in the current outbreak. Cases have also been reported in Sweden, Denmark, Britain, Austria and the Netherlands. Meanwhile Russia has banned imports of cucumbers, tomatoes and fresh salad from Spain and Germany.
 
 

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