Thursday, June 2, 2011

E.Coli & Politics: Health Planning for Epidemics

There are many unanswered questions in the current E. Coli outbreak in Germany. In general, politics and public health do not mix well as Canada found to its cost in the SARS outbreak.

DPA/ HZI/ Manfred Rohde

The haste to blame every case on Spain’s organic cucumber may in the end prove costly to Germany or indeed the EU which means that you and I may well be compensating Spanish farmers.


John Dalli rebuked Germany for premature and inaccurate conclusions on the source of contaminated food that have spread fear all over Europe and cost farmers in exports.
Mr Dalli told the EU parliament in Strasbourg that such public information must be scientifically sound and foolproof before it becomes public.

Can England’s new GP consortia plan for a similar outbreak taking into account that those E Coli victims that survived needed kidney dialysis and Germany’s hospitals are stretched to capacity. No single consortia can afford it and no single hospital given the tight bed situation will be able to cope.

Unanswered questions:
If cucumber is the culprit, then all the patients must have eaten them in Northern Germany. There is also a rumour that the E. Coli found on the cucumbers were not the same type that cause the problems.

Has the drinking water been tested properly give the low number of organism required to infect?

Canada’s major outbreak was to do with drinking water. By the way the Canadian government just agreed on a $72 million payout. If the utility company had been a private one, it would have gone bankrupt and again it would be the government that would be compensating the victims.

If Spain is found to be at fault, who would be paying? Would it not be EU citizens again.

The Cockroach Catcher felt strongly that Quorum Sensing should be looked into for such outbreaks.

The Germans found the outbreak puzzling too: good doctors and scientists should always question unusualness in any disease conditions.

These are their findings and questions:

Why not young people:
"Epidemics are for younger men." Tarr, the second major EHEC expert next to Karch, had also never heard of an O104:H4 outbreak.

In the email, Karch speculated over why the disease wasn't happening in children, as is normally the case, but only in adults. And why was the infection striking more people that ever before in Germany -- so many, in fact, that dialysis stations in several hospitals were almost full?

Karch and others speculate that the problem could lie in the pathogen itself. Perhaps the genetic material of this rare bacterium has mutated again, so that its toxin or its bond to the intestinal cells it damages has become stronger. Doctors hope that a complete sequencing of the genome, which is now being performed in Münster, will offer some answers.

This is why The Cockroach Catcher speculated on Quorum Sensing.

Plague DNA:
On Tuesday, the German newspaper Süddeutsche Zeitung reported that Karch had discovered that the O104:H4 bacteria responsible for the current outbreak is a so-called chimera that contains genetic materia from various E. coli bacteria. It also contains DNA sequences from plague bacteria, which makes it particularly pathogenic. There is no risk, however, that it could cause a form of plague, Karch emphasized in remarks to the newspaper.

The Cockroach Catcher grew up in Hong Kong. We always boil our drinking water, (boiled and cooled) and I cannot honestly remember eating salads

Here is the scary bit: Der Spiegel

Be it liquid manure, water or slugs, cucumbers or lettuce, organic or conventional farms -- whatever the source of the bacteria, the only solution for consumers is to wash their hands. Hand washing is also effective against smear infection, or transmission of the bacteria by way of unwashed hands after using the toilet, but this path of infection is very rare.
Fruit and vegetables are only truly germ-free when cooked. And until now, washing produce with water was seen as an effective way to eliminate the risk, because it was generally understood that E. coli is only found on the surface of produce.

That was until scientists in the department of plant pathology at the Scottish Crop Research Institute in Aberdeen made an alarming discovery: The pathogens apparently felt so comfortable on the tomatoes and lettuce they studied that they migrated from the surface to lower layers of tissue to colonize the fruit.

"Some veterinarians' profit margins are bigger than those of cocaine dealers," says Nicki Schirm, who has been a veterinarian in the state of Hesse for more than 25 years. When a veterinarian finds a sick chick among 20,000 other chicks, he treats the discovery as justification to preventively treat the entire flock with antibiotics, says Rupert Ebner, a veterinarian from the Bavarian city of Ingolstadt. "Nowadays, flock or herd health monitoring is the code name for the generous administration of drugs," says Ebner. In many cases, he adds, fake diagnoses are used to provide a justification for the use of antibiotics.

In large veterinary practices, profits from the sale of drugs can account for up to 80 percent of revenues. This is mainly due to the volume discounts offered by the pharmaceutical industry and the sweet privilege known as the right to dispense -- a special provision for the pharmaceutical monopoly. For more than 150 years, veterinarians have been allowed to both prescribe and sell medications -- with almost no supervision whatsoever.

Some 900 tons of antibiotics were fed to animals in Germany in 2010. This is 116 tons more than in 2005, and more than three times as much as the entire German population takes annually. Pharmaceutical producers were required to report their 2011 sales of veterinary drugs by the end of March. A number of companies did not comply, prompting the Federal Office of Consumer Protection and Food Safety to request the information in writing.

Old & Young: E. Coli O157

According to The Union of Concerned Scientists:
Microbial Drug Resistance 13(1):69-76.Akwar et al. 2007.
Risk factors for antimicrobial resistance among fecal Escherichia coli from residents on forty-three swine farms.
"Akwar et al. found that people living and working on swine farms where antibiotics were used in feed had increased chances of carrying resistant E. coli. In some cases, the risk of resistance for the farm workers was higher than if they had taken antibiotics themselves. Once farm workers are colonized by resistant bacteria they can transfer them to family members and others in their community."

The use of antibiotics in farm animals is widespread and is not restricted to the treatment of infections but for the enhancment of weight gain. In business terms it is the conversion ratio of feed to weight that matters. The Obama government may well be taking steps to control it due to the rising incidents of Hospital Infections. (See MRSA & Antibiotics: Obama & Farmers.)Chicken and other animals can grow up to twice as fast as 30 years ago when antibiotics were not in the feeds. Scary!
It may therefore require more than "washing hands" if we do not want more outbreaks like this and other ones.

Latest: Guardian

German hospitals are struggling to cope with the surge in patients caused by the E coli outbreak, as the death toll from the virus rose to 22.

The health minister, Daniel Bahr, said hospitals in northern Germany were finding it difficult to provide enough beds and treatment for patients, with the total number of cases increasing to 2,200.

"We're facing a tense situation with patient care," Bahr said, "but we will manage it."

Agriculture officials said that bean sprouts grown in one organic farm between Hamburg and Hanover were the likely cause of the illness.
Related Post: 
Quorum Sensing: E. Coli O157:H7,

1996 Report: Pennington Report

1 comment:

Panic Attacks said...

The part about bacteria is scary. It's good that handwashing is a solution. The damage that the E.coli bacteria can do should not be underestimated. Thank you for the highly informative article.