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A Critical Appraisal of The 2011 E.coli Outbreak of Food Poisoning in Germany

Introduction

Approximate a century ago, infections or infectious diseases were taken as the severe diseases and as the time passed and the medical science made progress, people started to take these diseases as common diseases, but these diseases cannot be avoided easily. A large scale outbreak came up in Germany in 2011 when the number of people in Germany abruptly became the victim of a bacterium’s infection and the cause was an E. coli (Rasko& Webster, 2011). E. coli (Escherichia coli) is the name of a bacteria or a germ that lives in human and the warm blooded animals’ intestines tracks (Liu, 2014). There were a number of causes of this outbreak, however, due to lack of proper diagnosis, the disease became widespread and caused number of death tolls. This paper aims to identify the timeline of outbreak in Germany and discusses the sources of E. coli, difficulties in isolating the E. coli, and provides further investigation on the outbreak. assignment writing help

Timeline of the Outbreaks and Factors Associated with the Causative Organism

On 24 May 2011, the German authorities reported three sudden deaths from an E. coli bacterium. That time, E. coli was not medically recognised as disease, nor was there any treatment. This led to a large number of death of toll in the country. It is observed that in initial time, 80 cases were identified as (HUS) hemolytic uremic syndrome and it is said that this bacterium type might be the same as the hamburger disease’ type but it was not confirmed (Berger, 2014). On 25 May 2011, the German authorities forbade to the consumers for purchasing fresh vegetables such as tomatoes, cucumber and leafy vegetables as a precautionary motive of food poisoning. On 26 May 2011, the authorities identified the three cucumbers from the Spain, which were the cause of the disease, but still the origin was unknown. Moreover, the European Union ordered for the checkup of the people traveling from or for the Germany (Barnettc, 2011).

On 27 May 2011, Spain's agriculture minister,‘Rosa Aguilar’, said that no other country is the victim of this infection so this is a blame only on the other countries. On 30 May, Russian authorities banned the imports of all the vegetables from Germany and Spain. Similarly, on 31May 2011, German authorities showed a doubt towards the Spanish cucumbers in which it may be the killer bacteria. On 1 June 2011, John Dalli the Europe's top health official emphasized on the need for testing the pinpoint because it has become a serious issue now. On 2 June 2011, Russian authorities banned the imports of all fresh vegetables from the 27 European Union member states. On 3 June 2011, no test was succeeded to clarify the original reason of this outbreak. On 5June 2011, the German sprouts came up as a suspected vegetable (Berger, Infectious Diseases of Germany, 2014). 

On 8 June 2011, number of new bacterial infections were observed in Germany. It was followed by the increase in the death toll in Germany and reached to 31. Later on, Germany identified the contaminated sprouts as the source of the bacterial infection, and at the same day German health authorities strictly forbade the consumers to have raw vegetables without the safety measures. Richard Lenki is the person, who did a clear cut work in this field and did an experiment on the bacterium called E. coli in 1988. His researches showed that E.coli possesses the power of evolving aerobically metabolized citrate’s ability while other population was not able and as inability is used to diagnose to make a difference from other. Therefore, it was closely related to the Salmonella bacterium (Rasko& Webster, 2011).

Martina Bielaszewska and some other researchers also tried to find out the reason of this infectious disease and they found that even a single case of this syndrome is totally associated with the E. coli type 0104:H4bacterium in Germany (Trent, 2012). The U.S. Surgeon, General William H. Stewart confirmed the disease another addition in the disease list. An important research was published by‘The Lancet Infectious Diseases& The New England Journal of Medicine’ in June. It identified that Shiga toxins was the important perspective in the German outbreak. Later on, similar researches and studies were utilized to diagnose the disease in Korea in the 1990s.

Difficulties in Isolating E.Coli in Germany

Normally the nature of diseases can be identified easily but there are some those diseases which can be difficult to identify because of the specific nature. Similarly, the main difficulty to isolate the E. coli in Germany was the several types of the bacterium and the source of bacterium through which it could be spread into the human. First and foremost, problem caused by E. coli was due to the two Shiga toxins (St1 and St2) because they are identical to some other toxins which are produced by the other bacterium called Shigella spp and become a cause of dysentery. In Germany the E. coli bacteria spread the food poisoning in the form of severe diarrhea, which was originally caused by a serotype enterohemorrhagic Shiga-toxins E. coli (EHEC) (Cristina Belmar Campos), and the symptoms of the infections were diarrhea hemolytic-uremic syndrome (HUS). To get rid of this infection, there was an urgent requirement for the proper treatment (Vaillancourt, 2012).

United States also experienced the same problem and confirmed the six cases and one death but the source of spreading infection could not be identified whether it was spreading out due to the travel from Germany or the reason was else. 1883 was the period when biologists find out the pinpoint of the bacteria when a disease named “hamburger disease” started in fast food lovers due to the consumption of beef and later on several other diseases of same nature were been observed. In 1885 German bacteriologist named as Theodor Escherich. Properly gave the concept of E .coli bacterium to the people E. coli and it is called the discovery of E. coli. In 1994, E. coli became an infection that was nationally notifiable. Unfortunately 8 May- 4 July 2011 was the period when Germany faced the largest outbreak of food poisoning due to the same reason and it reached at the extreme point on 22 May 2011 (Dimmock, Easton,& Leppard, 2009).

Sources of  E.Coli

The E. coli bacterium can be spread through different sources, For example by using the contaminated food and coming into the fecal contacts, by using the contaminated water for swimming, by using the raw vegetables and meat without washing and cooking them properly etc. However, it was suggested that the main source of this bacterial infection in Germany was the fresh vegetables (specifically cucumber) which were taken by the residents at that time as imported food. Additionally, the basic case was actually associated with sprouts (a kind of germinating seeds) consumption but the fecal oral transmission is also the listed (Sample, 2011). In Germany, this sprouted food was produced in a bulk and unfortunately the bacterium was not detected by the ministries and as a result, people suffered with severe diseases. Throughout the EU (European Union) and US (United States) almost there were 3842 registered cases in a number of hospitals, in which approximate 855 cases were of (HUS) hemolytic uremic syndrome 2987 cases were laboratory cases while 50 people’ death were confirmed (2011 E. Coli Outbreak in Germany, 2012). 

Investigation and Involvement of National and Iinternational Authorities

The Federal Institute of The Risk Assessment and the federal office of the consumer protection and food safety investigated and found the evidence that the cause of the outbreak is the sprouts, which are produced by a farm and the travelers are not responsible for this worst condition in Germany. On the national level, German authorities ordered to close the farm where the production of these sprouts was taking place and also declared that all the sprouts, which are present of that cultivation should be dumped because they are harmful to the health of the people (Deaths from E. coli still rising in Germany, 2011). While on the other hand, the Russian Federation banned all the imports of European Union food products and the Spanish farmers had to give away the produce. Since the priority always be on protecting the public health and thus the economic considerations should never be compromised public safety.

The solutions for minimizing economic damages and protecting the public health are the same. It implies that although the purpose is same but the terms and conditions for safety precautions are different on national and international level. On the international level, there are some very clear mechanisms for sharing the information. The one is through the International Health Regulations (IHR) while the other is through a technical-network of food safety authorities which is called the International Food Safety Authorities Network (INFOSAN). These two mechanisms are different and work in a complementary way. For instance in December of 2009, iodine toxicity was identified in the Australia linked to high levels of iodine in the product of soy milk which was produced in Japan (Berger, 2014).

The same product also had been exported to several other countries. Australia notified the WHO of the problem, under the IHR, and then this information was shared with other governments to ensure that ministries were aware of the impact on people’s health in their countries. This information was also sent out to INFOSAN members (INFOSAN is to ensure rapid sharing of information between national authorities and to promote sharing of best practices for dealing with food safety issues that includes emergencies) to ensure that the appropriate and timely action was taken to remove offending food product (Barnettc, 2011).

Role of Authorities

As there were few reports of. Coli infection in the people of UK because they traveled from Germany to UK for coming back and in this way the bacterium transformed, but there was no confirmation, Still the UK recommended that the fresh fruit and the vegetables should be washed carefully before eating. Not only has this but also washed hands firstly so that the possibilities of bacteria will be minimize. The Health Protection Agency (HPA) suggested that people who are returning from Germany with any kind of illness, take urgent medical attention and try to make sure that they mention their travel history. People who are travelling for going to Germany should also follow the advice of the authorities and should avoid eating fresh tomatoes, cucumbers and leafy salad that includes lettuce (Kate Kelland). The best way to protect yourself against food poisoning is to practice good food hygiene, such as washing your hands carefully before and after handling food.

Treatment / Prevention or Precaution

The main treatment of E. coli bacterium disease is to use antibiotics which work internally and make a life strong and provide protection against the infections. The best and the simple way to protect yourself against infections and food poisoning is to practice good food hygiene, such as clean hand wash carefully before and after having food because it is important. There may be germs on chopping boards and the surfaces of work, so use separate chopping boards. It is also important to cook food thoroughly and particularly meat. If you are reheating food then make sure that it is piping hot all the way and do not reheat food again and again. Try to keep the body hydrated. 

Conclusion

From the case study a clear cut lesson that a person gets is that public health has so many importance. To secure the people it is important to take some prompt steps in this field. For instance to provide health care through awareness, procedures of food safety that can minimize the risk of these organisms, Vaccinations, establishing the laboratories to identify the organisms spreading diseases, by using the improved techniques for testing the infection in the clinics, by providing the affordable methods of checkup to the people of states and use a good fertilizers to overcome outbreaks.