EHEC outbreak 2011: summary from a risk assessment perspective

The EHEC outbreak from May to July 2011 was the largest outbreak caused by enterohaemorrhagic Escherichia coli (EHEC) in Germany since the Second World War. In the final analysis, imported fenugreek seeds from Egypt contaminated with the enteroaggregative EHEC strain O104:H4 were identified as the highly likely cause of the epidemic. The final report now published summarises the central findings of the BfR on the EHEC outbreak as well as recommendations on the prevention of future outbreaks. “We may encounter such outbreaks again any day - we must therefore be well prepared at all times", says BfR President Professor Dr. Dr. Andreas Hensel.

The BfR made an essential contribution to the investigation into the outbreak and to providing information to other authorities, the media and the population at large. It provided expert guidance on the necessary risk assessments and scientific support to the federal and state authorities in the investigation, regarding the decisions on government measures and, finally, on the scientific exchange of information at the European level and risk communication to the public. The findings are published in the BfR scientific journal 04/2011 “EHEC Outbreak 2011 – Investigation into the Outbreak along the Food Supply Chain”.

The EHEC outbreak strain of early summer 2011 was the unusual EHEC strain O104:H4 about which little was known at the start of the epidemic. It has so far been observed extremely rarely and only in humans. As a result, investigating the causes of the outbreak posed a great challenge. The situation was exacerbated by the fact that the outbreak was marked by exceptionally severe symptoms such as acute kidney failure. Due to EHEC, 53 people died and 3,842 became ill, some of them very seriously, in Germany in the course of the epidemic.

The scientific volume provides a chronological overview of the outbreak and the BfR risk assessments. On the basis of the most up-to-date data and information available, the institute continuously monitored the scientific assessments and the inferred recommendations and adjusted them in accordance with the latest insights.

The report contains a detailed overview of the methodological procedures adopted when back and forward tracking suspicious foods which was the central measure to get to the bottom of the epidemic. Suspicious foods were systematically followed along the food supply chain in order to identify possible sources of the outbreak. The available methods of electronic data recording of delivery relations were, for the purpose of epidemiological outbreak investigation, expanded and adjusted. The BfR has developed adapted software solutions and quantitative assessments of delivery data, thereby enabling epidemiological verification of the causal food and its source.

The report explains the laboratory diagnostics and methodology development of the National Reference Laboratory for E.coli (NRL E. coli) of the BfR. Here a fine classification of suspicious E. coli isolates was made as a service for the diagnostic laboratories of the states, and numerous food samples were analysed.

A representative survey of the population conducted by the BfR on the risk perception of consumers provides information on the extent to which consumers have changed their nutrition and hygiene behaviour during and after the outbreak and how they rank the health risk of EHEC compared to chemical risks such as, for example, dioxin.

About the BfR

The Federal Institute for Risk Assessment (BfR) is a scientific institution within the portfolio of the Federal Ministry of Food, Agriculture and Consumer Protection (BMELV). It advises the Federal Government and Federal Laender on questions of food, chemical and product safety. The BfR conducts its own research on topics that are closely linked to its assessment tasks.

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