The past few days have seen the simultaneous publication of the first vetted medical-journal pieces on the vast European outbreak of E. coli O104. They’re fascinating for what they report that is new about this perplexing epidemic — now up to 3,802 cases including 43 deaths, according to the World Health Organization — and also for the further questions they raise.
Possibly most headline-worthy: Two reports in Eurosurveillance, Europe’s peer-reviewed open-access epidemiology journal, that suggest this strain is communicable from person to person and also produces unusual and troubling symptoms.
The person-to-person case first: A team from Leiden University Medical Centre in the Netherlands describe the experience of seven members of a Dutch family who were visiting Germany in the first weeks of the epidemic and then returned home about May 15. The young mother in the family came to the hospital May 24 after having abdominal pain and bloody diarrhea for two days. They thought she had common gastroenteritis — a bacterial or viral infection of the gut, which usually resolves on its own in a few days — and so did not give her antibiotics. Nevertheless, four days later, she developed severe hemolytic uremic syndrome (HUS), the dangerous after-effect of infection with E. coli strains that produce toxins, which destroy red blood cells, clogging the kidneys and bringing on kidney failure. HUS is often brought on by misapplied antibiotic treatment in toxin-producing (STEC) E. coli cases, but, in this case, the woman had not received any.