The EFSA Task Force established to coordinate investigations to track down the possible source of the French and German outbreaks of E. coli O104:H4 has concluded that one lot of fenugreek seeds imported from Egypt and used to produce sprouts is the most likely common link between the two outbreaks. However, it cannot be excluded that other lots of fenugreek imported from Egypt during the period 2009-2011 may be implicated. Based on these findings, EFSA recommends to the European Commission that all efforts be made to prevent any further consumer exposure to the suspect seeds and that forward tracing be carried out in all countries which may have received seeds from the concerned lots. In this context, EFSA continues to advise consumers not to grow sprouts for their own consumption and not to eat sprouts or sprouted seeds unless they have been cooked thoroughly.
In response to an urgent request from the European Commission regarding the ongoing outbreaks of Shiga-toxin producing Escherichia coli (STEC), serotype O104:H4, EFSA set up a Task Force on 26 June 2011 to provide immediate scientific assistance. EFSA scientists were joined on the Task Force by officials and experts from the European Commission, relevant EU Member States, the European Centre for Disease Prevention and Control (ECDC), the World Health Organisation (WHO) and Food and Agriculture Organisation (FAO).
Since May 2011, an outbreak of Shiga-toxin producing Escherichia coli (STEC) has been ongoing in Germany, though the number of new cases is rapidly decreasing. On 24 June 2011, French authorities reported an E. coli outbreak in the region of Bordeaux. Since the start of these outbreaks, there have been a large number of patients with bloody diarrhoea caused by STEC and an unusually high proportion of these have developed haemolytic uremic syndrome (HUS). To date, the E. coli O104:H4 outbreak is responsible for 48 deaths in Germany and one in Sweden. The total number of cases reported in the EU, Norway and Switzerland is 4,178.
The analysis of information from the French and German outbreaks leads to the conclusion that an imported lot of fenugreek seeds which was used to grow sprouts imported from Egypt by a German importer, is the most likely common link but other lots may be implicated. The report highlights that negative results from microbiological tests carried out on seeds cannot be interpreted as proof that a lot is not contaminated with STEC.
In light of the findings from the ongoing investigation and the conclusions of the tracing back exercise leading to fenugreek seeds as the most likely common link between the German and French outbreaks, EFSA considers that its previous advice issued jointly with ECDC on 29 June with respect to consumer protection remains valid. As seeds sold for sprouting are often sold as seed mixes and cross-contamination cannot be excluded, it is important that consumers are advised not to grow sprouts for their own consumption, and also not to eat sprouts or sprouted seeds unless they have been cooked thoroughly. This advice will be kept under review in the light of developments.
In a letter to the European Commission, EFSA outlines the principal conclusions of its report and identifies several recommendations related to preventing possible consumer exposure to the suspect seeds as well as the value of carrying out a risk assessment on sprout production and processing in view of further protecting public health.
The data collected from different Member States enabled an investigation of the relationship between seed suppliers, distributors and sprout producers, and sprout and seed recipients. These relationships have been plotted in distribution networks to show their complexity and the number of companies involved. The primary interest and focus of this work have been to identify common links between the clusters of human cases and the source of the suspected seeds.