Ministry of Health informs prevention of EHEC infection

On June 1st, in an ecological greenhouse near Almeria, Spain, workers were throwing freshly picked cucumbers that did not meet specifications into garbage trucks. On May 31st, the health department of Hamburg, Germany confirmed that the Spanish cucumber does not contain the O104 pathogen. In this regard, the Spanish government officials said that it does not rule out the need for compensation for economic losses in Germany to symptomatic treatment and inform the history of travel. China's Ministry of Health issued a notice on June 1 requesting the prevention and control of enterohaemorrhagic E. coli infection.

The Ministry of Health requires that medical institutions at all levels must strengthen the monitoring of cases, find cases of acute blood-like diarrhea, abdominal pain, or cases of clinical manifestations of hemolytic uremic syndrome, such as acute renal failure, hemolytic anemia, and thrombocytopenia, and should ask in the near future. Whether to travel to Germany or its neighboring countries. Patients who have the above clinical manifestations and have travel history should immediately report to the local disease control agency and collect faeces and other relevant specimens for testing. After the disease control agencies verify the case information, they must immediately report to the local health administrative department and the superior disease control agency and carry out laboratory tests. Enterohemorrhagic E. coli O104-positive specimens must be sent to the Chinese Center for Disease Control and Prevention for review.

The Ministry of Health requires that medical institutions at all levels must do a good job in the case medical treatment, closely observe changes in the condition, pay attention to rational drug use, and effectively prevent hemolytic uremic syndrome. Once hemolytic uremic syndrome occurs, an expert consultation should be organized in time to formulate a rational treatment plan according to the patient's condition and improve the success rate of treatment.

The Ministry of Health pointed out that the outbreak of enterohaemorrhagic E. coli is mostly an outbreak of food-borne disease. Generally, there is no need to isolate the patient, but EHEC causes infection. The Ministry of Health requires that medical and health institutions at all levels should effectively implement health education for patients and close contacts, and require that they pay attention to personal hygiene, especially hand hygiene; disinfectant disposal and sanitation and disinfection work must be done to prevent the occurrence of excreta. Nosocomial infection.

Enterohemorrhagic E. coli O104 is a rare serotype bacterium with a strong pathogenicity due to its ability to produce Shiga-like toxins. The incubation period for infection is 3 to 8 days, with an average of 3 to 4 days. The main clinical manifestations are: abdominal cramps and diarrhea, some cases of bloody diarrhea. Most patients recover within 10 days. A few patients, especially young children and the elderly, may have serious complications, such as hemolytic uremic syndrome characterized by acute renal failure, hemolytic anemia, and thrombocytopenia.

The Ministry of Health also reminded people who have traveled to Germany and its neighboring countries since April 2011 that they have experienced acute blood-stained diarrhoea, abdominal pain or anuria, and oliguria. They should promptly visit local medical institutions. When visiting a doctor, you should take the initiative to inform the doctor about your travel history.

Travelers to Germany recently have to maintain good hygiene habits and temporarily avoid eating raw tomatoes, cucumbers and lettuce. If you eat raw fruits and vegetables, be sure to thoroughly wash; cold dishes, meat products to be processed and stored separately raw and stored; do not drink raw water; wash hands before and after meals, wash hands after contact with animals and their excrement.

Two new methods or help to find the source of outbreaks The epidemic of enterohemorrhagic E. coli infections that broke out in Germany in mid-May is worsening, but the investigation of the source of the disease is still confusing. As of June 1st, there have been more than 1,500 confirmed and suspected cases in Germany, including 16 deaths; one death in Sweden. The total number of confirmed or suspected cases on the May 31st in Hamburg, which had the most serious infection, had increased to 569, including 110 critically ill patients. According to an announcement by the European Commission’s Spokesperson Pia Arungird-Hansen on May 31, there have been 3 suspected cases of enterohemorrhagic E. coli infection in the United States, while in Europe, Denmark, France, Both the Netherlands and Switzerland have reported confirmed or suspected cases. In addition, there are reports that case reports have also appeared in the United Kingdom, Austria, Poland, and Spain.

On May 31st, Cornelius Prufer-Stokes, the municipal councillor responsible for health in Hamburg, announced that the health department in Hamburg has verified that the cucumbers from Spain that were suspected earlier did not contain cucumbers. O104 pathogens are extracted from the patient's stool, so investigations of the origin of the disease can begin again. On May 26, the Hamburg Institute of Health announced the detection of enterohemorrhagic E.coli on cucumbers grown in Spain. Stokes explained that the Spanish cucumber has indeed identified EHEC, but the type is different from the patient's infection, but the number of E. coli infections in Hamburg's enterohemorrhagic disease is still rising, so the peak of infection may have passed. The judgment is out of date.

At the same time, the University of Münster, Germany, announced the development of a rapid diagnosis method that can confirm whether a patient is infected with enterohaemorrhagic E. coli within 4 to 24 hours. It can also confirm whether there is enterohemorrhagic E. coli in vegetables. At the same time, it shows that this special pathogen has increased two to three times in the past 10 years; the national reference laboratory in Berlin cooperated with relevant parties in France and also successfully developed a rapid determination of enterohemorrhagic E. coli O104. Method, and started to use in Germany. Experts expect that the above two methods will help find the source of the epidemic as soon as possible.

Spain wants to file a claim for innocence Spain is one of the world’s largest vegetable producers and one of the two countries with the largest export volume of vegetables in Europe. Fruit and vegetable cultivation has created a majority of agricultural jobs in Spain. Germany is its largest consumer in Europe. The impact of the “toxic cucumber crisis” on Spanish agriculture can be imagined. According to statistics from the Spanish Association of Fruit and Vegetable Producers and Exporters, the loss of Spanish farmers and exporters has reached 200 million euros since European countries announced that they stopped importing Spanish cucumbers. The Spanish side will lose 175 million to 2 per one week of this ban. Billion euros. Jose Maria, chairman of the Spanish Fruit and Vegetable Producers and Exporters Association, said that in the past week, the export volume of Spanish cucumber has plummeted from 50,000 to 70,000 tons previously, to 2,000 to 3,000 tons. What worries Spanish farmers is that the crisis of confidence has also affected the export orders of some summer seasonal fruits such as peaches, watermelons and honeydew melons that are not greenhouse-produced.

The Spanish Ministry of Agriculture stated on May 31 that it will submit an application to the European Union in order to provide compensation to the affected Spanish fruit and vegetable producers. Since the cucumber produced was also suspected by Hamburg, the loss of vegetable exports in the Netherlands was also more than 10 million euros. The Dutch Ministry of Agriculture requires the EU to make compensation. The German Farmers Association estimates that the epidemic has caused losses of 12 to 18 million euros for German vegetable farmers. In addition, Polish Minister of Agriculture Marek Savitzky expressed dissatisfaction with Germany notifying Poland of the specific outbreak until the first case of death occurred.

Aguilar, Minister of Environment, Rural and Ocean Affairs of Spain, said that the relevant authorities in Germany have prematurely questioned the behavior of the Spanish cucumber, causing the Spanish fruit and vegetable industry to suffer inevitability and demanding the immediate resumption of the commercial circulation of Spanish fruits and vegetables. The Spanish government does not The exclusion requires Germany to compensate and reserves the right to take action. Aguilar called on the German side to "accelerate the investigation" to determine the source of the infection. Spain’s first deputy prime minister and Minister of the Interior, Alfredo Perez Rourkakawa, said on June 1 that it did not rule out legal action against the German Hamburger.

Aegner, Germany's Minister of Food, Agriculture and Consumer Protection, responded by saying that the Hamburg approach was correct because according to EU regulations, early warning must be started as soon as possible. The German side believes that consumers' food safety should be based on consideration of economic interests. Germany's food safety inspections are relatively strict in the world. The main reason is that all purchasers have orders to stay at the bottom and they can provide the authorities with an investigation without reservation. Aigner also believes that it is imperative to carefully investigate the purchase channels and conduct inspections according to orders. However, from the actual situation, there is still a process to be solved.