German E coli strand leaves neurological mark on women

A DEADLY E coli outbreak that has so far claimed about 40 lives bucked previous trends by affecting mainly women instead of pre-school children, new research has found.

Previous form shows similar-strain E coli outbreaks affect both sexes equally and that it is a disease mainly found in pre-school children. However, the data collected in relation to the outbreak originating in Germany shows 87% of those hit by the disease were women over the age of 20.

A report in Eurosurveillance, a Euro-wide scientific journal that publishes data on communicable disease, said the German outbreak in May displayed “several intriguing microbiological characteristics” and “several novel epidemiological and clinical features”.

The authors of the report, Andreas Jansen, a co-ordinator of the Food and Waterborne Disease programme at the European Centre for Disease Prevention and Control (ECDC) and Dr J T Keilstein, a member of the Department of Nephrology and Hypertension at the Medical School in Hannover, Germany, said the clinic characteristics of the outbreak strain (STEC/VTEC O104:H4) “differed remarkably” from previously described STEC/VTEC infections.

Among the “completely unexpected” features was the development of severe neurological symptoms in half of patients within three to 10 days of being admitted to hospital, despite the fact that patients seemed to be responding to treatment.

“These patients who had at first seemed to improve or respond to therapy, deteriorated again. Some patients even had to be re-hospitalised three to four days after they had been discharged.”

They also said neurologists were “very concerned about the severity of neurological symptom(s) which ranged from mild disorientation and cognitive dissociation to stupor or severe, life-threatening seizures, yet which showed up under routine examination as “mild neurological alterations”, if any.

The response to antibiotics was poor.

“Worryingly, especially patients with seizures seemed to respond only weakly to standard antibody-based treatment regimes,” the authors said.

As of June 20, Germany had recorded 3,494 cases of infection and 39 deaths had been reported.

A handful of cases have been reported in other European countries, along with the USA and Canada.

Eurosurveillance also reports on a case of infection with the E coli outbreak strain involving household transmission in the Netherlands from a mother to her child. In both cases, neurological symptoms were present, with severe manifestation and an as yet unclear neurological outcome in the child.