The source of an E. coli outbreak in Germany that has killed four people and affected at least 200 more has been traced to fresh produce imports.
European health officials at the Stockholm-based European Centre for Disease Prevention and Control (ECDC) said on Thursday that cucumbers imported from Spainmay be the source of the outbreak with two unnamed Andalusian companies implicated.
The ECDC, which monitors diseases in the EU, said it had reports of 214 cases of hemolytic-uremic syndrome (HUS), a serious complication of a type of E. coli. HUS affects the blood, kidneys and, in severe cases, the central nervous system.
German officials said four people had died so far but the ECDC said its most recent information was that two people had died. Both were women, it said, one in her 80s and the other in her 20s.
Online journal Eurosurveillance reported that cases linked to this outbreak had been seen in Sweden, which reported nine instances of HUS, four in people who had recently travelled to northern Germany. Smaller numbers were also reported in Denmark, the Netherlands and Britain.
Of the 214 cases, 186 are 18 years of age or older and 146 are female. Early studies implicate raw tomatoes, cucumbers and lettuce as the source of the disease.
The Hamburg Institute for Hygiene and the Environment (HU) said that three of four contaminated cucumbers analysed by came from Spain. The country of origin of the other cucumber was not yet known.
Hamburg health minister Cornelia Pruefer-Storcks said: "The suspicion concerning the cause of the illnesses now points to cucumbers.”
The Spanish health ministry said: "While the cucumbers were produced in Spain, an investigation must find out at what stage of the production chain the contamination occurred.”
The ECDC report said it had found a "significant association between disease and the consumption of raw tomatoes, cucumbers and leafy salads" in its early investigations into the cause.
Germany imports around 182,000 tonnes of cucumbers a year from Spain.
The Fresh Produce Consortium said in a statement: "The UK fresh produce industry is aware of the serious outbreak of E.coli which is taking place in Germany. Investigations are on-going to confirm the source of the outbreak, including a potential link to cucumbers imported to Germany from Spain.
"The UK authorities are monitoring the situation and whether there are any implications for food distributed in the UK. To date we are not aware of evidence of any link to fresh produce imported to the UK. At this time of the year the majority of cucumbers on the UK market are grown in the UK.
"Food poisoning outbreaks linked with the contamination of fresh produce remain extremely rare in the UK. Good agricultural practices, hygiene preparations and packaging minimise the potential for contamination. The fresh produce industry has stringent standards in place to ensure that consumers can enjoy safe, healthy, good quality fresh produce.
"Further advice and information to consumers is available from the Health Protection Agency and the Food Standards Agency."
