We Eat Crap. It Makes Us Sick.
Our inability to talk about it is driving the hysteria around Europe's E. coli outbreak.
Escherichia coli is back. Every year an attack of food vs. people grips us, makes us think twice about crunching into that fresh cucumber or apple or celery stick, and reminds us of how deep in excrement we all are.
This year's E. coli outbreak in Germany is by all accounts a real doozy. In the past two weeks, 2,000 people across Europe and at least four in the United States have been affected. About 500 have developed hemolytic uremic syndrome—an otherwise rare complication that damages kidneys and destroys red blood cells—and 22 have died. Indeed, this outbreak appears to have stricken ill a record number of people for E. coli, though it falls far short of the legendary salmonella outbreak in 1994 that hit 224,000 people who ate contaminated American ice cream.
The severity of this E. colihas led some talking heads to hint that this might be the big one—a super-toxic, super-drug-resistant, super-sticky, never-before-seen, Armageddon sort of thing. To add to the drama, irate Spanish farmers are dumping vegetables at the local German Embassy, haggard public health officials are advising simultaneous calm with extra-heightened awareness (read: paranoia), and clumsy medical experts are grinning on TV like they just won the lottery. It's the typical circus that accompanies most public-health calamities, which begs the question: Should we be significantly more frightened of the German strain than of other E. coli?
My strong sense is no— the facts simply don't support a doomsday scenario. While any new strain carries the potential for a new wrinkle, this one seems to have only the usual bag of E. coli tricks. The German E. coli is categorized scientifically as strain O104 (that's oh-104, not zero-104) based on various characteristics of its cellular composition. Yet it causes a disease identical to that caused by the famous O157 strain, previously the dominant perpetrator of severe E. coli- related intestinal disease.
Beyond its lack of novelty, the most important clue that this is not the big one is the lack of secondary cases; the disease has spread to few if any people living with or caring for the sick. In contrast, outbreaks of diseases like cholera are fueled by secondary (and tertiary, etc.) cases, such that a single person can sicken an entire town. With the German O104, ingestion of bean sprouts (or perhaps another food to be blamed later) is the cause, not your neighbor's lousy hygiene.
Yet here we are in the midst of extreme hype around the situation. Why all the fuss? There are at least two distinct reasons for the mismatch. First is the always-present, always-perverse financial incentive for news organizations to goose up any outbreak or fan any panic: For them, bigger and badder sells more papers, drives more clicks, and attracts more eyeballs.
Kent Sepkowitz is a physician in New York City who writes about medicine.
Photograph of German farm by Sean Gallup/Getty Images.