How clean is your cucumber?

Travellers in third world countries are warned about not eating raw fruit or vegetables unless they’ve peeled them but few are concerned in countries with better standards of hygiene.

I’ve had giardia which has made me a bit paranoid about what I eat when away from home but I’d never have worried about salads in Germany.

However, that was before the news of illness and deaths there as a result of  haemolytic uraemic syndrome (HUS) and enterohemorrhagic E. coli (EHEC):

The number of patients in Germany presenting with HUS and bloody diarrhoea caused by STEC is 470, which is 97 more than the day before, and 1064 of EHEC, which is an increase of 268. Overall in Europe, 499 cases of HUS and 1115 cases of EHEC have been reported, 1614 in total.

Cases have now also been notified from: Austria (HUS 0, EHEC 2), Denmark (7, 7), France, (0, 6), Netherlands (4, 4), Norway, (0, 1), Spain, (1, 0), Sweden (15, 28) and Switzerland (0, 2) and the United Kingdom. (2, 1) All these cases except two are in people who had recently visited northern Germany or in one case, had contact with a visitor from northern Germany.

The BBC reports 16 people have died of the disease and the cause hasn’t been ascertained.

It was originally blamed on Spanish cucumbers at considerable cost:

Spain’s fruit and vegetable exporters estimate they have been losing more than 200m euros ($290m; £174m) since the outbreak emerged.

Germany has admitted the bacteria did not come from Spain as initially reported, but said the decision to issue the warning had been correct as a different strain of E.coli was present in Spanish cucumbers.

The speed and extent of the impact on Spanish producers is horrifying and reinforces the need for vigilance with food production and processing here for both health and financial reasons.

Siouxsie Wiles gives a scientist’s perspective on the outbreak:

Recently, researchers have shown how plants become contaminated with EHEC, and it makes scary reading. Most people would think that as long as they gave their vegetables a decent rinse before putting them in their salad, then all would be well. If only it were that simple. It turns out that the bacteria aren’t just hanging around on the surface of the plant. Shaw and colleagues (1) showed that EHEC attach to the very cells that open and close the pores plants use for gas exchange. From here, the bacteria can then get inside of the plant cell, where no amount of rinsing can reach them.

It’s not easy to get your five plus servings of fresh fruit and vegetables when you’re travelling at the best of times, but I’d rather risk a little vitamin and fibre deprivation than a stomach bug like this.

Swine flu pandemic official

The World Health Organisation has declared a swine-flu pandemic, the first gobal flu pandemic for 41 years.

WHO director general, Dr Margaret Chan, said:

The world is now at the start of the 2009 influenza pandemic.

We are in the earliest days of the pandemic. The virus is spreading under a close and careful watch.

No previous pandemic has been detected so early or watched so closely, in real-time, right at the very beginning. The world can now reap the benefits of investments, over the last five years, in pandemic preparedness.

We have a head start. This places us in a strong position. But it also creates a demand for advice and reassurance in the midst of limited data and considerable scientific uncertainty.

Thanks to close monitoring, thorough investigations, and frank reporting from countries, we have some early snapshots depicting spread of the virus and the range of illness it can cause.

We know, too, that this early, patchy picture can change very quickly. The virus writes the rules and this one, like all influenza viruses, can change the rules, without rhyme or reason, at any time.

In a media release yesterday, Health Minsiter Tony Ryall said that when WHO escalated its response there would be no need for as significant change in what was being done here. The focus was on containment.

The first concern is for health but there will also be economic costs through people having to take time off work and, while WHO is not advising any restrictions on travel, the pandemic is likely to lead to a downturn in tourism.

WHO meets to discuss pandemic announcement for swine flu

The World Health Orgnaisation is meeting to discuss upgrading Swine flu to pandemic  status.

A couple of days ago WHO reported that 74 countries had reported 27,737 cases of swine flu (H1N1) and that 41 people had died as a result of it.

A map showing its spread is here.

Macdoctor gives his 11th Swine flu update here.