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When the Stool Hits the Sprouts

by Albert Fuchs, M.D.

June 24, 2011 | 2:35 pm

... or Technology Phobia Can Be Fatal

[This post is perfectly safe for work, but may not be safe for lunch, as it mentions poop more frequently than you may find appetizing.]

This post is an update about the E. coli food poisoning outbreak in Germany that I posted about two weeks ago (link 1 below). If you didn’t read that post, please do, as it explains some important terms like hemolytic uremic syndrome (HUS) and shiga toxin-producing E. coli (STEC). Using these phrases at your next party will make you very popular. Trust me.

This week, the New England Journal of Medicine published a review of the data collected thus far on the STEC epidemic in Germany (2). A typical case consists of an incubation period of 8 days after eating contaminated food until symptoms occur. The typical symptoms have been bloody diarrhea and abdominal pain without fever. About 25% of patients have developed HUS several days later. More cases of bloody diarrhea and HUS are still being reported, so the outbreak is not yet over, though the incidence is declining. The incidence peaked on about May 22. As of June 18 a total of 3,222 cases have been identified, including 810 cases of HUS and 39 fatalities. About two thirds of the patients have been women.

This bacterial strain and this outbreak are unusual in that the fraction of cases that proceed to HUS is much higher than previous outbreaks. Also 89% of the cases have been in adults. Prior outbreaks have more predominantly affected children. This STEC strain is also resistant to antibiotics in the penicillin and cephalosporin families.

The New England Journal of Medicine article stated that “raw produce or salad condiments are suspected” and that the investigation was still ongoing, but a Wall Street Journal article (3) and the CDC investigation (4) state that the source of the outbreak has been traced to raw bean sprouts from one organic farm in Germany. How the E. coli contaminated the sprouts is still unclear, but E. coli contamination typically happens through contact with human or animal feces.

This is tragic, but doubly so because it was likely preventable. It’s also an important indictment of our society’s two most popular technology phobias.

The first phobia is our fear of radiation. I’ve written previously about the potential benefits of irradiating our food. It would eliminate much of bacterial food contamination. Even the LA Times is writing about this issue (5).

The second phobia is our fear of synthetic pesticides and fertilizers, manifested in our current infatuation with organic food. The fact that the contaminated bean sprouts were grown in an organic farm is relevant. Sprouts are among the most likely produce to be contaminated because they grow close to the ground in warm humid environments, perfect for contact with waste and for bacterial growth. And organic food that avoids synthetic fertilizer has to use natural fertilizer – animal waste.

Organic food has no health benefits over food grown with modern methods. Indeed it has health risks. It also uses more space and more resources (hence is more expensive) than food grown through modern farming. While I don’t begrudge those who wish to pay more because they believe that organic food tastes better, it is a solution that simply can never feed most of the world.

So carefully wash all your raw fruits and vegetables, support proposals for food irradiation, and reconsider your commitment to organic food. Because it turns out that the alternative to modern technology is stool in your salad.

Learn more:

(1) My post two weeks ago: Germany Struck by Major Food Poisoning Outbreak

(2) New England Journal of Medicine article: Epidemic Profile of Shiga-Toxin–Producing Escherichia coli O104:H4 Outbreak in Germany — Preliminary Report

(3) Wall Street Journal article: EU Confirms Bean Sprouts as E. Coli Source

(4) CDC Investigation Update: Outbreak of Shiga toxin-producing E. coli O104 (STEC O104:H4) Infections Associated with Travel to Germany

(5) LA Times article: Should food irradiation return to the table?

LA Times article: German E. coli strain combines deadly properties of two pathogens

For a very informative description of the benefits of modern farming, as well as other technical revolutions that make modern life possible, I highly recommend “The Rational Optimist: How Prosperity Evolves” by Matt Ridley.

Important legal mumbo jumbo:
Anything you read on the web should be used to supplement, not replace, your doctor’s advice.  Anything that I write is no exception.  I’m a doctor, but I’m not your doctor.

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ABOUT THE AUTHOR

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Practicing internal medicine in Beverly Hills since 2000, Dr. Fuchs brags that his practice is “tiny and meant to stay that way.” He has blogged for the past three years...

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