Image: JoNel Aleccia
By JoNel Aleccia Health writer
msnbc.com
updated 6/2/2011 6:22:24 PM ET 2011-06-02T22:22:24

Four U.S. residents who recently traveled to Germany and two U.S. servicemen stationed there may be among those sickened by a deadly food poisoning outbreak in Europe, U.S. health officials said Friday.

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Three of the travelers, two women and a man, remain hospitalized, while a fourth was treated by doctors, officials from the Centers for Disease Control said. All are awaiting results of tests to determine whether they are victims of a toxic strain of E. coli bacteria that has killed 18 people, sickened more than 1,700 and spread to at least 12 European countries since early May.

But even if they are infected, the U.S. travelers are unlikely to spark a spreading outbreak at home, say food safety experts who urge both common sense and caution.

“These humans aren’t going to introduce this strain into the U.S. and have it become a permanent, common resident,” said Dr. Timothy Jones, an epidemiologist who serves on the federal Food and Drug Administration’s Food Safety committee.

The bacteria can be spread by touch, but it’s not like other foodborne pathogens, such as shigella or norovirus, which can be highly contagious. Good hand hygiene and careful food preparation can reduce risks.

E. coli outbreak in Europe prompts change in airline menus

Instead, it would take a wholesale shift in the alarming bacteria identified as E. coli 0104:H4. Some scientists described the bacteria as an entirely new, super-toxic bug, but that may not be accurate. It has never been seen before in the U.S., CDC officials said, but there is a single 2006 report of an infection in a woman from Korea. In any case, it’s very rare, Jones said.

“The only way it would sort of erupt or explode in this country is if the original reservoir, whatever’s holding it in nature, got infected and spread it. Unless that happened, it wouldn’t really lodge here,” said Jones, who is also the state epidemiologist in Tennessee.

Source of deadly outbreak unclear
The trouble is, European officials haven’t yet pinned down the source of the deadly E. coli infections. Raw cucumbers, tomatoes and leafy greens have been implicated in the outbreak, but it remains unclear how the vegetables became contaminated.

It can be difficult and time-consuming to trace such food ingredients back to their source — and then to determine how the source became tainted. With a more common E. coli strain, the notorious E. coli 0157:H7, the reservoir for the infection is cattle, which harbor the bacteria in their guts.

The European system for analyzing foodborne outbreaks may be slower than that the U.S. system, Jones said. It could be days or far longer before scientists track down the source of the outbreak.

In the meantime, health officials in every U.S. state are alert for reports of illness caused by Shiga-toxin producing E. coli, or STEC, especially in people who recently traveled to Germany.

A spokeswoman for the Massachusetts Department of Public Health confirmed that the state had reported a case of hemolytic uremic syndrome, or HUS, a serious side effect of E. coli infection, in a traveler who’d been to northern Germany. She declined to release information about the patient’s gender, hometown, or condition.

No information about the other two travelers, both of whom contracted HUS, has been released.

U.S. residents have little to fear from produce imported from Europe and there’s no reason to stop eating fresh fruits and vegetables, government officials said. The FDA has received no shipments of tomatoes, cucumbers or lettuce from countries associated with the outbreak, said Siobhan DeLancey, an FDA spokeswoman. The U.S. imports very little produce during this time of year, she added.

Follow health reporter JoNel Aleccia on Twitter @jonel_aleccia.

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