Frequently Asked Questions – E. coli outbreak in Germany

There is a large outbreak of E. coli O104:H4 that began in Germany that has caused serious illness and several deaths. The source of the outbreak is not known at this time, but produce is suspected.

Most cases of illness are from northern Germany. Several cases have been reported from other countries within Europe, most of whom reported travel to Germany. The Public Health Agency of Canada has issued a Travel Health Notice warning Canadians about the outbreak and how to protect themselves from getting ill.

The majority of cases have been among adults and mainly among females. A higher than usual percentage of cases have developed haemolytic uremic syndrome (HUS) and there have been several deaths. HUS is a severe and sometimes fatal complication following infection with certain types of E. coli. Up-to-date information on the number of cases, including deaths is available on the European Centre for Disease Prevention and Control Web site.

Q1. Have there been any cases of E. coli O104:H4 in Canadians coming back from Germany?

To date, the Public Health Agency of Canada is aware of one case of E. coli O104:H4. This case has a travel history to Germany. 

Q2. How is PHAC monitoring for cases?

In collaboration with health authorities across Canada, the Public Health Agency of Canada is monitoring for cases related to this outbreak and has asked laboratories that require assistance with testing to forward any suspect E. coli samples to its National Microbiology Laboratory, where scientists can determine if they are linked to the outbreak in Germany.

Q3. Will this outbreak spread in Canada?

Most of the cases reported outside of Germany became ill after returning from travelling to Germany.

PHAC has posted a Travel Health Notice warning Canadians who plan to travel to Europe about the outbreak and how to protect themselves.

While E. coli can be transmitted person-to-person, it is not likely that this outbreak will spread in Canada. However, the Public Health Agency of Canada advises that people practise safe food handling measures at all times to protect against food-borne illness in general.

Q4. What are the symptoms of an E. coli infection?

Symptoms of E. coli infections include stomach cramps, nausea, vomiting, fever and bloody diarrhea.  If you are ill with severe diarrhea, especially bloody diarrhea, stay home from work or school and see your doctor. 

Q5. How do people contract an E. coli infection?

E. coli is most often transmitted by contaminated food and water. Previous outbreaks have been linked to contaminated ground beef, raw fruits and vegetables, nuts, untreated water, unpasteurized (raw) milk and (raw) milk products, and unpasteurized apple juice/cider.

Less commonly, E. coli bacteria can also spread from person-to-person. Therefore, proper hand-washing, as well as safe food handling and preparation practices are key to preventing food-borne illness.

Q6. What advice does PHAC have for travellers to Europe?

PHAC has issued a Travel Health Notice warning Canadians about the outbreak and how to protect themselves from getting ill.

Q7. How can Canadians protect themselves against any E. coli infection?

Canadians can help protect themselves against an E. coli infection—or other food-borne illness—by practising general food safety precautions at all times:

• Cook meat to the proper internal temperature.
• Wash fresh fruits and vegetables before eating them.
• Clean counters and cutting boards and wash your hands regularly.
• Read labels and follow cooking and storage instructions for all foods.
• Make sure to check the “best before” date on all foods.
• Use warm soapy water to clean knives, cutting boards, utensils, your hands and any surfaces that have come in contact with food, especially meat and fish.
• Refrigerate or freeze perishable food within two hours of cooking.
• Freeze or consume leftovers within four days of cooking.
• Always reheat leftovers until steaming hot before eating.
• Keep refrigerators clean and at a temperature below 4° C, or 40° F. Install a thermometer in your refrigerator to be sure.

Q8. Is there a vaccine that can protect Canadians from E. coli infections?

There is no vaccine available to protect Canadians from E. coli, which is why practising general food safety precautions is important.

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For information on the Government of Canada's enhanced surveillance for certain fresh produce from the European Union, please visit the Canadian Food Inspection Agency's website.