Escherichia coli O104:H4 outbreak from sprouted seeds.

From May to July 2011, one of the largest reported outbreaks of haemolytic uraemic syndrome (HUS) and bloody diarrhoea caused by the Shiga toxin-producing Escherichia coli (STEC) O104:H4 occurred in Germany and France. The hypothetical origin of the outbreak strain was a combined enteroaggregative E. coli and an enterohaemorrhagic E. coli with the ability to resist multi-antibiotics and produce Shiga-toxin 2. The combination of aggregative ability, antibiotic resistance and the production of Shiga-toxin 2 significantly affected the severity of the symptoms presented. Since humans may be the primary reservoir, it is likely that contamination could have occurred through contact with infected individuals. Farm food safety management, and hand hygiene training programmes are crucial to primary production to prevent or reduce risks of contamination.