German ministers defended their response to the E-coli outbreak that has killed 27 people and signalled possible changes in the way the country handles health crises in the future.
The German government has been criticised at home and around Europe for failing so far to pin down the cause of the outbreak that has stricken more than 2,700 people in 12 countries. All cases have been traced back to near Hamburg in northern Germany.
About a quarter of E-coli patients in the latest outbreak have developed a severe complication called haemolytic uremic syndrome affecting the blood, kidneys and nervous system.
"The E-coli and HUS outbreak in Germany is so severe that we have to react very quickly to announce these recommendations and we still can't give the all-clear," said Health Minister Daniel Bahr, referring to warnings not to eat certain raw vegetables, such as bean sprouts but also cucumbers, tomatoes and lettuce.
Damage to farming industtry
The European Union on Wednesday upped compensation to 210 million euros from 150 million for farmers hit by plummeting sales, after Germany first blamed cucumbers from Spain and other salad vegetables, and then German bean sprouts.
The economic damage to Europe's farming industry - with organic producers singled out for suspicion because they use manure rather than chemical fertiliser, putting crops more at risk of contamination - could reach half a billion euros.
A German organic producers' association said it was not enough to compensate farmers for under a third of their losses.
Hunt for source
Although the hunt for the source of infection now focuses on bean sprouts grown in Germany, cucumbers were back in the spotlight after traces of the E-coli strain were found in the eastern state of Saxony-Anhalt on cucumbers in a family's rubbish.
"There's no definitive proof the cucumber is the source of the E-coli outbreak," a state official said, adding that it was unclear when or how the cucumber became contaminated.
Germany has been criticised for hastily blaming Spanish cucumbers for the outbreak - which it later withdrew - and the lack of conclusive evidence that German sprouts are indeed the source. Excessive bureaucracy at federal and state level has also been blamed for slow crisis response.
Bahr said federal and regional health and food safety bodies would undertake an "immediate evaluation" of how they cooperate in what looks like the deadliest ever outbreak of E.coli.
The Robert Koch Institute, Germany's disease control body, reported an additional 318 E-coli-related cases on Wednesday.
"There will be new cases and unfortunately we have to expect more deaths, but the number of new infections is dropping significantly," Bahr said.
Tests on farm workers, seeds
Speaking at a news conference with EU health chief John Dalli and German health officials, Bahr said that a slowdown in the number of new infections was cause for "cautious optimism."
But he conceded that the source of the outbreak may never be positively identified, as scientists have warned.
Analysis of samples from restaurants, canteens and kitchens which prepared food where patients ate has failed to yield conclusive evidence for the theory that organic sprouts from a farm in the state of Lower Saxony were to blame.
Agriculture Minister Ilse Aigner said officials were still tracking more cases linked to the bean sprout farm, where at least one worker is known to have contracted the bacteria and had to have part of her intestine removed in surgery.
Two other workers at the farm had E-coli symptoms but both have since recovered, making it unlikely that tests could prove they had the new strain, a Lower Saxony agriculture ministry spokesman Gert Hahne said.
Investigators were also testing the seeds used at the farm after analysis of bean sprouts were so far inconclusive, Hahne said. Seeds from southern Europe and Asia were used at the farm and were likely shipped via Hamburg and Rotterdam, he said.
Dalli said the European Commission was convinced that the German investigation into the cause of the outbreak was heading in the right direction and defended the decision to issue health warnings on some vegetables, despite the impact on farmers.
"The advice and information reported to the public domain can stand up to rigorous scrutiny," he said, adding that only once the outbreak is over should Germany start looking at reforms to its crisis management.
"It's very different in the eye of the crisis," he said.
With the critical spotlight on the German federal system which divides responsibility for crisis response between state and central authorities, Bahr rejected calls for a national "epidemic police" and called this a "typical German" response.
"This is not the right time, at the height of the outbreak, to talk about structural (reforms)," Bahr said, adding that authorities needed to see through their current mandates.
Dalli advised Berlin to use the experience of countries which have dealt with E-coli outbreaks before.
The United States and Japan have had similar deadly outbreaks linked to sprouts while it was a Chinese laboratory that used DNA sequencing technology to identify this E-coli outbreak as a new and "highly infectious and toxic" strain. - (Eric Kelsey and Brian Rohan/Reuters Health, June 2011)