Germany is currently experiencing a large outbreak of haemolytic uraemic syndrome (HUS), which is a serious complication from verocytotoxin-producing E. coli (VTEC) infection that requires hospitalisation. Since the second week of May, there have been reports of approximately 276 cases of HUS and two people are reported to have died.

The outbreak is mainly affecting adults - almost 70 per cent of who are female. The cases are occurring mainly in northern Germany, but there are also reports from southern and eastern Germany.

This strain of VTEC infection suspected in this outbreak is O104 which is a rare strain of the infection and seldom seen in the UK.

The German authorities have confirmed that they have identified organic cucumbers from two provinces of Spain (Almeria and Malaga) as one of the sources of the outbreak. Investigations are ongoing in Germany to identify other potential sources, while a third suspect batch of cucumbers originating in the Netherlands and traded in Germany is also under investigation. Some food products have also been withdrawn from the German market.

The Food Standards Agency is monitoring the situation closely and stress there is currently no evidence that any affected organic cucumbers from the sources identified have been distributed to the UK.

The European Commission report that the Spanish authorities are focusing their efforts on pinpointing the exact site of production of the organic cucumbers in question.

Until all sources of the outbreak are known, the German authorities are advising people in Germany to avoid eating raw tomatoes, cucumbers and lettuce, especially in the north of the country, until further notice.

The Health Protection Agency (HPA) and the National Travel Health Network and Centre (NaTHNaC) advises anyone travelling to Germany to follow the advice from the German authorities. In addition, returning travellers with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention any recent travel history.

England has so far seen three cases in German nationals, two with HUS and one with bloody diarrhoea. One of the HUS cases has been confirmed as having VTEC O104 infection which is causing this outbreak. There are no reports of any secondary infection in the UK. Other European countries are continuing to see cases of HUS and bloody diarrhoea among returning travellers.

The HPA is keeping a close watch for potential cases reported in England and is working with colleagues in the devolved administrations to recommend they do the same. In addition it is in the process of alerting health professionals to the situation and advising them to urgently investigate potential cases with a travel history to Germany.

The HPA is also working closely with the Department of Health and the Food Standards Agency. The FSA is monitoring the situation closely and if there are any implications for food distributed in the UK they will provide an update.