Germany was quick to point the blame at cucumbers imported from Spain, triggering trade tensions [Reuters]
An outbreak of killer E. coli that has spread to 12 countries and killed 19 people may be linked to a Hamburg festival in May and could have caused a 20th death.
As authorities continued on Saturday to hunt the source of the killer bug, the Robert Koch Institute (RKI), Germany's national disease centre, is looking closely at a harbour festival that took place in Hamburg on May 6-8.
The weekly newspaper Focus said the festival drew 1.5 million visitors from Germany and abroad and noted that the first reported case of E. coli infection followed just a week later in the city's university hospital.
German media also said a man in his 50s who died in Brandenberg may be the 20th victim, but the cause of death was uncertain because he had several other infections as well as E. coli.
The latest confirmed death was of an 80-year-old woman in the northern German state of Mecklenburg-Western Pomerania on Friday.
She succumbed as German authorities were still warning consumers off raw vegetables, despite the EU's Reference Laboratory for E. coli in Rome saying scientific tests had failed to support a link to the outbreak.
Faced with uncertainty over the source of the outbreak, reports said police were investigating a possible deliberate act and were also checking two restaurants in the northern town of Lubeck, one in which 17 diners fell ill and another in which eight women were sickened, one of whom died.
The proprietor of one of the restaurants said he was devastated to hear many of his guests were infected by the rare virulent bacteria.
"It was like a blow to the head when I heard the news," Joachim Berger said in an interview in the kitchen of his restaurant, 60km northeast of the outbreak's epicentre in Hamburg.
"We had everyone here tested and everything was disinfected. I paid for the tests myself because safety is important for our guests and employees," he said.
On Thursday Germany authorities said the number of new infections appeared to be stabilising. But Reinhard Brunkhorst, president of the German Nephrology Society, said: "We are dealing here in fact with the biggest epidemic caused by bacteria in recent decades."
All but one of the fatalities since the outbreak of enterohaemorrhagic E. coli (EHEC) poisoning began last month have occurred in Germany. A patient who died in Sweden had recently returned from Germany.
Regional German health authorities have reported more than 2,000 cases of people falling ill, with symptoms including stomach cramps, diarrhoea, fever and vomiting.
A large majority are female, suggesting the source is "probably something that women prefer more than men", Andrea Ellis, an epidemiologist at the World Health Organisation's department of food safety, said in Geneva.
In some cases the infection can lead to bloody diarrhoea and potentially life-threatening conditions such as haemolytic uraemic syndrome (HUS), a kidney disease.
At least 552 people, 520 of them in Germany, have HUS, according to the WHO, with 10 other European countries plus the US reporting HUS or EHEC infections.
The outbreak was "the largest epidemic of HUS to have occurred anywhere in the world", according to Francois-Xavier Weill, head of France's National Reference Centre for E. coli.
In addition to Germany, cases of E. coli poisoning have been reported in Austria, Britain, the Czech Republic, Denmark, France, The Netherlands, Norway, Spain, Sweden, Switzerland and the US.
Britain confirmed four more cases of poisoning on Friday, bringing the total number of infected in the country to 11.
Each is related to German travel and three of the patients have HUS, the Health Protection Agency said.
The WHO has identified the bacteria as a rare E. coli strain never before connected to an outbreak of food poisoning. But researchers in Hamburg said earlier they and Chinese colleagues had found the strain was a "new type" which is extremely aggressive and resistant to antibiotics.
E. coli is a common bacteria found in meat, vegetables and fruit. It normally lives in the intestines of people and animals where it helps the body break down food. There are hundreds of E. coli strains but some are harmful.
Germany authorities were quick to point the blame for the outbreak at cucumbers imported from Spain, triggering trade tensions.
Angela Merkel, the German chancellor, defended the false cucumber alert in a phone call on Thursday with Jose Luis Rodriguez Zapatero, the Spanish prime minister, saying authorities were "duty-bound to inform the public at all times".
The advisory, retracted this week, left tens of thousands of tonnes of Spanish produce unsold, costing Spanish growers an estimated 200 million euros a week.
To ease tension over the heavy losses, European agriculture ministers are scheduled to meet in Luxembourg for talks after June 17, according to diplomats.
With no clarity on the source of the mysterious bacteria, the outbreak has led some countries such as Russia and Lebanon to ban vegetables from the EU, in moves criticised by the 27-member bloc.