The Pennsylvania Department of Health is now aware of at least 13 people infected with E. coli O157:H7 who swam in the lake at Cowans Gap State Park.

In a brief e-mail statement this afternoon, press aide Thomas Hostetter said the current numbers include six people from Franklin County, four from Lancaster County, and one from Huntingdon County. There are also two Maryland residents who got sick after visiting the park.

Hostetter said the E. coli outbreak at Cowans Gap remains under investigation, and that more updates will be released as they become available.
 

The numbers of dead and dying continue to spin out of control in Europe s no one seems to know how this happened.

German Health Minister Daniel Bahr said Monday that authorities still haven't pinned down definitively the source of the E. coli infection — and "we unfortunately still have to expect a rising number of cases."

An EU official who spoke on condition of anonymity due to standing regulations, said the transport chain was long, and the cucumbers from Spain could have been contaminated at any point along the route.

Spain, meanwhile, went on the defensive, saying there was no proof that the E. coli outbreak has been caused by Spanish vegetables.

"You can't attribute the origin of this sickness to Spain," Spain's Secretary of State for European Affairs, Diego Lopez Garrido told reporters in Brussels. "There is no proof and that's why we are going to demand accountability from those who have blamed Spain for this matter."

Kai Kupferschmidt, who initially reported it was E. coli O104 that has killed three and sickened over 400 in Germany, writes for Science Insider today that an initial sorta-case control study hasn’t provided any clues as to the source of the outbreak.

But Kupferschmidt does provide excellent background on E. coli O104, and notes that German authorities reported earlier today that the number of hemolytic-uremic syndrome (HUS) cases had reached 140; there are normally 60 HUS cases in Germany in a year.

Most EHEC infections are caused by a notorious serotype called O157:H7; researchers refer to that serotype and four others frequently found in Europe as the "gang of five." But the German reference laboratory for EHEC in Wernigerode has so far identified the serotype of EHEC in stool samples from five patients as O104.

Scientists have been baffled not only by the outbreak's size and rapid spread in northern Germany but also by the fact that it affects mostly adults and females, an odd pattern because EHEC usually sickens children.

That makes the outbreak highly unusual, says Helge Karch, head of the National Consulting Laboratory on Hemolytic Uremic Syndrome in Münster. Among Karch's E. coli isolates from 588 HUS patients collected over the past 20 years, only two are O104. In another unusual twist, Karch has found the strain to be eae-negative. The gene eae codes for the protein intimin, which the bacteria uses to attach to the intestinal wall. Most pathogenic EHEC serogroups are eae-positive.

It is still unclear whether the serotype might explain the strange pattern of infections. E. coli O104 first emerged as a pathogen in a small outbreak in Helena, Montana, in early 1994. Four people developed abdominal cramps and bloody diarrhea. Experts at the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta identified a serotype called O104:H21 as the culprit. A CDC investigation later found up to 18 patients; most of them were women and the median age was 36 years.
 

At least two children from Rush County are critically ill after getting E. coli poisoning, and health officials are now looking into whether the children got sick at the Rush County Fair.

Four-year-old Kathleen Ragan (right) is at Peyton Manning Children's Hospital in Indianapolis, undergoing dialysis for hemolytic-uremic syndrome. She's one of four reported cases of E. coli. Fox59 News has received reports that Kathleen along with three other children may have contracted the disease while attending the county fair.

Kathleen's mother says she did use hand sanitizer as she petted animals there, but her symptoms of fatigue, diarrhea and bloody stools started the day after the fair ended.