Multidisciplinary response to the Escherichia coli 0104 outbreak in Europe.

The 2011 outbreak of Escherichia coli (E. coli) O104 in northern Germany resulted in over 4,100 illnesses, 900 cases of hemolytic uremic syndrome, and 50 deaths. The U.S. Army's Public Health Command Region-Europe established a multidisciplinary advisory team to prevent E. coli O104 exposure in the Department of Defense (DoD) population. This decentralized, interagency team engaged European public health authorities and coordinated control measures including risk communication. Following German public health investigations, the DoD advisory team compiled information from available official reports, assessed risk, and published guidance to halt the local procurement and supply of suspect foods for all DoD installations in Europe. Advisory team members processed outbreak information, adjusted advisories, and coordinated response efforts. The advisory team quickly identified authoritative information sources, coordinated case definitions, and streamlined potential case reporting. Timely and accurate risk assessment, management, and communication were vital in protecting the DoD population during this outbreak. There were no cases in DoD-related personnel.