A deadly outbreak of E. coli in Germany remains unsolved, despite more than 400 people falling ill and three deaths.
In August 2025, an outbreak caused by enterohemorrhagic Escherichia coli (EHEC) was identified. Most cases occurred in the north and west of the country. Most affected were children under 10 years of age, and some developed hemolytic uremic syndrome (HUS), a serious systemic complication of E. coli infection that can lead to kidney failure, brain damage and death.
The causative agent was identified as E. coli O45:H2. This type of E. coli is rarely found in Germany. It was detected only 13 times between January 2015 and June 2025, and these isolates are not genetically related to the outbreak strain.
German officials have said the outbreak is most likely food related, but despite extensive efforts, specific sources of infection have not yet been identified. The investigation into the cause continues. This includes interviewing patients and their parents by telephone, conducting a case-control study, and analyzing purchase receipts.
Past the peak
199 diseases were confirmed, including 53 cases of HUS. There are also nine probable and 220 probable outbreak cases. This means there are 428 cases associated with the outbreak.
Previous total amounted to 351 patients with 183 confirmed infections and 48 cases of HUS.
Two confirmed cases have died: a patient aged 5 to 10 years with HUS and a woman aged 70 to 80 years infected with E. coli. One probable case: a patient over 90 years of age also died.
Confirmed cases fell ill between August 11 and October 16. The median age of these cases is 4 years with a range from less than 1 to 94 years. All patients with HUS are children. Authorities said the number of reported cases appears to be slowing.
The most affected states remain Mecklenburg-Vorpommern and North Rhine-Westphalia. Nine of the 16 federal states have four or more outbreaks.
The Robert Koch Institute (RKI) has received information about four travel-related outbreaks. A woman from the United States was in Mecklenburg-Vorpommern before she became ill, a child from the Netherlands was shopping for groceries in Germany, a child living in Germany became ill in Italy, and a child from Luxembourg became ill without any signs of infection in Germany.
The incident is the largest since the 2011 E. coli O104 outbreak, which was linked to the consumption of fenugreek sprouts. The final number of cases in this outbreak was 4075, including 908 cases of HUS and 50 deaths in 16 countries.
