O Legado da Medicina Moderna: Doenças Incuráveis

Por Luis R. Miranda
The Real Agenda
20 de fevereiro de 2012

A natureza sempre encontra uma maneira de evoluir e sobreviver. O que poderia estar pensando em um ser humano, quando cría um produto farmacêutico a fim de “erradicar” um vírus ou bactéria? Os seres humanos não sabem o suficiente sobre os microorganismos, como vivem ou se adaptam a ambientes adversos para afirmar que um tratamento foi encontrado ou que há uma cura universal. O problema não é a procura de uma solução para nos manter livres de doenças, mas sím a arrogância dos chamados especialistas e cientistas que  dizem que a solução final foi encontrada. O campo da medicina tem evoluído ao longo do tempo, e continua evoluindo até hoje. Nenhum tratamento é final, nenhuma cura é livre de defeitos. A humanidade evolui e melhora, e assim acontece com os vírus e bactérias.

Um dos pecados mais perigosos da medicina moderna e os seus praticantes é assumir que as suas descobertas e os benefícios que vêm com elas vão acabar com toda a dor e sofrimento. A natureza continua mostrando que eles estão errados, uma e outra vez.

O mais recente exemplo do que chamo de “insanidade médica” está aumentando o número de doenças intratáveis e incuráveis. Assim como as ervas daninhas têm encontrado uma maneira de sobreviver ao ataque de herbicidas criando mecanismos para sobreviver, vírus e bactérias absorvem o impacto dos antibióticos e evoluem ao longo de gerações, para se tornar não só intratáveis, mas em muitos casos incuráveis.

No Reino Unido, novas bactérias e vírus são resistentes aos medicamentos tradicionais e agora representam uma ameaça maior do que a apresentada pela Aids ou o vírus que em teoría causa as pandémias de gripe. A bactéria E. Coli é um exemplo do tipo de ameaça que está quase fora de controle. Infecção com E.coli está se tornando uma doença que é impossível de tratar. Segundo o professor Peter Hawkey, do grupo de analise do governo sobre a resistência aos antibióticos, o aumento lento mas constante do número de bactérias que estão se tornando intratáveis até agora matam 25.000 pessoas por ano na União Europeia.

Entretanto, as infecções e mortes por doenças incuráveis e intratáveis não estão confinadas à Europa. A ameaça de uma bactéria ou um vírus incurável que vai se espalhar por todo um continente ou o mundo não seria um evento raro. Na verdade, a presença da bactéria E. coli no sangue de pacientes aumentou 30 por cento. De acordo com relatórios oficiais, o número de pessoas que foram vítimas de infecções bacterianas subiu de 18.000 para 25.000 em apenas quatro anos. A percentagem de microorganismos resistentes aos antibióticos foi de 1 por cento a 10 por cento em apenas 11 anos.

“Apenas uma em cada 20 infecções com E. coli é bacteremia, pelo que os dados acima são apenas a ponta de um iceberg de casos de pessoas infectadas “, diz um relatório elaborado pelo Professor Hawkey e seu grupo de estudo.

Enquanto isso, as empresas farmacêuticas que antes viam o desenvolvimento de antibióticos como uma grande oportunidade para encher seus bolsos com dinheiro agora não vêem incentivo para continuar ou iniciar uma nova pesquisa sobre melhores medicamentos que podem ajudar a diminuir os efeitos do que parecem ser microorganismos imunes. Não é de interesse comercial para as grandes farmacêuticas continuar  investindo tempo e dinheiro com medicamentos que os pacientes tomam por alguns dias e que estarão obsoletos em questão de anos. É mais rentável projetar drogas que os pacientes continuam usando por décadas.

Tal como acontece com a gripe aviária e gripe suína, E. Coli geralmente afeta pessoas idosas e pessoas com problemas crônicos de saúde, que são duas das populações mais vulneráveis. As pessoas nesses dois grupos não costumam morrer de ataque viral ou bacteriano, mas devido a complicações médicas que aumentam o uso de antibióticos, o qual faz com que os ataques de vírus e bactérias sejam implacáveis. E. coli tem uma ameaça ainda maior do que o MRSA, à meticilina resistent Staphylococcus aureus, que é causada por uma estirpe de estafilococo resistente aos antibióticos.

Enquanto os antibióticos tornam-se ineficazes para o tratamento de E. coli e MRSA, a necessidade de medicamentos mais fortes é mais evidente. No entanto, a atual linha de tratamento antibiótico está chegando aos seus limites. A utilização de carbapenêmicos, que são a última linha disponível já está encontrando resistência. “Nos últimos dois ou três anos vimos [microorganismos] desenvolvendo resistência aos medicamentos carbapenêmicos, o nível mais alto nos tratamentos com antibióticos que é citado como o instrumento de último recurso quando se trata de infecções virais ou bacterianas. No final de 2011, o Centro Europeu de Controlo e Prevenção de Doenças citou várias bactérias como a causa do envenenamento do sangue; entre elas a K. pneumoniae que também é resistente aos carbapenêmicos em alguns países.

De acordo com o ECDC, o número de bactérias resistentes a carbapenêmicos aumentou de 7 por cento a 15 por cento.

Assim como acontece com os seres humanos, os microorganismos como bactérias e vírus, historicamente, encontraram formas de superar perigos naturais para sobreviver. No caso de bactérias, no entanto, a evolução não é medida em décadas ou séculos. Processos reprodutivos e de desenvolvimento ocorrem mais rapidamente do que nos seres humanos e podem se adaptar a ambientes agressivos dentro de meses ou anos. A evolução e adaptação das formas de vida, tais como bactérias é tão simples como é explicado em qualquer aula de ciência da escola primária. Embora muitas bactérias ou vírus podem ser mortos por antibióticos, alguns sempre irão sobreviver e os membros sobreviventes modificarão a sua estrutura genética para criar uma resistência aos antibióticos. As bactérias têm a vantagem sobre os antibióticos porque sua capacidade para sobreviver e adaptar-se é quase infinita, enquanto que o número de combinações de antibióticos utilizados para combate-los é limitado.

Simplificando, a medicina moderna criou uma solução temporária para um problema perene e, agora, as empresas farmacêuticas estao sem iniciativa, sem ideias e sem ciência para continuar a luta. Aparentemente, os microorganismos tem vencido a última batalha. Eu me pergunto o que aconteceria se os seres humanos tivessem tratado as infecções causadas por bactérias da mesma forma que as bactérias progressaram contra os antibióticos. E se em vez de criar novas cepas mortais de gripe H5N1, os cientistas tivessem usado seu tempo tentando entender que os seres humanos são apenas uma pequena parte da natureza, e não seus criadores.

La Herencia de la Medicina Moderna: Enfermedades Incurables

Por Luis R. Miranda
The Real Agenda
20 de febrero 2012

La naturaleza siempre encuentra una manera de evolucionar y sobrevivir. ¿Qué podría estar pensando un ser humano, cuando un producto farmacéutico se crea con el fin de “erradicar” a un virus o una bacteria? Los seres humanos no saben lo suficiente sobre los microorganismos, cómo viven o se adaptan a ambientes adversos para afirmar que un tratamiento ha sido encontrado o que existe una cura universal. No es la búsqueda de una solución para mantenernos a todos libres de la enfermedad lo que está mal, sino la arrogancia de los llamados expertos y científicos para afirmar que la solución final se ha encontrado. El campo de la medicina ha evolucionado durante el tiempo que ha existido, y sigue haciéndolo hoy en día. No existen tratamientos finales, no hay cura sin defectos. La humanidad evoluciona y mejora, y también lo hacen los virus y bacterias.

Uno de los pecados más peligrosos de la medicina moderna y los que la practican es asumir que sus descubrimientos y los beneficios que creen que vienen con ellos de alguna manera van a terminar con todo el dolor y el sufrimiento. La naturaleza demuestra que se equivocan una y otra vez.

El último ejemplo de lo que yo llamo la locura médica es el aumento de las enfermedades intratables e incurables. Así como las malas hierbas han encontrado una manera de sobrevivir al ataque de los herbicidas y han creado mecanismos para sobrevivir, los virus y las bacterias absorben el impacto de los antibióticos y evolucionan a través de generaciones, para tornarse no sólo intratable, pero en muchos casos incurables.

En el Reino Unido, nuevas bacterias y virus resultan ser resistentes a las medicinas tradicionales y ahora representan una amenaza mayor que la presentada por el SIDA o el virus que causa una pandemia de gripe. La bacteria E. Coli es un ejemplo del tipo de amenaza que está yendose de las manos. Infección por E coli se está convirtiendo en una enfermedad que es imposible de tratar. Según el profesor Peter Hawkey, del grupo de trabajo gubernamental sobre resistencia a los antibióticos, el aumento lento pero constante del número de bacterias que se están convirtiendo en intratables hasta el momento causa la muerte de 25.000 personas al año en la Unión Europea.

Sin embargo, las infecciones y muertes debido a las enfermedades incurables e intratables no se limitan al continente europeo. La amenaza de una bacteria o un virus incurable que se extienda por todo un continente o el mundo entero no sería un evento poco común. De hecho, la presencia de la bacteria E. coli en la sangre de pacientes subió 30 por ciento. De acuerdo con informes oficiales, el número de personas que fueron víctimas de las infecciones bacterianas se elevó de 18.000 a 25.000 en tan sólo cuatro años. El porcentaje de microorganismos resistentes a los antibióticos fue de 1 por ciento a 10 por ciento en tan sólo 11 años.

“Sólo uno de cada 20 de las infecciones con E. coli es una bacteriemia, por lo que los datos anteriores son sólo la punta de un iceberg sobre los casos de personas infectadas”, dice un informe elaborado por el Profesor Hawkey y su grupo de estudio.

Mientras tanto, las compañías farmacéuticas que una vez vieron el desarrollo de los antibióticos como una gran oportunidad para llenar sus bolsillos con dinero ahora no ven ningún incentivo para continuar o iniciar una nueva investigación sobre la mejora de los medicamentos que pueden ayudar a disminuir los efectos de lo que parecen ser microorganismos inmunes . No es comercialmente interesante para grandes potencias farmacéuticas seguir invirtiendo tiempo y dinero en los medicamentos que los pacientes toman por pocos días, y que serán obsoletos en cuestión de años. Es más rentable diseñar fármacos que los pacientes seguirán usando durante décadas.

Al igual que ocurre con la gripe aviar y la gripe porcina, E. Coli suele afectar a personas de edad avanzada y personas con problemas de salud crónicos, las cuales son dos de las poblaciones más vulnerables. La gente en estos dos grupos por lo general no mueren a causa del ataque viral o bacterian, pero debido a las complicaciones médicas que aumentan por el uso de antibióticos que hace que los ataques de los vírus y las bactérias sean implacable. E. coli presenta una amenaza aún mayor que el SARM, Staphylococcus aureus resistent meticilina, que es causada por una cepa de estafilococo resistente a los antibióticos.

Mientras los tratamientos con antibióticos se vuelven ineficaces para el tratamiento de E. coli y las infecciones por SARM, la necesidad de utilizar medicamentos más fuertes es más evidente. Sin embargo, la línea actual de tratamientos con antibióticos está llegando al límite. El uso de carbapenems, que son la última línea disponible. Y la resistencia a estos antibióticos ya está surgiendo. “En los últimos dos o tres años hemos visto [organismos] desarrollando resistencia a los medicamentos carbapenémicos, el nivel más alto en los tratamientos con antibióticos que es más citado como el instrumento de último recurso cuando se trata de infecciones virales o bacterianas. A finales de 2011, el Centro Europeo para el Control y Prevención de Enfermedades citó varias bacterias como causantes del envenenamiento de la sangre. Entre ellas la K. pneumoniae resistente a los carbapenémicos en algunos países.

Según el ECDC, el número de bacterias resistentes a los carbapenémicos ha aumentado del 7 por ciento al 15 por ciento.

Justo como lo hemos hecho los humanos, los microorganismos tales como bacterias y virus han encontrado históricamente formas de superar las amenazas naturales para sobrevivir. En el caso de las bacterias, sin embargo, su evolución no se mide en décadas o siglos. Sus procesos reproductivos y evolutivos se producen más rápido que en los seres humanos y pueden adaptarse a los ambientes hostiles en cuestión de meses o años. La evolución y la adaptación de las formas de vida tales como las bacterias es tan simple como se explica en cualquier clase de ciencias de la escuela primaria. Aunque muchas bacterias o virus pueden ser destruidas por los antibióticos, algunos de ellos siempre van a sobrevivir y los miembros supervivientes va a modificar su estructura genética para crear una resistencia a los antibióticos. Las bacterias tienen la ventaja frente a los antibióticos es que su capacidad para sobrevivir y adaptarse es casi infinita, mientras que el número de combinaciones de antibióticos utilizados para combatirlos es limitado.

Dicho en términos simples, la medicina moderna ha creado una solución temporal para un problema eterno, y ahora, las compañías farmacéuticas se quedaron sin iniciativa, sin ideas y sin ciencia para continuar la lucha. Al parecer, los microorganismos han ganado la última batalla. Me gustaría saber qué hubiera pasado si los seres humanos se hubieran ocupado de las infecciones causadas por bacterias de la misma forma en que las bactérias progresan contra los antibióticos. ¿Qué pasa si en lugar de crear nuevas cepas mortales de la gripe H5N1, los científicos hubieran usado su tiempo intentando entender que los seres humanos son sólo una pequeña parte de la naturaleza, no sus creadores.

The Heritage of Modern Medicine: Incurable Disease

by Luis R. Miranda
The Real Agenda
February 20, 2012

Nature always finds a way to evolve and to survive. What could a human be thinking when a pharmaceutical is created in order to “eradicate” a virus or a bacteria? Humans don’t know nearly enough about microorganisms, how they live or adapt to adverse environments to claim that a treatment has been found or a universal cure exists. It is not the pursuit of a solution to keep us all free from disease what is wrong, but the arrogance of the so-called experts and scientists to claim that a final solution has been found. The field of medicine has evolved for as long as it has existed; and continues to do so today. There are no ultimate treatments, no flawless cures. Humanity evolves and improves, and so do viruses and bacteria.

One of the most dangerous sins of modern medicine and those who practice it is to assume that their discoveries and the benefits they believe come with them will somehow end all pain and suffering. Nature proves them wrong again and again.

The latest example of what I call medical insanity is the rise of untreatable, incurable disease. Just as weeds have found a way to survive the attack of herbicides and created mechanisms to survive, viruses and bacteria absorbed the shock from antibiotics and evolved through generations not only to become untreatable, but in many cases incurable.

In the United Kingdom, new bacteria and viruses turn out to be resistant to traditional medicines and now pose a threat greater than that presented by AIDS or a virus that causes a flu pandemic. E. Coli bacterium is an example of the type of menace that is getting out of hand. E Coli infection is turning into a disease that is impossible to treat. According to professor Peter Hawkey, from the Government’s antibiotic-resistance working group, the slow but consistent rise of bacteria that are becoming untreatable so far resulted in the death of 25,000 people a year in the European Union alone.

But the infections and deaths due to incurable and untreatable disease is not limited to the European continent. The threat of an untreatable bacteria or a virus spreading throughout a continent or the whole globe would not be an uncommon event. In fact, the presence of E. Coli bacterium in the blood of patients went up 30 percent. According to official accounts, the number of people who were victims of bacterial infections rose from 18,000 to 25,000 in just four years. The percentage of organisms resistant to antibiotics went from 1 percent to 10 percent in only 11 years.

“Only one in 20 of infections with [resistant] E.coli is a bacteraemia, so the above data are only the tip of an iceberg of infected individuals,” reads a report produced by Professor Hawkey.

Meanwhile, the pharmaceutical companies that once saw the development of antibiotics as a great opportunity to fill their pockets with money don’t see any incentive to continue or start new research into better medicines that can help diminish the effects of what seem to be immune microorganisms. It is not commercially interesting for Big Pharma powerhouses to continue to invest time and money in drugs that are taken by patients for just a few days, and that will be made obsolete in a matter of years. It is more profitable to engineer drugs that patients will depend on for decades at a time.

Just as it happens with the Bird Flu and the Swine Flu, E. Coli often attacks the elderly and the sick, two of the most vulnerable populations out there. People in these two groups usually die not because of the bacterial or viral attack, but due to medical complications that are enhanced by the relentless attacks caused by the already antibiotic-immune microorganisms. E. Coli poses an even greater threat that MRSA, Methicillin-resistant Staphylococcus aureus, which is caused by a strain of staph bacteria also resistant to the antibiotics.

As more and more antibiotic treatments become ineffective to treat E.Coli and MRSA infections, the need to use stronger drugs is more apparent. But the current line of antibiotic treatments is getting to the limit. The use of carbapenems, which are the last line available. And resistance to those is already emerging. “In the last two or three years we have seen [organisms] develop which destroy carbapenems, the highest level in antibiotic treatments is more often than not cited as the tool of last resort when dealing with viral or bacterial infections. Late in 2011, the European Centre for Disease Control and Prevention cited several bacteria such as the blood poisoning K.pneumoniae as resistant to carbapenems in some countries.

According to the ECDC, the number of bacteria resistant to carbapenems has risen from 7 percent to 15 percent.

Microorganisms such as bacteria and viruses have historically found ways to overcome natural as well as man-made threats in order to survive. In the case of the bacteria, though, their evolution is not measured in decades or centuries. Their reproductive and evolutionary processes occur faster than in humans and they can adapt to hostile environments in a matter of months. The evolution and adaptation of life forms such as bacteria is as simple as it is explained in any science elementary school classroom. Although many bacteria or viruses may be killed by antibiotics, a few of them will always survive and those surviving members will modify their genetic structure to create a resistance to antibiotics. The advantage bacteria have against antibiotics is that their ability to survive and adapt is almost infinite, while the number of antibiotic combinations used to combat them is limited.

Put in simple terms, modern medicine has created temporary solutions for an everlasting problem, and now, pharmaceutical companies are out of ideas and science to continue the fight. It seems microorganisms have won the latest battle. I would like to know what would have happened if humans would have dealt with infections the same way bacteria deal with antibiotics. What if instead of creating new strains of the H5N1 flu, scientists would have understood that humans are just a small part of nature, not its creator.


This is what some scientists know about Europe’s E. Coli

Reuters
June 3, 2011

The deadly strain of E. coli that has killed at least 17 people in Europe and sickened 1,500 has never been seen in a human population and it may be the most toxic yet, health experts said on Thursday.

Here are answers to some frequently asked questions about the outbreak.

1. What is E. coli? Escherichia coli (E. coli) are a group of bacteria that live in the intestines of many animals, including humans. Most strains are harmless, but others can cause illness ranging from diarrhea to pneumonia. E. coli infections can be mild to life-threatening.

2. How is E. coli spread? E. coli infections are caused by ingesting the feces of infected animals or humans, often via contaminated food or water. People can contaminate food by failing to wash their hands after using the toilet or changing a baby’s diaper, although person-to-person infection is rare. Feces from animals, ranging from cows to birds, can contaminate water or crops.

3. What is the strain? The strain that is sickening people in Germany and other parts of Europe, known as 0104:H4, is part of a class of bacteria known as Shiga toxin-producing Escherichia coli, or STEC. It is the first time the strain has caused an outbreak in humans. Symptoms of STEC infections vary for each person but often include severe stomach cramps, diarrhea (often bloody) and vomiting. Low fever (less than 101 degrees F/38.5 degrees C) also may be present. Most people recover within five to seven days.

4. What are the major complications of this strain? Hundreds of people sickened in the outbreak have developed hemolytic uremic syndrome, or HUS, a life-threatening complication of E. coli infections. The syndrome, which results in the destruction of red blood cells and severe kidney problems, usually arises about a week after diarrhea starts.

Symptoms of HUS include decreased frequency of urination, extreme fatigue and the loss of the skin’s pink color. Children, the elderly and people with compromised immune systems usually are at highest risk for HUS. In the case of this outbreak, healthy adult women have been hard hit.

5. What is the medical treatment? Experts said supportive therapy, including hydration, is important. Treatment for HUS includes dialysis for kidney failure and blood transfusions for anemia. Antibiotics should not be used, as there is no evidence that treatment with antibiotics is helpful. Antibiotics and antidiarrheal agents like Imodium also may increase risk of HUS.

Source: U.S. Centers for Disease Control and Prevention

New E. Coli strain: Combination of two different E. Coli bacteria

Genetic sequencing suggests it is more virulent and toxin-producing

By Maria Cheng
AP
June 2, 2011

An entirely new super-toxic bug is causing the frightening food poisoning outbreak that has sickened at least 1,600 people and killed 18, researchers and global health officials said Thursday.

The DNA of the new E. coli strain, believed to have contaminated salad vegetables, was analyzed by Chinese and German scientists. It contains several genes that cause antibiotic resistance and is similar to a strain that causes serious diarrhea and is found in the Central African Republic, according to a statement from the Shenzhen, China-based laboratory, BGI. Those scientists were working together with the University Medical Center Hamburg-Eppendorf.

“This is a unique strain that has never been isolated from patients before,” Hilde Kruse, a food safety expert at the World Health Organization, told The Associated Press. The new strain has “various characteristics that make it more virulent and toxin-producing” than the many E. coli strains people naturally carry in their intestines.

Preliminary genetic sequencing suggests the strain is a never before seen combination of two different E. coli bacteria, with aggressive genes that could explain why the outbreak appears to be so massive and dangerous, the agency said.

Researchers have so far been unable to pinpoint the food source of the illness, which has now spread to at least 10 European countries and fanned uncertainty about eating tomatoes, cucumbers and lettuce. The germ has caused 499 to develop a kidney failure complication. Germany is hardest hit.

Fearful of the outbreak spreading east to Russia, the country extended a ban on vegetables to the entire European Union from just Germany and Spain, a move the bloc quickly called disproportionate.

Kruse said it’s not uncommon for bacteria to continually mutate, evolving and swapping genes. It is difficult to explain where the new strain came from, she said, but strains of bacteria from both humans and animals easily trade genes, similar to how animal viruses like Ebola sometimes jump into humans.

“One should think of an animal source,” Kruse said. “Many animals are hosts of various types of toxin-producing E. coli.” Some scientists suspect the deadly E. coli might have originated in contaminated manure used to fertilize vegetables.

Previous E. coli outbreaks have mainly hit children and the elderly, but the European outbreak is disproportionately affecting adults, especially women. Kruse said there might be something particular about the bacteria strain that makes it more dangerous for adults.

But she cautioned that since people with milder cases probably aren’t seeking medical help, officials don’t know just how big the outbreak is. “It’s hard to say how virulent (this new E. coli strain) is because we just don’t know the real number of people affected.”

Nearly all the sick people either live in Germany or recently traveled there. British officials announced four new cases, including three Britons who recently visited Germany and a German person on holiday in England.

The WHO recommends that to avoid food-borne illnesses people wash their hands before eating or cooking food, separating raw and cooked meat from other foods, thoroughly cooking food, and washing fruits and vegetables, especially if eaten raw. Experts also recommend peeling raw fruits and vegetables if possible.

Russia had earlier this week banned fresh imports from Spain and Germany, but it expanded the ban Thursday to include the entire EU. The United Arab Emirates issued a temporary ban on cucumbers from Spain, Germany, Denmark and the Netherlands.

Lyubov Voropayeva, spokeswoman for the Russian Agency for the Supervision of Consumer Rights, told the AP the Russian ban has been imposed immediately and indefinitely. No fatalities or infections have yet been reported in Russia.

“How many more lives of European citizens does it take for European officials to tackle this problem?” the agency’s chief Gennady Onishchenko said to the state-owned RIA Novosti news agency.

Frederic Vincent, a spokesman for the EU’s Health and Consumer Policy Commissioner John Dalli, said Thursday that the European Commission would write to Russia to demand further clarification. The Italian farmers association Coldiretti criticized the ban as “absurd.”

One expert said the fact the strain is new may have complicated the response to the outbreak. “Officials may not have had the correct tests to detect it, which may explain the initial delay in reporting,” said Paul Hunter, a professor of health protection at the University of East Anglia in England.

He said the number of new cases would likely slow to a trickle in the next few days. The incubation period for this type of E. coli is about three to eight days, and most people recover within 10 days.

“Salads have a relatively short shelf life and it’s likely the contaminated food would have been consumed in one to two weeks,” Hunter said.

But Hunter warned the outbreak could continue if there is secondary transmission of the disease, which often happens when children are infected. The disease can be spread when infected people don’t take proper hygiene measures, like bathing or hand washing..

Phil Tarr, a professor of molecular microbiology at Washington University, said the discovery of a new strain wasn’t particularly significant scientifically.

“Every strain is a mutant, if you define mutant as an organism that has picked up DNA from another source,” he said. He said more analysis was needed to find out more about the strain’s origins, how long it’s been around and its ability to make people sick.

Meanwhile, Spain’s prime minister slammed the European Commission and Germany for early on singling out the country’s produce as a possible source of the outbreak, and said the government would demand explanations and reparations.

Jose Luis Rodriguez Zapatero told Spanish National Radio that the German federal government was ultimately responsible for the allegations, adding that Spain would seek “conclusive explanations and sufficient reparations.”

Spanish farmers say the accusations have devastated their credibility and exports. In Valencia, protesting farmers dumped some 300 kilos (700 pounds) of fruit and vegetables — cabbage, tomatoes, peppers, cucumbers and other produce — outside the German consulate.

The outbreak is already considered the third-largest involving E. coli in recent world history, and it may be the deadliest. Twelve people died in a 1996 Japanese outbreak that reportedly sickened more than 9,000, and seven died in a 2000 Canadian outbreak.