Source of E.coli Infection May Never Be Known: Germany's Decentralized Healthcare System

Though the government can’t really be blamed, many think the E.coli outbreak that has killed 27 people so far and sickened thousands more, might not have been so long, or deadly, if the German healthcare information system were not so disconnected and localized, according to the New York Times.

While scientists are still trying to pinpoint the source of the E. coli outbreak, it may never be known, and because of this, the German government is facing increasing criticism over its handling of the crisis, reports the Christian Science Monitor accused of mismanagement and inaccuracy.

There is no central authority gathering and publishing information on the outbreak and its possible causes.

German public health officials have become fodder for American late-night TV shows because of their conflicting messages, warnings followed by retractions, first tomatoes and cucumbers, then bean sprouts, as the source of the outbreak, and as time is critical, and is running out, in locating the source of the infection, its origins may never be known.   

Experts complain that Germans are interviewing people about foods they ate about a month ago, and it’s almost impossible to know how accurate that information is, according to an article in the Taipei Times.

Others wondered why it was taking so long to identify the source. “If you gave us 200 cases and five days, we should be able to solve this outbreak,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, whose team has contained numerous food-borne outbreaks in the US, in the same article in the Taipei Times. In the article, Osterholm called the German effort “erratic” and “a disaster” and said officials should have done more detailed patient interviews as soon as the epidemic began.

What’s missing say many is a centralized, more streamlined crisis management model, both at a state level and within the EU bureaucracy, according to the Christian Science Monitor, one like FoodNet in the U.S., which puts together clinical data from laboratories and hospitals in 10 states, according to the New York Times.

Physicians for years have fought attempts to create a national healthcare information pipeline, even though the country quickly adapted to electronic health records (EHRs) to store patient information, according to

The contemporary healthcare system in Germany is extremely decentralized, split between the federal level, the regional level and a complex system of physicians’ associations, according to epSOS, an organization committed to building an interoperable health information system in Europe .

Germany’s privacy laws are very strict, another reason why physicians have been reluctant to endorse a national heathcare information exchange. 

These reasons seem to be what’s at the heart of the resistance, according to a study done by the Department of Informatics, Technische Universität München, and the

 Department of Economics, Universität Kassel, Germany.

So it looks like the cause of this virulent outbreak may never be known. Thankfully, I’ve never had E.coli. But I’m enough of a hypochondriac to think that, even if I were so inclined, I’d never eat bean sprouts, tomatoes, or cucumbers again. Thank goodness you can’t get E.coli from Baskin Robbins’ Pralines & Cream. . .can you?