Outbreak reportindependent cross-checkabstract checked I-VEG-136 standard review
French cluster confirms fenugreek sprouts
Outbreak of Shiga toxin-producing Escherichia coli O104:H4 associated with organic fenugreek sprouts, France, June 2011.
Overview
King LA et al.. Clin Infect Dis 2012 · PMID 22460976 · DOI 10.1093/cid/cis255
In a 2011 French cluster with the same strain, eating fenugreek sprouts raised illness risk five-fold.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Find the vehicle of a French O104:H4 cluster.
- How was the study done?
Cohort study.
- How many people, animals or samples were studied?
24 cases.
- What was actually found?
Fenugreek sprouts.
- How large was the observed effect?
RR 5.1 (2.3-11.1).
- What do the results mean in everyday life?
Confirms sprouts, not cucumbers.
- What are the study's limitations?
Small.
- What does it say about Elawady's specific claim?
Contradicts the cucumber part.
- Do the results apply to Germany and Europe?
European.
- What can explicitly not be concluded from this study?
Not applicable.
Scientific in-depth review
1. Full reference
- Authors
- King LA et al.
- Journal
- Clin Infect Dis
- Year
- 2012
- Identifier
- PMID 22460976 DOI 10.1093/cid/cis255
- Verification
- verified – PubMed efetch 2026-10-26; Crossref 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
What was the vehicle of the June 2011 STEC O104:H4 cluster near Bordeaux?
3. Study design and population
- Study design
- Outbreak report – Retrospective cohort outbreak investigation
- Population
Adults attending a community event
- Country
France
- Period
June 2011
- Sample size
24 cases (14% attack rate)
- Inclusion and exclusion criteria
not stated in abstract
4. Methods and endpoints
- Exposure / intervention
Foods served, incl. sprout types
- Comparator
Non-exposed attendees
- Endpoints
HUS or diarrhoea
- Statistical methods
Poisson regression (multivariable)
5. Actual results
- Results
Fenugreek was the only sprout type independently associated with illness (RR 5.1, 95% CI 2.3-11.1); comparison with the German investigation identified fenugreek sprouts as the common vehicle.
- Absolute risks
not reported
- Authors' conclusion
Point-source outbreak associated with fenugreek sprouts; led to Europe-wide control measures.
6. Strengths
- Independent second outbreak with cohort design
7. Weaknesses
- Small
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Recall bias possible.
9. Assessment of the statistical interpretation
RR 5.1 (2.3-11.1).
10. Relevance to the specific claim
Independent confirmation of fenugreek sprouts as vehicle; no cucumber involvement.
11. Independent contrary findings
none
12. Transferability to Germany and Europe
French.
13. Overall methodological judgement
Contradicts the cucumber part.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
none
15. Linked fact checks
- Germany's 2011 E. coli O104:H4 epidemic was traced to sprouts and cucumbers. – Studies contradicting or limiting the claim