A deadly outbreak of the E. coli pathogen that spread across Europe last month has been traced to a shipment of contaminated fenugreek seeds from Egypt. Originally it was believed that contaminated fresh produce from Spain was the source although no conclusive evidence was found.

The seeds were apparently brought into Europe through a German importer, who then distributed the spice to others, according to a joint report released Thursday by investigators.

“The consumption of fenugreek sprouts has been implicated as a possible source of the recent E. coli O104:H4 outbreak in Germany and France,” reported the European Food Safety Authority and the European Centre for Disease Prevention and Control.

Officials followed up and reported on a second outbreak of the E. coli pathogen when it struck Bordeaux, France, where they also identified a cluster of haemolytic uremic syndrome (HUS). The strain, capable of producing “Shiga” toxins, causes sickness ranging from mild intestinal disease to severe kidney complications. A serious and sometimes deadly complication, HUS is characterized by acute renal failure, haemolytic anaemia and thrombocytopenia. Transmission of the infection occurs mainly through contaminated food, water or contact with animals, although person-to-person transmission is also possible among close contacts.

Since the European E. coli outbreak was first reported, 48 people have died and nearly 4,000 others have been taken ill, the report said.

And there may be more to come.

Investigators noted the seeds are likely to still be in the marketplace, adding, “… other batches of potentially contaminated seeds are still available within the EU and perhaps outside. Currently ongoing intensive epidemiological, microbiological and food trace-back and trace-forward investigations will therefore be vital.”

Shoppers were warned that “Until the investigation has been finalized, ECDC and EFSA strongly recommend advising consumers not to grow sprouts for their own consumption and not to eat sprouts or sprouted seeds unless they have been cooked thoroughly.” 

Fenugreek seeds and leaves are used as flavorings in South Asia, China and in Mediterranean countries, including Israel. The seeds are especially used in Yemenite cuisine, specifically in a favorite dish called "hilbeh" in which they are ground and then soaked in water until they have swelled and softened into a gel-like substance, and then are whipped with other ingredients to make a savory dip. This preparation is said by Yemenite Jews to balance blood pressure and glucose levels, and is generally consumed at each Sabbath meal.