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updated 6/11/2011 12:24:34 AM ET 2011-06-11T04:24:34

German vegetable sprouts caused the E. coli outbreak that has killed 31 people and sickened more than 3,000, investigators announced Friday after tracking the bacteria from patients in hospital beds to restaurants and then farm fields.

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Reinhard Burger, president of the Robert Koch Institute, Germany's national disease control center, said the pattern of the outbreak had produced enough evidence to draw that conclusion even though no tests of sprouts from an organic farm in Lower Saxony had come back positive for the E. coli strain behind the outbreak.

"In this way, it was possible to narrow down epidemiologically the cause of the outbreak of the illness to the consumption of sprouts," Burger said at a press conference with the heads of Germany's Federal Institute for Risk Assessment and Federal Office for Consumer Protection. "It is the sprouts."

The breakthrough came after a task force from the three institutes linked separate clusters of patients who had fallen sick to 26 restaurants and cafeterias that had received produce from the organic farm.

"It was like a crime thriller where you have to find the bad guy," said Helmut Tschiersky-Schoeneburg from the consumer protection agency.

"They even studied the menus, the ingredients, looked at bills and took pictures of the different meals, which they then showed to those who had fallen ill," said Andreas Hensel, head of the risk assessment agency.

Burger said all the tainted sprouts may have either been consumed or thrown away by now, but warned that the crisis is not yet over and people should still not eat sprouts.

Hensel, however, said authorities were lifting the warning against eating cucumbers, tomatoes and lettuce. "Lettuce, tomatoes and cucumbers should be eaten again — it is all healthy produce," he said.

U.S. counts five linked cases
Health officials say the count of U.S. cases linked to the food poisoning outbreak in Europe has grown to five.

The U.S. Centers for Disease Control and Prevention on Friday added a case to the count. Unlike the previous four, the new case was not someone who had been to Germany — it was a family member who apparently was infected from close contact with one of the travelers.

One case has been confirmed as the same form of E. coli, and the other four are still suspected. They include people in Massachusetts, Wisconsin and Michigan. None died.

Identifying culprits
Russia agreed to lift its ban on European vegetable imports and Spanish farmers who had been hardest hit in the crisis as wary Europeans shunned vegetables breathed a sigh of relief.

Norman Noah, a professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine who has investigated numerous food-borne outbreaks, said the culprits are often identified only by epidemiological evidence, because the contaminated food has long since disappeared by the time scientists begin taking samples.

"Having gone this far down the line, the chances of finding contaminated food is quite small," Noah said. "If (laboratory) evidence is missing, then epidemiological evidence can be quite compelling."

While the farm on the outskirts of the northern German village of Bienenbuettel blamed for the outbreak was shut down last Thursday and all of its produce recalled, the experts said they could not exclude the possibility that some tainted sprouts were still being used and people could still get infected with E. coli.

Also, since it has not yet be established why the sprouts were bad — whether the seeds had been contaminated or the farm's water — the experts said it was possible that other farms could also be affected. No other farms have been shut down, however.

Germany has been the epicenter of the world's deadliest known E. coli outbreak, with 2,988 people sickened, 759 of whom are suffering from a serious complication that can cause kidney failure. The World Health Organization says 97 others have fallen sick in 12 other European countries, as well as three in the United States.

Thirty people have died in Germany, and one in Sweden.

In recent days the number of new E. coli cases have been dropping, but it was not clear whether the epidemic was waning or whether consumers were just successfully shunning tainted vegetables.

The sprouts were initially blamed for the outbreak on Sunday, but authorities backpedaled the following day after lab tests came in negative and there was not yet enough epidemiological evidence. During the course of the investigation, non-lethal E. coli was also found on cucumbers from Spain and beet sprouts from the Netherlands — prompting general fears about produce from the European Union.

Russia and Saudi Arabia had issued a blanket ban on vegetable imports from the EU, and EU farmers claimed to be losing up to €417 million ($611 million) a week as demand plummeted and ripe produce was left to rot in fields and warehouses. The EU pledged Wednesday it would offer farmers compensation of up to €210 million ($306 million) for the E. coli losses.

Andres Gongora, leader of the Spanish farm association COAG, was cautiously optimistic that confidence in Spanish produce would return but still furious with German authorities.

"At this point, the German government has very little credibility when it comes to clarifying the source of this bacteria," Gongora said from the southern city of Malaga, where COAG was giving away tons of fruit and vegetables to promote Spanish produce as safe. "You have to be careful because Germany has screwed up several times now."

Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Timeline: Food contamination

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