The E. coli outbreak concentrated in northern Germany has spread to 11 other countries, including the U.S., the World Health Organization said Friday, amid increasing concern about the new strain's virulence.

The German government said a "European solution" will be found to compensate vegetable growers and traders who have suffered losses as consumers avoid raw vegetables and salads.

By Thursday, 1,122 cases of enterohemorrhagic Escherichia coli had been reported, while 502 cases of hemolytic uremic syndrome (HUS), a form of kidney failure caused by this E. coli strain, had been reported, the WHO said.



In all but two of the cases the patients lived in or had recently visited northern Germany.

But the number of cases of HUS in the country had increased to 520, German authorities said Friday.

So far, the outbreak has killed 18 people in Germany and one in Sweden. Most of the victims have been women.

Health officials said four people in the U.S. might be linked to the outbreak.

All four were in northern Germany in May and officials are confident that they were infected with E. coli in that country. Three of them -- two women and a man -- are hospitalized with a kidney complication that has become a hallmark of the outbreak.

Besides Germany and the U.S., the countries affected are: Austria, Czech Republic, Denmark, France, the Netherlands, Norway, Sweden, Spain, Switzerland and Britain.

Though Spanish cucumbers were cleared of blame for spreading the bug, described by Chinese researchers as a "new super-toxic" bacterium, a German Consumer Ministry spokesman repeated that consumers should avoid eating raw cucumbers, tomatoes and salad.

The difficulties doctors experience in treating the rare infection was raising concerns Friday.

"The severity of this strain has resulted in great pressure on the health services," said Winifred Kern of the University Hospital in Freiburg.

In northern Germany, hospitals were "experiencing a problem with availability of intensive care beds due to the high number of cases with life threatening complications," he said.

Doctors also questioned Europe's preparedness to deal with future outbreaks.

"This most recent E. coli epidemic, of a strain previously unseen in an outbreak, shows us yet again that new bacteria and infections are just around the corner," said Giuseppe Cornaglia, president of the European Society of Clinical Microbiology and Infectious Diseases. "The pan-European nature of this E. coli outbreak ... reinforces the need for concerted cooperation across borders to tackle not only this outbreak, but also future ones."

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