E. Coli Advice Issued Amid Rise In Cases - 20 June 2024

As of 18 June, there have been a further 45 cases associated with the recent outbreak of STEC O145 since the last update (14 June), bringing the total number of confirmed cases to 256 in the UK. All currently confirmed cases had symptom onset dates before 31 May. Although the rate of cases has now slowed, we expect the figure to rise as NHS laboratories refer specimens to UKHSA for genomic sequencing which can link cases to this outbreak strain.

Confirmed case totals:
168 in England
56 in Scotland
29 in Wales
3 in Northern Ireland (evidence suggests that they acquired their infection in England)

Based on information from 227 cases to date, 38% were admitted to hospital.

Investigations have highlighted pre-packaged sandwich products containing lettuce as the likely source of the outbreak.

Based on evidence to date, the Food Standards Agency (FSA) and Food Standards Scotland (FSS) have published precautionary product recall notices covering a range of products that are potentially contaminated with E. coli. Working closely with the FSA, FSS and the devolved public health agencies, epidemiological investigations, whole genome sequence analysis and food chain investigations are still ongoing to confirm the cause of this outbreak.

Dr Colin Brown, Incident Director at UKHSA, said:
"Symptoms of infections with STEC include severe and sometimes bloody diarrhoea, stomach cramps, vomiting and fever. While diarrhoea and vomiting can have a range of causes, there are simple steps you can take to reduce your risk and risk of infecting others.

"Washing your hands with soap and warm water and using disinfectants to clean surfaces will help stop any further spread of infection. If you are unwell, you should not prepare food for others while unwell and avoid visiting people in hospitals or care homes to avoid passing on the infection in these settings. Do not return to work, school or nursery until 48 hours after your symptoms have stopped. If you are concerned about your symptoms, follow NHS.UK guidance on when to seek help and the steps you can take to avoid further spread to family and friends."

Darren Whitby, Head of Incidents at the FSA said:
"Several sandwich manufacturers have now taken precautionary action to withdraw and recall various sandwiches, wraps, subs and rolls, as food chain and epidemiological links have enabled us to narrow down a wide range of foods consumed to a small number of salad leaves that have been used in these products.

"This follows extensive investigations into the cause of an ongoing outbreak caused by shiga toxin-producing E.coli (STEC) which is being carried out by the FSA, FSS and UKHSA, working closely with the relevant enforcing authorities across Local Authorities). A full list of products implicated in the product recalls can be found in the product recall notices (PRINs).

"This remains a complex investigation and we continue to work at pace with the relevant businesses and local authorities to ensure necessary steps are being taken to protect consumers.

"Although we are confident in the source of the outbreak being linked to a small number of salad leaves, which we identified early on through extensive food chain analysis, work continues to identify the root cause of the outbreak with the growers, suppliers and manufacturers so that actions can be taken to prevent a re-occurrence. We will remain vigilant until the root cause of the outbreak is confirmed and we are keeping an open mind about possible causes of the outbreak. Information is being gathered at pace and is under constant review to ensure we minimise any further risk to consumers."