Mystery E.coli outbreak that left 37 in hospital and more than 100 sick was ‘likely caused by ready-to-eat dairy’
A READY-to-eat food containing dairy is likely to be behind a UK-wide E. coli outbreak, an expert warns.
At least 37 people have been admitted to hospital and 113 cases confirmed between May 25 and June 4, according to the UK Health Security Agency (UKHSA).
Officials believe the source to be a “nationally distributed food item”, but have not given any further information.
Hugh Pennington, emeritus professor of bacteriology at the University of Aberdeen, reckons it isn’t something that needs to be cooked as it’s unlikely so many people would make the same mistake.
He told the Mail on Sunday: “It would be much more likely to be foods that are not going to be cooked before they are consumed.
“We’ve had outbreaks associated with dairy products, for example.
“Cheese is a classic, and we’ve had ice cream before. There’s a whole range – any dairy products that are being processed.”
Cheese made from unpasteurised milk is the most likely culprit, he added.
All the cases recorded in the outbreak involve Shiga toxin-producing E. coli O145 (STEC), with 81 in England, 18 in Wales, 13 in Scotland and one person in Northern Ireland who believes they fell ill in England.
Those affected range in age from two to 79, with the majority of cases in young adults. Numbers are expected to rise.
Owing to the “wide geographic spread of cases”, the UKHSA believes the outbreak is linked to a nationally distributed food item or multiple food items.
The UKHSA said it is working with public health agencies in Scotland, Northern Ireland and Wales, the Food Standards Agency (FSA) and Food Standards Scotland to determine the cause of people’s illness.
Of the 81 people identified so far in England, 61 have provided information to the UKHSA related to food, travel and potential exposures.
Of these 61, some 37 have been admitted to hospital, the UKHSA said, though the true figure is expected to be much higher.
E. coli are a diverse group of bacteria that are normally harmless and live in the intestines of humans and animals.
However, some strains produce toxins that can make people very ill, such as STEC.
People infected with STEC can suffer diarrhoea, and about 50 per cent of cases have bloody diarrhoea.
Other symptoms include stomach cramps and fever. These things can last up to two weeks in uncomplicated cases.
Some patients, mainly children, may develop haemolytic uraemic syndrome, which is a serious life-threatening condition resulting in kidney failure.
A small proportion of adults may develop a similar condition called thrombotic thrombocytopaenic purpura (TTP).
An expert's view
Dr Richard Anderson, head of learning and development at the food hygiene experts High Speed Training, said: “The news that food poisoning cases are soaring is deeply concerning.
“A combination of looser checks on imported meat entering the country, combined with budget cuts for local authorities and environmental health standards agencies, has created a food environment in the UK that poses a higher risk to consumers.
“Because of this, it’s important that Brits understand what food types class as high risk, and how to safely prepare and cook them in the home.
The most common forms of food poisoning in the UK come from raw or undercooked foods.
“E.coli is a potentially fatal infection, particularly in older people. You can prevent it by thoroughly cooking your meat,” he added.
STEC is often transmitted by eating contaminated food.
This is often minced beef, unpasteurised dairy and fresh produce like spinach, lettuce, fruit and vegetables.
But can also be spread by close contact with an infected person, as well as direct contact with an infected animal or where it lives.
Prof Pennington told Sky News: “Traditionally with E. coli, as it affects women more than men, we focus on salads.
“But [in this outbreak], it doesn’t mean the two-year-old ate the food.
“About 20 per cent of cases of this particular kind of E. coli are in families where the bug has spread from one infected person to others.
“Somebody preparing the food may not have washed their hands after going to the toilet, for example.
“That’s a possibility that needs to be looked at.”
E.coli is a potentially fatal infection, particularly in older people
Dr Richard Anderson
He added that not everybody that gets infected will display symptoms.
“It’s a bit like Covid in that respect,” Prof Pennington said.
“There are some people who are infected but don’t know it as they don’t have any symptoms.”
The UKHSA said there is currently no evidence linking the outbreak to open farms, drinking water or swimming in contaminated sea, lakes or rivers.
‘DO NOT RETURN TO WORK’
Trish Mannes, incident director at UKHSA, said: “If you have diarrhoea and vomiting, you can take steps to avoid passing it on to family and friends.
“NHS.uk has information on what to do if you have symptoms and when to seek medical advice.
“Washing your hands with soap and warm water and using disinfectants to clean surfaces will help stop infections from spreading.
“If you are unwell with diarrhoea and vomiting, 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.”
Darren Whitby, head of incidents and resilience at the FSA, said it is working to identify the source of the illness “which is likely to be linked to one or more food items”.
People are advised to call NHS 111 or contact their GP surgery if they are worried about a baby under 12 months, a child stops breast or bottle feeding while they are ill, a child under five has signs of dehydration such as fewer wet nappies, and if older children or adults still have signs of dehydration after using oral rehydration sachets.
Help should also be sought if people are being sick and cannot keep fluid down, there is bloody diarrhoea or bleeding from the bottom, diarrhoea lasts more than seven days or vomiting for more than two days, the UKHSA said.
What are the symptoms of STEC?
Shiga toxin-producing Escherichia coli can cause gastrointestinal illness that can become severe.
The most common type of STEC in the UK is O157, according to a 2017 report by Public Health England.
Some people who are exposed to STEC do not become ill. Others develop stomach cramps and bloody diarrhoea.
Symptoms can also include vomiting, fever, and chills.
In severe cases, the infection can damage organs, such as the kidneys.
Symptoms can appear anywhere from one to ten days after exposure but usually appear around three to four days after exposure.
Most of those affected by the bug will get better without treatment within a week. Sufferers are advised to drink plenty of fluids to stay hydrated.
Are you at risk of getting it?
People can become infected by:
- Eating contaminated food
- Contact with infected animals either directly or through inadvertent contact with animal faeces, for example at farms, petting farms and campsites
- Contact with other people who have the illness (through inadequate hand hygiene after using the toilet, before food handling – particularly in households, nurseries, infant schools, or both
- Drinking water from inadequately treated water supplies
- Swimming or playing in contaminated water such as ponds or streams
STEC are very infectious because very few bacteria are needed to cause illness.
This means that disease can spread easily within families and in other settings such as day nurseries, primary schools, nursing homes and hospitals where there are young children and others who might have difficulty keeping clean.
How can you protect yourself from STEC?
An STEC infection can be prevented by taking the following precautions:
- Cook all minced meat products (burgers, meatloaf, meatballs) thoroughly, until the colour is the same all the way through, and no blood runs from them
- Ensure refrigerators are working correctly – bacteria grow more quickly at temperatures over 4oC
- Only leave cooked foods, meat and dairy products out at room temperature for a short time
- Store uncooked meats below-cooked meats and salad vegetables to avoid dripping juices onto ready-to-eat food
- Store uncooked and cooked meats on different plates, and avoid all contact between raw and cooked meats
- Thoroughly wash all salad vegetables and do not prepare them with utensils that have also been used for raw meat
- Children and the elderly who are particularly susceptible to the severe effects of STEC should avoid eating or drinking unpasteurised dairy products
- People who have been ill should not prepare food for others for at least 48 hours after they have recovered
- Boil any drinking water if you are unsure of its source
- Do not swim in water that you think may be contaminated by cattle and sheep in nearby fields
- Wash your hands thoroughly after using the toilet (or helping others including changing nappies), handling raw meat, before meals and after contact with animals
Source: PHE