The UK Health Security Agency (UKHSA), in collaboration with public health agencies across Scotland, Northern Ireland, and Wales, is actively investigating a surge in Shiga toxin-producing E coli (STEC) cases in the United Kingdom over recent weeks.
The STEC Outbreak
STEC infections can lead to severe bloody diarrhoea and, in some instances, more serious complications. While contaminated food consumption is a common mode of transmission, the bacteria can also spread through close contact with infected individuals or direct exposure to contaminated animals or their environments.
Whole genome sequencing of samples from the ongoing investigation indicates that most cases are part of a single outbreak. Given the widespread geographic distribution of cases, it is likely that this outbreak is linked to a nationally distributed food item or multiple food items. However, the precise source remains unconfirmed, and there is currently no evidence connecting the outbreak to open farms, drinking water, or swimming in contaminated seawater, lakes, or rivers. Public health agencies are collaborating closely with the Food Standards Agency (FSA) and Food Standards Scotland to further investigate.
As of June 4, a total of 113 confirmed cases have been associated with this STEC O145 outbreak in the UK, all reported since May 25, 2024:
- 81 cases in England
- 18 cases in Wales
- 13 cases in Scotland
- 1 case in Northern Ireland (evidence suggests they acquired the infection while visiting England)
Typically, the UK sees approximately 1,500 STEC cases annually. The number of confirmed cases linked to this outbreak is expected to rise as additional samples undergo whole genome sequencing.
Demographics and Hospitalisations
The affected individuals span a wide age range, from 2 years old to 79 years old, with the majority of cases occurring in young adults. Among the 81 cases identified in England, 61 individuals have provided information to UKHSA regarding food, travel, and potential exposures. Of these, 61% have required hospitalisation.
While the source of the outbreak remains unknown, there are steps individuals can take to reduce their risk of gastrointestinal infections and limit further spread:
- Hand Hygiene: Regularly wash hands with warm water and soap. Alcohol-based gels do not effectively kill all pathogens causing diarrhoea illnesses.
- Food Safety: Follow proper food hygiene practices, including washing fruits and vegetables thoroughly and cooking food to recommended temperatures.
- Isolation: If you experience diarrhoea and vomiting, avoid preparing food for others and refrain from visiting hospitals or care homes to prevent transmission.
- Return to Normal Activities: Wait at least 48 hours after symptoms have ceased before returning to work, school, or nursery.
Expert Insights
Trish Mannes, Incident Director at UKHSA, emphasises the importance of preventing secondary transmission: “Symptoms of STEC infections include severe and sometimes bloody diarrhoea, stomach cramps, vomiting, and fever. If you’re unwell, take precautions to avoid passing it on to family and friends.”
Darren Whitby, Head of Incidents and Resilience at the FSA, underscores the need for good hygiene practices when handling and preparing food. Thoroughly washing hands, cleaning surfaces, and preventing cross-contamination are crucial steps to curbing the outbreak.
The FSA continues to collaborate with UKHSA and relevant public health bodies to identify the specific food items associated with the illness.