One of Spain’s most important resorts on the western Mediterranean is infecting British travelers with E. coli O157:H7, the United Kingdom’s Health Protection Agency (HPA) reported over the weekend.

Spain’s resort of Benidorm is the common factor for up to 14 confirmed cases of E. coli O157:H7, HPA reports.  British travelers are returning from the resort with the infection.

UK health officials report that the onset dates for the foodborne illnesses have been from Nov. 12 to Nov 21st.  All laboratory-confirmed cases are adults, with four people known to have been admitted to the hospital after returning to the UK.  Two were later discharged.

HPA is working with Spanish health authorities to assist in their investigation. HPA will be supporting the investigation by conducting interviews with people affected in the UK to help identify a possible source.

As gastrointestinal infections can be contracted from a number of different sources, identifying the source involved in this cluster will be key to offering definitive advice to travelers.

However, there are some simple measures that people visiting Benidorm can take to protect themselves and their families against this infection:

• Because E. coli can be transmitted through the oral-fecal route it is important to practice good hand hygiene procedures (wash hands thoroughly with soap and hot water) especially before eating, after going to the toilet and after touching any animals
• Ensure food is cooked thoroughly to avoid contamination and avoid food outlets where uncooked meat is in contact with cooked food or food that isn’t cooked prior to serving e.g. salads

After being infected with E. coli bacteria it usually takes two to four days before symptoms develop, but symptoms can occur between one and 14 days.  Symptoms experienced by people with E. coli O157 can vary from no illness to having mild or bloody diarrhea.  A small minority of cases (2-7%, and mainly children) can experience more severe symptoms such as kidney failure.

Any travelers who have recently returned from this resort and who suspect that they or their children may have E. coli O157 infection should contact their health care provider as soon as possible.  HPA is advising the following to prevent other people being affected by secondary infection in the home or workplace:

Anyone who has had an E. coli O157 infection should stay at home until they have been completely free of symptoms for 48 hours.

Wash hands thoroughly with soap in running water (everyone should wash their hands after contact with anyone with symptoms, particularly after handling their clothes or bedding).

Wash soiled clothing and bed linen separately from other clothes at the highest temperature possible (e.g. 60°C).

Clean and disinfect hard surfaces such as toilet seats and door handles using hot water and detergent. 

Dispose of cloths used to clean surfaces by placing them in a plastic bag, sealing the neck and placing in household waste. Thoroughly wash rubber gloves in hot water and detergent after use, then rinse and allow drying.

As the source of infection has not yet been identified it is possible that future cases of E. coli O157 linked to Benidorm may be identified in coming weeks.

HPA is collating information to assist local investigations and provide data to inform actions that might be taken at an international level.