The Salmonella bareilly outbreak in the United Kingdom is now all but certain to be stemming from the consumption of raw or under-cooked bean sprouts, the UK’s Health Protection Agency said Wednesday. It has infected at least 129 people.

Health officials said they have now confirmed 106 S. Bareilly cases in England, 19 in Scotland, three in Wales and one in Northern Ireland since early August.  The HPA Center for Infections, located in Colindale, says it would normally see fewer than ten S. Bareilly cases during such a period.

HPA issued a warning to caterers and the public in the UK to heed the advice of the Food Standards Agency (FSA) about the need to thoroughly wash and cook any raw bean sprouts before they are eaten unless they are clearly labeled as ready-to-eat.

S. Bareilly isolated from the English and Scottish cases were indistinguishable from each other, indicating a common source for the infection.

“Questioning people with confirmed Salmonella Bareilly infection produced some evidence of a link with bean sprouts and we have now isolated Salmonella from a bean sprout sample, said Professor Qutub Syed, who chairs the HPA Outbreak Control Team investigating the cases. ” Although we won’t know for a few days if it is the same strain of salmonella as in the human cases, it is an important development in the investigation.”

The FSA issued the following advice:

  • keep bean sprouts refrigerated

  • avoid sprouts that have turned brown or have a strange odor

  • rinse raw bean sprouts thoroughly

  • follow any instructions on the packaging and use the bean sprouts by the ‘use by’ dates

  • bean sprouts that are labeled ‘ready to eat’ can be eaten uncooked, as long as they are consumed within the ‘use by’ date

  • bean sprouts not labeled ‘ready to eat’ should be cooked thoroughly until they are piping hot all the way through

  • if you are unsure whether the bean sprouts are ‘ready to eat’, or in the absence of clear preparation instructions, always cook the bean sprouts thoroughly before eating. This includes bean sprouts that are labeled or appear ‘pre-washed’, but are not described as ‘ready to eat’

For any person considered being in a vulnerable group:

  • as a precautionary measure, cook all bean sprouts before eating them

  • ensure bean sprouts are heated thoroughly until they are piping hot all the way through, including those labeled ‘ready to eat’

  • Vulnerable groups are people with weakened immune systems, as well as the elderly, the very young and pregnant women.

“It is also important for people who prepare meals in catering establishments and in the home to keep raw bean sprouts separate from other salad products, including ready-to-eat bean sprouts, to avoid the risk of cross-contamination, the Professor added.   “If there is any doubt as to whether bean sprouts are “ready-to-eat”, or in the absence of clear preparation instructions, the FSA advises that bean sprouts should be washed and thoroughly cooked as a precaution. If this advice is followed bean sprouts will be safe to eat.”

The outbreak control team (OCT) investigating the rise in Salmonella Bareilly cases is led by the Health Protection Agency (HPA) and includes the Food Standards Agency (FSA), Health Protection Scotland and Environmental health officers from several local authorities.

Salmonella bacteria are commonly found in the gastrointestinal tracts of wild and domestic animals and birds, especially poultry, and occasionally in humans. Salmonella Bareilly is a strain of salmonella that causes gastro-enteritis in humans through consumption of contaminated food.

Infection with salmonella can cause watery and sometimes bloody diarrhea, abdominal pain, headache, nausea, vomiting and fever.

Illness can range from mild to severe. The elderly, infants, and those with impaired immune systems are more likely to have severe illness. In some cases, Salmonella infection may spread from the intestines to the blood stream and then to other body sites and can be fatal without treatment. However, death from salmonella infection is rare.

Salmonella infection frequently results from contact with contaminated food products; the cross-contamination of cooked food by raw food; and/or a failure to cook food properly. Contact with infected animals may also result in human infection. Person-to-person spread can occur, particularly during the diarrheal phase of illness.