The United Kingdom is dealing with a serious outbreak of E. coli and several strains of Salmonella Enteritidis, according to the Food Standards Agency (FSA).

One more case has been added to the ongoing Shiga toxin-producing E. coli (STEC) O183 outbreak, bringing the total to 25 sick since May.

One person has died; while most patients live in England, others are sick in Northern Ireland, Scotland, and Wales.

FSA and the UK Health Security Agency (UKHSA) are trying to find the source with help from other public health agencies. Several product supply chains have been investigated, but no vehicle of infection has yet been identified.

Reported symptoms are severe, with six people hospitalized. Patients range from 0 to 74 years old, with the most cases in the 0 to 9 age group. One person developed Hemolytic Uremic Syndrome (HUS). HUS is a severe complication associated with E. coli infections that causes kidney failure.

E. coli O183 is an extremely rare serotype, with only 15 cases in the UK since 2016.

FSA is also investigating outbreaks of separate strains of Salmonella Enteritidis linked to Polish eggs and poultry products. 

One outbreak is behind 47 confirmed cases, of which 25 were linked to a restaurant and another 18 ill people had probable restaurant exposure.

Polish authorities found Salmonella Enteriditis at one site that sent eggs to the UK. Eggs from this source have also been linked to a second UK restaurant associated with the outbreak.

Another serotype has been linked to 87 illnesses, with 35 reported in June and July. Most cases recorded this year have links to bakeries in Cornwall, and epidemiological investigations suggest eggs used in custard tarts as the likely cause of the outbreak. Food supply chain investigations have found that eggs were likely to have come from Poland, but work with the manufacturer and supplier is ongoing.  

AHPA incident involvement
In other developments, the Animal and Plant Health Agency (APHA) has revealed no investigations into STEC outbreaks were conducted in the second quarter of 2023.

APHA analyzed seven Cryptosporidium parvum outbreaks from April to June, with five in England and two in Wales.

One was an incident of cryptosporidiosis traced to a milk vending machine. Three were linked to open farms, two to commercial farms, and one to farm shop premises with animals onsite.

For the on-farm vending machine investigation, 32 cattle samples were collected. Cryptosporidium parvum DNA was detected in four calf and two cow samples. The same profiles as the human outbreak strain were confirmed in two calf samples.

In another outbreak with sampling at an open farm, 30 feces samples were taken. Six lamb samples were PCR positive, with three confirmed as Cryptosporidium parvum of the same subtype as human cases.

APHA also helped in an incident involving a butcher who had fallen ill and was hospitalized with bacterial meningitis. Streptococcus suis infection was confirmed.

Advice to reduce the risk of infection included a review of hygiene and working practices. Preventive measures include wearing gloves while processing pig meat or slaughtering and handwashing after handling raw pork meat. Proper cooking of pork is also essential. The FSA advises that pork products should be thoroughly cooked as this will eliminate Streptococcus suis in meat.

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