Public health agencies across the United Kingdom are searching for the source of an E. coli outbreak that has sickened more than 100 people in less than two weeks.

There have been 113 confirmed cases in the Shiga toxin-producing E. coli (STEC) O145 outbreak since May 25.

The UK Health Security Agency (UKHSA), Public Health Scotland, and Public Health Wales are investigating the rise in infections.

81 people are sick in England, 18 in Wales, and 13 in Scotland. Northern Ireland has one patient who likely acquired the infection in England.

UKHSA warned that confirmed cases will rise as further samples undergo whole genome sequencing. Typically, the UK sees about 1,500 STEC infections per year.

Widely distributed food item
Patients range in age from 2 to 79 years old, with the majority being young adults. Of the 81 cases in England, 61 have provided information to UKHSA on food, travel, and potential exposures, and 37 people have been hospitalized.

Whole genome sequencing of samples indicates that most cases are part of a single outbreak. Based on the wide geographic spread of sick people, it is likely that the outbreak is linked to a nationally distributed food item or multiple items, said UKHSA.

The Food Standards Agency (FSA) and Food Standards Scotland (FSS) are also involved in the outbreak investigation.

Darren Whitby, head of incidents and resilience at the FSA, said the agency is working to identify the source of illnesses.

“We always advise consumers and those looking after vulnerable people to ensure good hygiene practices are followed when handling and preparing food, regularly washing hands with soap and warm water and ensuring equipment, utensils, and surfaces come into contact with are cleaned thoroughly to prevent cross-contamination. You should not prepare food for others if you have had symptoms or for 48 hours after symptoms stop,” he said. 

There is no connection with the E. coli O145 outbreak reported earlier this year, which was linked to raw milk cheese produced by Mrs Kirkham’s that sickened people in England and Scotland.

In this incident, 36 confirmed cases and one probable infection were reported since late July 2023, with the majority falling ill in November. The last reported primary patient had symptom onset of Dec. 23, 2023. One person developed hemolytic uremic syndrome (HUS) and later died.

About E. coli infections
Food contaminated with E. coli does not usually look, smell, or taste spoiled. Anyone can become sick with an E. coli infection. Infants, children, seniors, and people with weakened immune systems are at higher risk of serious illness because their immune systems are fragile, according to the CDC.

Anyone who has developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible food poisoning. Specific tests are required to diagnose the infections, which can mimic other illnesses.

The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications, according to the Centers for Disease Control and Prevention (CDC).

About 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, tiredness, decreased frequency of urination, small unexplained bruises or bleeding, and pallor. 

Many people with HUS recover within a few weeks, but some suffer permanent injuries or death. This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients. 

People who experience HUS symptoms should immediately seek emergency medical care. People with HUS will likely be hospitalized because the condition can cause other severe and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.

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