The Animal and Plant Health Agency (APHA) has been involved in four E. coli outbreak investigations so far this year in the United Kingdom.

A Shiga toxin-producing E. coli (STEC) O145 outbreak was linked to unpasteurized milk cheese produced by Mrs. Kirkham’s in Lancashire. APHA contributed to the incident management team investigation, including an advisory visit and epidemiologically relevant sampling.

Patients fell ill between July and December 2023. In late July 2024, the UK Health Security Agency (UKHSA) notified the Food Standards Agency (FSA) of four cases between June and July, taking the number of sick people to 40, including two deaths. One death was part of the latest update. While there is a microbiological link between the latest patients and previous cases, investigations did not identify a food chain connection between them and Mrs. Kirkham’s products.

Animal contact risks
The number of people sick in each E. coli outbreak was not disclosed by APHA and the UKHSA has not yet provided the figures when asked by Food Safety News.

A STEC O26 outbreak was epidemiologically linked with animal contact at a farm visitor attraction.

Following an advisory and sampling visit E. coli O26 was detected in animal feces samples, which on further characterization with sequencing at the UKHSA GBRU, were found to be the same strain as human isolates. The farm made recommended improvements and there have been no further cases, so the outbreak is considered resolved.

Comparison of human and animal isolates by whole genome sequencing (WGS) is performed by the Gastrointestinal Bacteria Reference Unit (GBRU) at the UKHSA.

APHA also assisted with the investigation of two combined STEC and Cryptosporidium outbreaks, both linked to open farms. One involved STEC O157, the other STEC O26.

In the STEC O157 and Cryptosporidium outbreak, 10 E. coli O157 isolates, identified by APHA from bacteriology on fresh animal feces samples, were sent to the GBRU. These were confirmed as genetically identical to the human outbreak strain of STEC O157.

The most frequently identified deficiencies at animal contact visitor attractions, such as open farms, include poor handwashing facilities; suboptimal supervision of animal contact; contamination of walkways with soiled animal bedding or feces; and unclear marking of animal contact versus non-contact areas.

A dozen Cryptosporidium outbreaks
APHA was also part of investigations into 12 cryptosporidium incidents and outbreaks in 2024.

April to June is traditionally the busiest time for cryptosporidiosis investigations and is related to the frequency of open farm visits by families or school groups around Easter and bank holidays.

Eleven were epidemiologically linked to farms in England, and one to a farm in Wales.

There were four APHA farm advisory visits, three with sampling. APHA provided veterinary advice during investigations which covered identified deficiencies to assist farm businesses to comply with the Industry Code of Practice for visitor attractions.

This year, some farm attractions were offering cuddling of young lambs and piglets to visitors. This involves close, prolonged contact, and potential for clothing and footwear contamination. Activities like this increase the risk of transmission of a range of zoonotic organisms, said APHA.

The agency said the availability of appropriate and suitably located handwashing facilities including soap, rather than antimicrobial gel, is extremely important.

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