Is Lettuce the cause of the UK E. coli O145 outbreak that has sickened at least 211

Food manufacturers are recalling at least 60 types of pre-packed sandwiches, wraps and salads sold in major supermarkets because of possible contamination with E. coli. 

E. coli bacteria have not been detected in the products, but they are being recalled as a precaution. It is understood these are items containing salad leaves.

Retailers involved include Aldi, Asda, Co-op and Morrisons.

As of 11 June, there have been a further 98 cases associated with this outbreak of STEC O145 in the UK, bringing the total number of confirmed cases to 211. All cases had sample dates before 31 May, but we expect this figure to rise as whole genome sequencing is ongoing to find any further cases which may be linked to the outbreak.

• 147 in England
• 27 in Wales
• 35 in Scotland
• 2 in Northern Ireland (for these cases, evidence suggests that they acquired their infection while visiting England)

Based on information from 160 cases to date, 42% were admitted to hospital.

UKHSA has worked closely with the Food Standards Agency (FSA), Food Standards Scotland and the devolved public health agencies to investigate the incident, carrying out epidemiological investigations and whole genome sequence analysis to help identify foods commonly consumed by the cases.

As a result of evidence gathered to date, product recall information notices have been published by FSA as a precaution.

Trish Mannes, Incident Director at UKHSA, said:

We would like to thank all the cases who have provided information that has enabled us, through epidemiological analysis of questionnaire data and food tracing investigations, to narrow down the likely food product linked to this outbreak.

Symptoms of infections with STEC include severe and sometimes bloody diarrhoea, stomach cramps, vomiting and fever. If you are unwell, have eaten salad leaves recently and are concerned about any symptoms, follow NHS.uk guidance on when to seek help and the steps you can take to avoid further spread to family and friends.

While diarrhoea and vomiting can have a range of causes, there are simple steps you can take to reduce your risk and risk of infecting others. Washing your hands with soap and warm water and using disinfectants to clean surfaces will help stop any further spread of infection. If you are unwell with diarrhoea and vomiting, you should not prepare food for others while unwell and avoid visiting people in hospitals or care homes to avoid passing on the infection in these settings. Do not return to work, school or nursery until 48 hours after your symptoms have stopped.

Darren Whitby, Head of Incidents at the FSA, said: 

Sandwich manufacturers are taking a precautionary measure to recall various sandwiches, wraps, subs and rolls in response to findings from investigations by the Food Standards Agency (FSA), Food Standards Scotland (FSS) and UK Health Security Agency (UKHSA) who are working to identify the cause of an ongoing outbreak caused by shiga toxin-producing E.coli (STEC). The full list of products can be found in the product recall information notice (PRIN).  

This is a complex investigation, and we have worked swiftly with the relevant businesses and the local authorities concerned to narrow down the wide range of foods consumed to a small number of salad leaf products that have been used in sandwiches, wraps, subs and rolls. Following thorough food chain analysis, these products are being recalled as a precaution.  

Infections caused by STEC bacteria can cause severe bloody diarrhoea and, in some cases, more serious complications. We therefore advise any consumers who have any of these products not to eat them.  

The FSA is here to ensure that food is safe. If there are products on the market that are not, we won’t hesitate to take action to remove them.

Republished with permission from Bill Marler and Marler Clark. Copyright (c) Marler Clark LLP, PS. All rights reserved.