One person has died in a Shiga toxin-producing E. coli (STEC) outbreak in the United Kingdom, according to the UK Health Security Agency (UKHSA).

UKHSA, Public Health Scotland (PHS), and other agencies are investigating the E. coli O145 outbreak identified by analyzing whole genome sequencing (WGS) data.

Thirty confirmed cases have been reported across England and Scotland since late July 2023, with the majority in December.

Fifteen patients are female, and 15 are male, with ages ranging from 7 to 81 and a median of 35 years old. 

Of 19 people with information available, a dozen have reported bloody diarrhea, 11 have been hospitalized, and one person developed hemolytic uremic syndrome (HUS), a serious and life-threatening condition mainly affecting the kidneys.

link to raw milk cheese
Epidemiological and food chain investigations have identified links between some patients and a range of unpasteurized cheeses produced by a business in England.

The Food Standards Agency (FSA) and Food Standards Scotland (FSS) previously warned people that a type of raw milk cheese may be contaminated with STEC.

Four of Mrs Kirkham’s Lancashire Cheese products have been recalled as a precaution. They are mild and creamy Lancashire, tasty Lancashire, mature Lancashire, and smoked Lancashire. All use by dates of all batches purchased since Oct. 2023 are affected.

All sizes of No 1 Waitrose and Partners, Farmhouse Kirkham’s Lancashire cheese with use by dates from Oct. 30, 2023, to Jan. 16, 2024, have also been recalled.

A statement from Mrs Kirkham said there had not yet been any testing on products for the specific E. coli type behind the outbreak to confirm contamination. The firm has suspended all orders until investigations are completed.

Several other non-O157 outbreaks
UKHSA has also been investigating three other non-O157 STEC outbreaks across the UK since October 2023.

They include a different strain of E. coli O145 and two E. coli O26 outbreaks. The number of sick people involved in these incidents varies from 15 to 44.

During October and November, the number of non-O157 STEC cases notified to UKHSA was over double the median reported compared to past years, excluding the COVID-19 pandemic period.     

While detection of non-O157 STEC has increased in recent years following the implementation of molecular detection methods in frontline laboratories, this level of reporting has not been seen before at this time of year and cannot be wholly attributed to the adoption of molecular-based technology, said UKHSA.

Analysis of information from patient questionnaires and the national distribution of cases suggests that the outbreaks are likely foodborne and involve various sources.

Earlier in 2023, a STEC O183 outbreak affected 25 people since May. While most patients lived in England, others were sick in Northern Ireland, Scotland, and Wales. One person died, and six were hospitalized. Patients ranged in age from less than 1 to 74 years old, with the most cases in the less than 1 to 9 age group. One person developed HUS.