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ANYONE with diarrhoea and vomiting has been told to stay at home, as experts warn E. coli cases linked to a "nationally distributed food item" are likely to rise.
An outbreak of Shiga toxin-producing E. coli (STEC) has sickened over 100 people across the UK and hospitalised 37.
The UK Health Security Agency (UKHSA) warned that cases of the illness - which is often spread through contaminated food - will probably continue multiplying.
"Typically, we see around 1,500 cases of STEC over a full year," it said in a health alert about the outbreak.
"Numbers of confirmed cases associated with this outbreak are expected to rise as further samples undergo whole genome sequencing."
Dr Will Welfare, strategic response director at the UKHSA, also told Sky News infections are "likely to rise".
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He added: "We expect to see further confirmed cases as we process more samples."
As of June 4, there there have been 113 confirmed cases associated with this outbreak of STEC O145 in the UK.
All of them have been reported since May 25, with 81 recorded in England, 18 in Wales, 13 in Scotland and one in Northern Ireland.
Though the majority of people struck down have been young adults, children as young as two have been affected.
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Around 37 people have been raced to hospital, all of them in England.
It's prompted health officials to warn that anyone experiencing symptoms typical of STEC should stay at home until they have abated to avoid spreading the illness.
Jim McMenamin, head of health protection (infection services) at Public Health Scotland, said: "Anyone with diarrhoea or vomiting should avoid attending places such as schools, workplaces or social gatherings until at least 48 hours after their symptoms have ceased."
As cases are spread across the UK, the UKHSA said this E. coli outbreak is "most likely linked to a nationally distributed food item or multiple food items".
But the exact source of the outbreak has not yet been confirmed.
"There is currently no evidence linking the outbreak to open farms, drinking water or swimming in contaminated seawater, lakes or rivers," officials added.
Infections caused by STEC can cause severe bloody diarrhoea and, in some cases, more serious complications.
It tends to be passed on by eating contaminated food, but the nasty illness can also be spread by close contact with an infected person.
What are the symptoms of STEC?
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Shiga toxin-producing Escherichia coli can cause gastrointestinal illness that can become severe.
The most common type of STEC in the UK is O157, according to a 2017 report by Public Health England.
Some people who are exposed to STEC do not become ill. Others develop stomach cramps and bloody diarrhoea.
Symptoms can also include vomiting, fever, and chills.
In severe cases, the infection can damage organs, such as the kidneys.
Symptoms can appear anywhere from one to ten days after exposure but usually appear around three to four days after exposure.
Most of those affected by the bug will get better without treatment within a week. Sufferers are advised to drink plenty of fluids to stay hydrated.
Are you at risk of getting it?
People can become infected by:
- Eating contaminated food
- Contact with infected animals either directly or through inadvertent contact with animal faeces, for example at farms, petting farms and campsites
- Contact with other people who have the illness (through inadequate hand hygiene after using the toilet, before food handling - particularly in households, nurseries, infant schools, or both
- Drinking water from inadequately treated water supplies
- Swimming or playing in contaminated water such as ponds or streams
STEC are very infectious because very few bacteria are needed to cause illness.
This means that disease can spread easily within families and in other settings such as day nurseries, primary schools, nursing homes and hospitals where there are young children and others who might have difficulty keeping clean.
How can you protect yourself from STEC?
An STEC infection can be prevented by taking the following precautions:
- Cook all minced meat products (burgers, meatloaf, meatballs) thoroughly, until the colour is the same all the way through, and no blood runs from them
- Ensure refrigerators are working correctly - bacteria grow more quickly at temperatures over 4oC
- Only leave cooked foods, meat and dairy products out at room temperature for a short time
- Store uncooked meats below-cooked meats and salad vegetables to avoid dripping juices onto ready-to-eat food
- Store uncooked and cooked meats on different plates, and avoid all contact between raw and cooked meats
- Thoroughly wash all salad vegetables and do not prepare them with utensils that have also been used for raw meat
- Children and the elderly who are particularly susceptible to the severe effects of STEC should avoid eating or drinking unpasteurised dairy products
- People who have been ill should not prepare food for others for at least 48 hours after they have recovered
- Boil any drinking water if you are unsure of its source
- Do not swim in water that you think may be contaminated by cattle and sheep in nearby fields
- Wash your hands thoroughly after using the toilet (or helping others including changing nappies), handling raw meat, before meals and after contact with animals
Source: PHE
How concerning is this outbreak?
Bacteriologist and food safety expert Prof Nicola Holden said: “Any outbreak of STEC is a concern because it is a serious, notifiable pathogen that can cause severe and sometimes fatal disease."
The bug tends to more seriously affect young children, she explained, with symptoms ranging from diarrhoea and vomiting to bloody diarrhoea and haemolytic uremic syndrome (HUS) - a rare kidney condition.
As to whether we can expect to see more people fall ill with STEC, Prof Holden said: “It depends on how long the outbreak has been going for.
"UKHSA have said they expect the numbers to increase as they continue with detection."
She said cases numbers will depend on the source of infections.
The outbreak might last longer if it's related to a perishable product, but it may be "more prolonged" if it's tied to product with a longer shelf life.
“UKHSA will be working with colleagues from different public bodies, including our excellent food standards agencies to identify the source," Prof Holden added.
How can I protect myself from STEC?
Appearing on Radio 4's Today programme, Prof Holden had a few words of advice on how to remain safe amidst the outbreak.
"What people can do is make sure they’re very vigilant about hand washing and follow advice from food standard agencies about keeping their food safe and keeping good hygiene in the kitchen," she said.
"We’re coming up to barbecue season. People must make sure those beef burgers are cooked thoroughly and not raw in the middle, for example."
The UKHSA advised taking the following steps to cut your risk of gastrointestinal infections and limiting STEC spread:
- Regularly wash your hands with warm water and soap — alcohol gels do not kill all bugs that cause diarrhoeal illness
- Follow food hygiene measures such as washing fruit and vegetables and cooking food properly
- If you have diarrhoea and vomiting, you should not prepare food for others and avoid visiting people in hospitals or care homes to avoid passing on the infection
- You should not return to work, school or nursery until 48 hours after your symptoms have stopped
Mr McMenamin said: "To help stop infections like E. coli from spreading, we advise regular hand washing using soap and water, particularly after using the toilet and before preparing food.
"People should also use disinfectants to clean surfaces that may be contaminated.
"Anyone experiencing severe and sometimes bloody diarrhoea, stomach cramps, vomiting and fever should call their GP or 111 to seek advice."
Call NHS 111 or contact your GP surgery if:
- You’re worried about a baby under 12 months
- Your child stops breast or bottle feeding while they’re ill
- A child under five years has signs of dehydration, such as fewer wet nappies
- You or your child (over five years) still have signs of dehydration after using oral rehydration sachets
- You or your child keep being sick and cannot keep fluid down
- You or your child have bloody diarrhoea or bleeding from the bottom
- You or your child have diarrhoea for more than 7 days or vomiting for more than two days
A spate of severe gastrointestinal illnesses caused by a rare strain of STEC was also detected in the UK in June last year.
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At the time, officials suggested hard cheese, strawberries cucumbers, peppers and watermelon could be the source.
But a report published in the journal Microbial Genomics last month confirmed that sufferers likely picked the illness up from eating beef burgers or minced beef.