The number of people sick in an E. coli outbreak in the United Kingdom has passed 200.

There have been 211 confirmed patients in the Shiga toxin-producing E. coli (STEC) O145 outbreak since late May.

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

In total, 147 people are sick in England, 27 in Wales and 35 in Scotland. Northern Ireland has two patients, who likely acquired their infections in England. Patients have been recorded in most age groups, with the majority being young adults.

Based on information from 160 cases, at least 67 were admitted to hospital.

UKHSA warned that the numbers of confirmed cases are expected to rise as further samples undergo whole genome sequencing.

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.”

Salad-containing products recalled
The Food Standards Agency (FSA) and Food Standards Scotland (FSS) are also involved in the outbreak investigation, which has seen Samworth Brothers and Greencore Group recall a range of products sold at a variety of retailers as a precautionary measure.

Samworth Brothers Manton Wood recalled various Tesco and One Stop sandwiches and wraps with dates of June 16 and 17 because of possible contamination with E. coli.

The Greencore Group recall includes various sandwiches, wraps and salads sold at Aldi, Asda, Boots, Co-op, Morrisons, and Sainsbury’s with dates up to June 16.

Darren Whitby, head of incidents at the FSA, said the manufacturers are recalling various sandwiches, wraps, subs, and rolls in response to findings from investigations by the FSA, FSS and UKHSA.

“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. 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,” he said.

Paul Hunter, Professor in Medicine, University of East Anglia (UEA), said: “If the current outbreak is linked with sandwiches, then the most likely problem is contaminated ingredients. The most likely ingredient would be leafy salads or sprouted seeds. The most common identified reason that the product had been contaminated was contaminated water during growth, harvesting or processing.”

About E. coli infections
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, feeling very tired, 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 serious and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.

(To sign up for a free subscription to Food Safety News, click here.)