One death and seven HUS cases in the E. coli outbreak in Britain

One person has died in an E. coli outbreak in Britain linked to lettuce leaves.

The UK Health Security Agency (UKHSA) has identified two people in England who died within 28 days of becoming infected with the outbreak. Based on information from healthcare physicians, only one death is likely linked to a STEC infection. Both individuals had underlying medical conditions and the deaths occurred in May.

UKHSA also revealed that the incident is a re-emergence of a STEC cluster investigated in 2023 where no source could be confirmed.

Seven HUS cases
There have been 275 confirmed patients in the Shiga toxin-producing E. coli (STEC) O145 outbreak since May 2024. All confirmed cases had an onset of symptoms before June 4.

A total of 182 people are sick in England, 31 in Wales and 58 in Scotland. Northern Ireland has four cases and is believed to have acquired the infections in England.

Of the 122 hospitalized cases, 57 percent were women and had a mean age of 35 years, with a range of 6 to 85 years.

Seven cases of hemolytic uremic syndrome (HUS) have been linked to the outbreak. HUS is a clinical syndrome related to E. coli that can lead to renal failure and death. Five HUS cases live in England and two in Scotland. Six are women and all cases range in age from 12 to 59 years old.

Of the 273 primary cases, 57 percent are women, with a mean age of 30 years and a range of 1 to 89 years. The most affected age groups were 20 to 29 and 30 to 39 years.

Amy Douglas, incident director at UKHSA, said: “We are pleased that fewer cases have been reported, but we still expect a few more cases to be linked to this outbreak as more samples are referred to us for testing.”

Save suspicion
Work by the Food Standards Agency (FSA) and Food Standards Scotland (FSS) led to the recall and recall of several sandwiches, wraps, subs and sandwiches.

The study found that a higher than expected proportion of patients reported eating pre-packed sandwiches in the seven days before they became unwell. Epidemiological studies have shown a statistically significant association between disease and the consumption of lettuce sandwiches.

Samworth brothers, this! and Greencore Group recalled a range of products sold in several stores including Tesco, Aldi, Asda, Boots, WH Smith, Co-op, Morrisons and Sainsbury’s.

FSA and FSS have identified one supplier of potentially contaminated lettuce, but investigations are ongoing at two other lettuce suppliers in the grower stage of the supply chain.

All test results were negative for STEC, but common or indicative E. coli was identified in sandwich and salad products, indicating possible contamination.

Regarding short shelf life and highly perishable products such as salads, microbiological confirmation of the outbreak in the affected foods is difficult as these have usually already been consumed, UKHSA said.

Ready-to-eat salads can become contaminated with pathogens before harvest through flooding, rainwater runoff, or irrigation water containing animal feces, or after harvest during washing and packaging.

“While we are confident that the likely source of the outbreak is related to lettuce, work continues to confirm this and work with growers, suppliers and manufacturers to identify the root cause of the outbreak so that action can be taken to prevent a recurrence ,” said Darren Whitby, head of incidents at the FSA.

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