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expert reaction to UKHSA E.coli advice amid rise in cases

Scientists comment UKHSA advice following a rise in E.coli cases.


Prof Nicola Holden, Bacteriologist and a member of Applied Microbiology International’s Food Security Advisory Group and who runs the Food Security Centre at Scotland’s Rural University College (SRUC), said: 

 How concerning is this outbreak? How dangerous is E.coli?

“Any outbreak of Shiga toxin-producing E. coli (STEC) is a concern because it is a serious, notifiable pathogen that can cause severe and sometime fatal disease. Disease can range from gastroenteritis, to bloody diarrhoea, to a liver disease haemolytic uremic syndrome. It tends to be more serious in very young children.

“This variant of the group of Shiga-toxin producing E. coli (STEC) is within the O145 serotype, not the O157 that we would see more commonly when it first emerged in the 80s and 90s. Unfortunately serotype is not always a predictor of disease outcome, and O145 can be just as dangerous as O157.”


What kind of work will be being done to work out the source of the outbreak?

“UKHSA will be working with colleagues from different public bodies, including our excellent food standards agencies (in the devolved nations) to identify the source. They have expert epidemiologists well versed in how to accurately estimate where the source is. This is normally an estimate because if it is a food product, it’s often been consumed or destroyed and is no longer present with the contaminating pathogens. Alternatively sources could be animals, from direct contact, e.g. petting zoos.

“UKHSA also pioneered and use powerful genomics technologies to accurately identify which pathogens belong to the same outbreak.


Should we expect more cases or can we not say?

“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. There is a dependency on the type of source, e.g. the epidemiological curves look different for a perishable product compared to something long-lasting, which may be more prolonged.

“STEC has been with us since the 1980s. It is a continually evolving bacteria that, as a group, has a high degree of genetic diversity. Sometimes that makes it difficult to detect pathogens from surveillance efforts that may have the potential to cause disease, because their genetics don’t always follow a predictable pattern that definitively identify them as such.”


Any other comments?

“In the UK and internationally there are excellent efforts to continue to control and treat STEC. We work from the basic biosciences, to applied treatments in the clinic, to improved detection systems. This has helped to improve management where we know there are increased risks of transmission. We continue to improve the science, application and treatment as we learn more about evolution of the STEC group. Compared to other pathogens, the numbers of STEC are (thankfully) relatively low -however it is a priority pathogen because of the severity of disease.  

“The UK has enhanced its surveillance programmes from biological threats like STEC, and we have excellent initiatives, like the FSA-led PATH-SAFE (pathogen surveillance in agriculture food and environment). The public bodies take this pathogen very seriously and continue to work hard on its control.”



Declared interests

Prof Nicola Holden: I sit on the scientific advisory steering group for the PATH-SAFE programme, and have previously been funded by FSA.

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