The public has been urged to 'take steps' following a significant increase in a bug that triggers vomiting, diarrhoea and stomach cramps. The UK Health Security Agency (UKHSA) revealed on Wednesday that there was a 26% surge in Shiga toxin-producing Escherichia coli (STEC) infections in England in 2024 compared to the previous year.
In total, 2,544 confirmed cases of STEC were reported in England during 2024, marking a 26.1% rise from 2023's figure of 2018 cases. This included 564 instances of STEC serotype O157 and 1,980 of other STEC serotypes (non-O157).
The UKHSA clarified that STEC are bacteria that can lead to gastroenteritis, with symptoms varying from mild to severe diarrhoea, stomach cramps, vomiting and dehydration. In extreme cases, they can result in haemolytic uraemic syndrome (HUS), a severe, potentially fatal condition primarily affecting the kidneys.
STEC bacteria are transmitted through contact with animals or their faeces, ingestion of contaminated food or water, and from person to person.
The greatest number of STEC cases in 2024 occurred amongst youngsters aged one to four years (84 cases of STEC O157 and 273 cases of STEC non-O157), according to the UKHSA. The elevated rate of confirmed STEC infections in toddlers aged one to four years could be attributed to several contributing factors including insufficient time to develop resistance to infection, underdeveloped personal hygiene habits, parents being more inclined to seek medical attention when small children show symptoms, and possible contact with risk elements such as interaction with livestock, especially at children's farms.
Cases linked to foreign travel surged by 60.5% from 114 in 2023 to 183 in 2024. The UKHSA noted this rise in travel-associated STEC infections "may reflect changes in international travel patterns or improved ascertainment of travel history during investigations, although the underlying reasons remain uncertain".
During 2024, 2.1% of STEC O157 cases and 1.7% of STEC non-O157 cases progressed to HUS. Seven fatalities occurred amongst STEC patients - two from STEC O157 and five from non-O157.
Dr Gauri Godbole, deputy director, gastrointestinal infections, food safety and One Health at UKHSA, said: "STEC cases rose by around a quarter in 2024. While this rise is partly due to one foodborne outbreak, we have been seeing STEC cases gradually increase since 2022 and therefore it's important for people to take steps to prevent infection.
"If you have any STEC symptoms, like mild to bloody diarrhoea, stomach cramps, vomiting and dehydration, wash your hands with soap and warm water and use bleach-based products to clean surfaces. Don't prepare food for others if you have symptoms or for 48 hours after symptoms stop.
"It is important for parents to make sure that young children wash their hands with soap and hot water and dry them thoroughly before eating where possible, especially after playing outdoors and visiting pet farms. If you are travelling abroad, it's important to remember routine hygiene practises to reduce your chances of becoming unwell.
"Rarely STEC can progress to cause kidney failure and life-threatening illness, particularly in young children and elderly. Please consult your GP or healthcare professional if you have blood in your stools or severe dehydration and continue to hydrate yourself."
Natasha Smith, director of food policy at the Food Standards Agency (FSA), said: "Public safety is our highest priority. The FSA works closely with UKHSA and other partners to monitor and assess the latest foodborne disease data. We are working together to understand the reasons behind the rise in STEC cases, as well as trends in other pathogens, to help us take the necessary action to protect public health.
"We've launched a new food safety campaign to help people stay safe - find out more on food.gov.uk. We're also working with local authorities and industry to support businesses meet their legal responsibility to make sure food is safe. Consumers can further protect themselves by checking Food Hygiene Ratings on food.gov.uk before eating out.
"When preparing food at home, people can reduce their risk of food poisoning by following good hygiene practices and by following advice on the 4Cs of food hygiene: chilling, cleaning, cooking, and avoiding cross-contamination."
During 2024, UKHSA alongside partner organisations examined five STEC outbreaks affecting 467 individuals, with 348 cases occurring in England. Each outbreak stemmed from STEC non-O157 strains.
Contaminated beef, fresh fruit, and salad leaves were identified as the sources behind three of these incidents. The most severe outbreak was traced to tainted salad leaves, resulting in 293 cases, including 196 within England.
Among the 293 affected individuals, 126 required hospitalisation, 11 developed HUS complications, and two fatalities occurred. The agency reported that cases of STEC non-O157 have nearly tripled since 2019, while O157 cases have reverted to pre-pandemic figures.
The surge in STEC non-O157 in 2024 is attributed to an outbreak associated with salad leaves. Enhanced detection methods employed by diagnostic laboratories, such as Polymerase Chain Reaction (PCR), have improved the identification of human cases in recent years.
Unlike O157 types which typically spike in summer, STEC non-O157 infections usually peak in autumn, prompting UKHSA and FSA to urge everyone to exercise caution all year round.
How to protect yourself and others from food poisoning
More information is available at Food safety and hygiene at home | Food Standards Agency.
