Category: Uncategorized

The Health and Safety Executive’s (HSE) have published their Work-related fatal injuries in Great Britain 2024 report which reveals a total of 138 workers were killed in work-related accidents in Great Britain in 2023/24, an increase of 2 fatalities from 2022/23

The most common kinds of fatal accidents to workers continue as falls from a height, struck by moving vehicle, and struck by moving object, between them accounting for around 70% of fatal injuries to workers in 2023/24.

The construction and agriculture, forestry and fishing sectors continue to account for the greatest number of workers killed in fatal accidents each year, between them accounting for just over half of all fatal injuries to workers in 2023/24.

Male workers continue to account for the vast majority of fatal injuries, with 95% of workers fatally injured in 2023/24 being men, a similar proportion to earlier years. Furthermore, deaths to workers aged 60 and over continue to account for a substantial proportion of the total – 34% in 2023/24.

The HSE explains that the fatal injuries to workers and members of the public figures are provisional and will be finalised in July 2025 to reflect any necessary adjustments.

City of York Council has launched a new service designed to send free air pollution alerts and health advice to residents and visitors most likely to be affected by air pollution. 

The York Air Quality Alert service is funded by DEFRA and aims to give advanced warning of when air pollution is expected to be higher than usual, up to 3 days ahead.

The service will provide clear and easy-to-read information about day-to-day pollution across the city. Anyone can sign up to these alerts by text, email or voicemail, and users can select alerts for different areas of the city, depending on where they live or work.

Air pollution levels often rise on hot, sunny days in summer, and on cold, still days in winter. Once these levels increase, they often remain high for 2 or 3 days; this a called a pollution episode. Pollution episodes in York are uncommon; but when they do occur, they can have a serious impact on people who suffer from respiratory or cardiovascular conditions like asthma, emphysema, bronchitis or heart disease.

Councillor Jenny Kent, Executive Member for Environment and Climate Emergency at City of York Council, said:

“This is a really simple and easy to use tool to help residents with health conditions affected by air pollution plan ahead and reduce exposure.

“We hope these forecasts will also raise awareness of air pollution across the city and encourage people to consider their air quality impact in helping to protect everyone’s health. Poor air quality is a contributory factor in 1 in 22 deaths in York. We can all improve this statistic; share a lift to work, work from home or walk, catch the bus or cycle, if possible, especially on days with high pollution. Solid fuel fires should also be avoided wherever possible.

“The new website will display maps outlining day-to-day air pollution levels. The alerts sent out will offer guidance on whether people are at risk from air pollution on a particular day and provide advice on how to stay healthy and aware.”

The new service is being introduced as part of York’s updated Air Quality Action Plan. The plan outlines actions that the council will take to raise awareness of air pollution and improve air quality in the city over the next 5 years. It aims to go beyond the current National Air Quality Objectives and work towards meeting the World Health Organisation Air Quality Guidelines.

The prevalence of Vibrio in seafood is expected to increase both globally and in Europe because of climate change according to EFSA’s scientists.

EFSA’s scientists have carried out an assessment of the public health aspects of Vibrio spp. related to the consumption of seafood and anticipated that the occurrence and levels of Vibrio in seafood will rise in response to coastal warming and extreme weather events.

Vibrios are waterborne bacteria that mainly live in marine coastal waters and brackish areas (where rivers meet the sea) and thrive in warm waters with moderate salinity. Some strains are pathogenic and can cause gastroenteritis or severe infections.

The bacterial group of Vibrio comprises several species that can cause Vibriosis. In the European Union, Vibrio parahaemolyticus, Vibrio vulnificus, and Vibrio cholerae are the species of highest relevance for public health regarding seafood consumption. V. parahaemolyticus can cause gastroenteritis in healthy individuals, while V. vulnificus and V. cholerae non-O1/non-O139 can lead to severe infections, sepsis, and death in vulnerable individuals.

Due to an increase in extreme weather events, like heatwaves, over the past 20 years, Europe has seen a rise in Vibrio infections. Warmer coastal waters have led to an expansion of areas where Vibrio bacteria can multiply, resulting in a higher risk of infections from the consumption of contaminated seafood. Regions that are particularly at risk include those with brackish or low-salinity waters (e.g., the Baltic Sea, Baltic and North Sea transitional waters, and the Black Sea) as well as coastal areas with large-river inflows.

In EFSA’s assessment, experts anticipate that the occurrence and levels of Vibrio in seafood will increase globally and in Europe, especially in low-salinity/brackish waters, due to the effects of climate change, such as coastal warming and extreme weather events like heatwaves.

To prevent and control Vibrio in seafood, maintaining the cold chain during processing, transportation, and storage is crucial, particularly for seafood intended to be consumed raw. Possible measures to reduce Vibrio are high pressure processing, irradiation and (flash) freezing followed by long-term frozen storage. Depuration, which involves placing live molluscs in tanks with clean, circulating seawater to filter out microbes, is recommended under controlled conditions for live oyster consumption. Recommendations for consumers include ensuring proper handling and cooking of seafood, and avoiding consumption of raw or undercooked products, especially for vulnerable individuals.

Experts assessed 46 studies in 16 countries covering the 2000 to 2022 period. Vibrio parahaemolyticus was found in 20 percent of more than 10,600 tested seafood samples, with one in five positives containing pathogenic strains. Vibrio vulnificus was detected in around 6 percent of almost 3,000 seafood samples. The prevalence of Non-chlorogenic Vibrio cholera was estimated at 4 percent.

In the EU, 32 outbreaks caused by Vibrio in seafood were reported from 2010 to 2021, causing 221 cases, of which 57 were hospitalised. 75 Rapid Alert System for Food and Feed (RASFF) notifications covering Vibrio in seafood were reported between 2010 and January 2023. Only four were associated with food of EU origin.

Australia’s largest Vibrio parahaemolyticus outbreak in raw oysters in 2021 affected more than 250 people and led to Food Standards Australia New Zealand (FSANZ) requesting information from several countries, including those in the EU, about Vibrio in 2022.

In 2022, the German Federal Institute for Risk Assessment (BfR) published a health risk assessment on the occurrence of Vibrio in food, which said that the consumption of raw or insufficiently cooked food products is one of the most critical factors for transmission.

Studies on Vibrio isolates found in seafood or from isolates causing foodborne infections in Europe detected resistance to several antimicrobials, including those of last resort.

Scientists said a priority for future research is establishing an EU-wide baseline survey for Vibrio in seafood products, including at the primary production and retail stages. They recommended developing a case definition for human vibriosis at the EU level and considering vibriosis for compulsory reporting.

A food business owner in Somerset has been ordered to pay more than £50,000 following a successful prosecution for failing to test chickens and eggs for salmonella before they went into the food chain following a joint investigation by Devon County Council trading standards service and the Food Standards Agency (FSA).

Poultry farmer Stuart Perkins of SG Perkins Ltd, age 38 from Somerset, received the substantial fine at Bath Magistrates Court on Wednesday 3 July after pleading guilty to various offences under The Food Safety and Hygiene (England) Regulations 2013 and the Animal Health Act 1981 and was found to was also found to have presented birds for slaughter with either falsified documents or with documentation which did not relate to those particular birds.

The FSA, working with partners including Avon and Somerset police, Environmental Health and Trading Standards, executed a search warrant at the poultry farm and abattoir in November 2023 and found evidence of traceability concerns and that Perkins had falsified Salmonella testing certificates.  This meant birds had been slaughtered for the food chain without proof they were free from disease. 

The Animal and Plant Health Agency supported the investigations, monitoring the welfare of the poultry on site and collecting official Salmonella samples. 

The court heard that Perkins ran a farm producing boiler chickens and free-range eggs, with the chickens being processed at his abattoir across the road.

By law, farms producing eggs are required to conduct routine salmonella tests in their poultry sheds every 15 weeks during the laying period.

In addition, all birds must arrive at the slaughterhouse with the salmonella test result and the date the sample was taken.

But when the Egg Marketing Inspector visited the farm and requested salmonella reports, Perkins produced 16 reports dated back to August 2021, 13 of which had been falsified.

As part of the investigation, 43 documents showing that testing had been carried out on the chickens were also found to have been filled out by Perkins himself.

Perkins and his company, SG Perkins Limited was ordered to pay a total of £50,830.75.

This includes a fine of £5000 for each of the offences prosecuted by the Food Standards Agency (£20,000 total), and £3500 for each of the offences related to his business (total £7000).

Costs of £15472.75 were awarded to the FSA and costs of £6358 were awarded to Devon County Council (Trading Standards) and a victim surcharge of £2000.

The UK Covid-19 Inquiry has published a report of its first investigation into the nation’s resilience and preparedness for the pandemic and makes 10 key recommendations.

These recommendations include a major overhaul of how the UK government prepares for civil emergencies such as the Covid-19 pandemic.

Other key recommendations include a radical simplification of civil emergency preparedness and resilience systems, holding a UK-wide pandemic response exercise at least every three years and the creation of a single, independent statutory body responsible for whole system preparedness and response.

In what is the first of a series of reports that set out the UK Covid-19 Inquiry’s recommendations and findings, its chair Baroness Heather Hallett recommends fundamental reform of how the UK government and the devolved administrations prepare for whole-system civil emergencies.

The inquiry’s first report (Module 1) examined the state of the UK’s structures and procedures and how well they prepared for and responded to the pandemic. Prior to the first public hearing, 18,000 documents were disclosed to the core participants so they could prepare, notes the report.

Hearings for Module 1 were held in London in June and July 2023 and the Chair heard from current and former politicians as well as key scientists, experts, civil servants and bereaved family members.

Following these hearings, the Inquiry’s findings and recommendations are set out in the report published.

In her findings, the Chair concludes that the UK’s system of building preparedness for the pandemic suffered from several significant flaws.

These include a flawed approach to risk assessment, a failure to fully learn from past civil emergency exercises and outbreaks of disease, and Ministers not receiving a broad enough range of scientific advice and failing to challenge the advice they did get.

Baroness Hallett acknowledges the pressure on politicians and others to make tough decisions about how resources should be used. However, she also stresses that if the UK had been better prepared, the nation could have avoided some of the significant and long-lasting financial, economic and human costs of the Covid-19 pandemic.

In summary her recommendations are:

• A radical simplification of the civil emergency preparedness and resilience systems. This includes rationalising and streamlining the current bureaucracy and providing better, simpler Ministerial and official structures and leadership;
• A new approach to risk assessment that provides for a better and more comprehensive evaluation of a wider range of actual risks;
• A new UK-wide approach to the development of strategy, which learns lessons from the past and from regular civil emergency exercises and takes proper account of existing inequalities and vulnerabilities;
  Better systems of data collection and sharing in advance of future pandemics, and the commissioning of a wider range of research projects;
• Holding a UK-wide pandemic response exercise at least every three years and publishing the outcome;
  Bringing in external expertise from outside government and the Civil Service to challenge and guard against the known problem of ‘groupthink’;
• Publication of regular reports on the system of civil emergency preparedness and resilience;
• Lastly and most importantly, the creation of a single, independent statutory body responsible for whole system preparedness and response. It will consult widely, for example with experts in the field of preparedness and resilience and the voluntary, community and social sector, and provide strategic advice to government and make recommendations.

The Chair believes that all 10 recommendations are reasonable and deliverable and all must be implemented in a timely manner. The Inquiry and the Chair will be monitoring the implementation of the recommendations and will hold those in power to account.

The Chair has today restated her aim to conclude all public hearings by summer 2026, and to publish reports with findings and recommendations as the Inquiry progresses.

The Inquiry’s next report – focusing on Core UK decision-making and political governance – including in Scotland, Wales and Northern Ireland (Modules 2, 2A, 2B and 2C) – is expected to be published in 2025.

Future reports will focus on specific areas, including:

• Modules 2, 2A, 2B, 2C: Core UK decision-making and political governance – including Scotland, Wales and Northern Ireland
• Module 3: Healthcare systems
• Module 4: Vaccines and therapeutics
• Module 5: Procurement – procurement and distribution of key equipment and supplies
• Module 6: The care sector
• Module 7: Test, trace, and isolate programmes
• Module 8: Children and young people
• Module 9: Economic response to the pandemic

For more details of these modules visit the Inquiry’s website.

The Chair is also examining the best way to fulfil her Terms of Reference and investigate the impact of the pandemic on the population of the UK. This will cover a wide range of those affected and include the impact on mental health. https://covid19.public-inquiry.uk/reports/

Public Health Scotland (PHS) has published a three-year Adverse Weather and Health Plan which sets out how the organisation, with support from the Scottish Government and working in partnership with key stakeholders, will help to protect the health of the population from weather-related harm.

It is anticipated that climate change will have an increasing impact on Scotland’s weather. Climate predictions suggest that Scotland can expect adverse weather events, such as floods and heatwaves, to become more frequent and intense.

Such adverse weather events, will directly and indirectly impact health and wellbeing, potentially widening existing health inequalities.

Jess Baker, Public Health Consultant, Environmental Public Health Team, PHS said:

“The impacts of adverse weather events on health can be significant, often amplifying existing health conditions and sometimes resulting in premature death, disease and disability.

“This Adverse Weather and Health Plan sets out PHS’s commitment to working with partners to help mitigate, prepare for, and respond to the potential health risks associated with hot and cold weather, flooding and drought. There are several areas for action which we believe can make a real difference over the coming years, including developing our epidemiology and surveillance systems to help assess and monitor public health action.

“PHS cannot achieve the actions outlined in the plan alone, and the time and expertise of those who have contributed to it is greatly appreciated. In the coming months, work will be undertaken with Scottish Government, partners across public health and wider stakeholders to establish how we will work together as we move forward.”

View the Adverse Weather and Health Plan.

Legislation giving Ministers and local authorities the tools needed to increase reuse and recycling rates, as well as modernise and improve waste and recycling services, has been passed.

The Circular Economy Bill will give Ministers the powers to:

• set local recycling targets, building on the experience of Wales, which has the best recycling rate in the UK
• set statutory targets for delivery of a circular economy to measure progress in transforming the economy
• restrict the disposal of unsold consumer goods, to prevent good products ending up in landfill
• place charges on single-use items like disposable cups to encourage the move to reusable alternatives
• give local authorities additional enforcement powers, allowing them to crack down on flytipping and littering from cars.

The measures will be underpinned by support and investment, building on the investments already made through the £70 million Recycling Improvement Fund.

Minister for Climate Action Gillian Martin said: “There are huge opportunities in having an economy which makes reuse and recycling the default choice for Scottish households, businesses and the public sector.

“We have already seen businesses creating jobs by turning what we might otherwise throw away into valuable new products and services.

“The measures in the Circular Economy Bill will give local Councils and the Scottish Government the powers needed to support the sustainable use of resources and cut greenhouse gas emissions.

“For people to do the right thing for the planet, it is crucial that everyone experiences a modern, easy to use waste service.

“We will continue to work with local authorities and householders to co-design how these powers are implemented to take account of different circumstances and needs on our journey towards a truly circular economy.”

Public Health Scotland (PHS) has published Public health guidance for cyanobacteria.

This guidance provides updated information on the public health risks associated with cyanobacteria. It provides background information about cyanobacteria, cyanotoxins and the occurrence of cyanobacterial incidents in Scotland. 

This guidance recommends each NHS board area should make a local action plan in collaboration with relevant stakeholders.

This guidance also advises on surveillance and approaches for investigating public health incidents possibly associated with cyanobacteria. An editable cyanobacteria risk assessment template is available on this page to download.

Information about the roles and responsibilities of relevant agencies is included.

You can access the guidance on the PHS website: Public health guidance for cyanobacteria

Welcome to the June newsletter.  
 
The Institute was pleased to welcome members from the European Federation of Environmental Health, which is a geographical group reporting to the International Federation of Environmental Health (IFEH), to the office on 14 and 15 May for a series of meetings and networking.  The meetings, chaired by Mr Henning Hansen, Denmark and secretary, Louise Manson (REHIS), were held in the Forteath Room, with Bernard Forteath in attendance who is a Past President of the IFEH. Also in attendance was the very recently appointed IFEH President Dr Bruno Cvetkovic (Croatia). 

The King’s Birthday Honours List, 2024
 
The Institute was delighted to see John M Beveridge, REHIS Fellow and Past President, recognised in the King’s Birthday Honours List.  He has been awarded an MBE for his efforts in paddle steamer preservation.  John is the founder of the Loch Lomond Steamship Company and without John, the Maid of the Loch would have been scrapped and not where she is today on Loch Lomond.

(Taken from Facebook, Paddle Steamer Preservation Society)

REHIS Council Meeting
 
The Institute’s elected Council met on Saturday 1 June, where along with their standard Institute business, the President chaired a useful discussion on how to attract more people to the Environmental Profession, and how to attract more Environmental Health Officers in Scotland to be part of their professional Institute. A healthy and growing REHIS membership allows the work of the Institute to continue to thrive and each Council member agreed that this should be communicated to their fellow colleagues and through as many Environmental Health channels as possible.
 
The Institute is continuing to speak with the University of West of Scotland in the hope that first-year entrants can be accepted to the BSc Hons in Environmental Health with Professional Practice course from 2025.  The Institute is also in positive discussions with Abertay University about a possible Master’s Degree in Environmental Health.  We will continue to keep members updated on this.
 
Professional Examinations
 
Plans are well underway for the next diet of professional interviews which are being held from 1 October 2024 at the Carnegie Conference Centre, Dunfermline. Candidates intending to present for interviews in relation to the REHIS Diploma in Environmental Health at this diet must have their portfolio submitted by 9 July 2024. Candidates intending to present for qualifications awarded by the SFSORB must have the required case study and/or reports submitted by 20 August 2024.
 
The Institute is always happy to welcome volunteers coming forward for the position of examiner or assessor at the Professional Exams to support the next generation of Environmental Health Officers, and Food Safety Officers.  For anyone interested please contact the Institute.
 
Maintaining Continuing Professional Development (CPD)
 
Members are reminded that CPD needn’t involve attending an event ‘in person’ and can be online learning (with many courses available free of charge), ‘on the job’ learning, researching a particular piece of work or reading appropriate journals/reports. 
 
There are many interesting online forums and participation at the forums can also be useful CPD, such as the Highfield Food Safety Forum on LinkedIn. Highfield Food Safety Forum | Groups | LinkedIn .  This Forum also provides monthly lunchtime webinars for current food related topics and panel discussions

Three medical groups in Scotland marked Clean Air Day by calling on the Scottish Government to reduce the recommended limits for air pollution in an effort to align them with those of the World Health Organisation.

The Royal College of Physicians of Edinburgh (RCPE), Royal College of General Practitioners (RCGP) in Scotland and Royal College of Paediatrics and Child Health (RCPCH) in Scotland are asking that yearly average levels of nitrogen dioxide (NO2) be reduced  from 40µg/m³ to 20 µg/m³, over the next five years, and to the WHO-recommended level of 10µg/m³ by 2035.

They are also asking that the Scottish Government focuses on reducing peak levels of traffic-related air pollution.

Commenting, Professor Jill Belch, Co-Chair of the Royal College of Physicians of Edinburgh’s short-life working group on air pollution, said: ‘The Royal College of Physicians of Edinburgh has consistently called for urgent action on air pollution. Clean Air Day is the perfect time to remind political leaders that there’s much more to do in reducing the preventable ill health caused by air pollution.

‘We recently proposed to the Scottish Government a pilot scheme to place air quality monitors near a number of urban primary schools in our largest cities. By doing so, we could collect better data on air pollution “hotspots” near schools, which could make Scotland better informed to create policy to reduce child ill health linked to air pollution.’

Professor Andrew Elder, President, The Royal College of Physicians of Edinburgh said: ‘Prevention of illness and disease must be central to the Scottish Government’s plans for public health. Air pollution must be a continued focus of preventative efforts – particularly to avoid exposing children to harmful air in the early stages of their lives. We ask all politicians in Scotland to take this matter seriously – and meet the levels recommended by the World Health Organization.’

Dr Mairi Stark, Scottish Officer, The Royal College of Paediatrics and Child Health said: ‘As paediatricians, we see first-hand the detrimental impact air pollution has on children. Children are particularly vulnerable to air pollution, as they breathe faster and inhale more airborne toxicants in proportion to their weight, than adults exposed to the same air pollution. This can have a lasting impact on their health and development. Studies show that children and young people in deprived communities also bear the greatest burden of air pollution, exacerbating already rampant health inequalities.

‘The Scottish Government must act to address this and prevent further widening of child health disparities. Urgent action is required to meet WHO recommendations and ensure children in Scotland grow up in a healthy environment. RCPCH calls on the Scottish Government to make child health a focal point in all climate change policies and prioritise reducing air pollution.’

Dr Munro Stewart, Joint clinician representative for Climate and Sustainability at RCGP Scotland: ‘There is much to be gained from action on improving air quality. Air pollution impacts all the organs in our body and contributes to Scotland’s poor record of health inequity. The Scottish Government should take action and commit to this yearly average target for nitrogen dioxide, alongside a holistic approach to this multi-factorial challenge, as this will deliver healthier communities and reduce demand on an overstretched NHS.’

Healthier Housing Partnership are organising an international conference and have inviting people to register interest for the event and calling for people to submit papers.

More details can be found in the attached document below and here.

Why this conference?

Extreme events – including heatwaves, flooding, droughts, wild-fires, tsunamis, tornadoes and earthquakes – are occurring more frequently and with greater intensity. These events damage and destroy homes and communities causing physical, mental and financial suffering.

What will the conference cover?

This conference will look at the support victims and communities need post-event; how housing can be replaced; how existing housing can be adapted and new housing designed and constructed to build resilience into housing and neighbourhoods and protect mental, physical and social health.

What approach will we take?

Our approach focuses on housing as a prime protector of health, supporting feelings of safety and well-being and creating a sense of home. We want to exchange reactions to dealing with the aftermath of extreme events; extend the knowledge base linking people’s health and wellbeing. We want to provide a forum for sharing international experience, approaches and case studies which include preventive/protective solutions to avoid problems in the future. We want the conference to enable an international network of professionals, academics, organisations and bodies to develop.

Who should attend?

Individuals and bodies directly and indirectly involved in housing and health, and in predicting and responding to all forms of extreme events, including housing professionals; medical doctors; public health professionals; sociologists; meteorologists and first responders.

How will the conference be organised?

This will be a recorded on-line event leading to the production of a conference report. It will consist of a half day session setting out the conference ambitions; a full day of good practice presentations and thematic workshops and a final half day summarising what have we have learnt and still need to learn.

Conference organisers

The conference is being organised by the Healthier Housing Partnership, an independent partnership of academics, housing, environmental health and regeneration practitioners and housing and health researchers formed in 2015. Our aims are to promote healthier housing and raise the standard of existing and new housing to achieve wider social benefits. Further information is available here: https://www.healthierhousing.co.uk/

Invitation to submit abstracts

Submissions are invited for oral presentation at the conference. Papers will be selected on the basis of abstracts comprising a maximum of 500 words submitted by 1 October 2024. 

The focus of the conference is the housing and health aspects of extreme events and papers must reflect this, addressing one or more of the following themes:

Theme 1:

First Response
Physical and mental health and support; food and water; sanitation and disease

Theme 2:

Temporary Post Event Management
Provision of shelter, health care and support, sustaining culture and religion

Theme 3:

Short and Medium Term Stabilising
Intermediate accommodation and infrastructure; personal and social support; and public and environmental support

Theme 4:

Planning and Designing for the Future
Learning from the event and planning for construction of resilient and adapted housing, neighbourhoods and communities

Theme 5:

Building for the Future
Preparation for construction of adapted housing, neighbourhoods and communities; for health, medical , education, other support services; and for occupations, trades and businesses

The abstracts should include:

• The lead author’s name, institutional and departmental affiliations and contact details
• All co-authors’ names, institutional and departmental affiliations and contact details
• A summary defining the topic area, referring to specific issues that the intended paper will address, the evidence being marshalled, the scope of discussion and conclusions

Abstracts will be reviewed to ensure a varied, authoritative and integrated selection of papers around the topic. Author(s) of accepted abstracts will be invited to submit a full paper (approximately 3,000 words), which will be reviewed and, if accepted, the author(s) will be invited to present the paper within the conference.

Submission process

• Abstract submission
  Deadline: 1 October 2024
• Notification of abstract review
  Deadline:1 November 2024
• Paper submission
  Deadline: 1 February 2025

All accepted papers will be published in the conference proceedings and indexed in the conference website digital library

Author(s) of accepted papers will be required to register for the conference.

You can register your interest in the conference and here.

Public Health Scotland (PHS) has been working with NHS Boards in Scotland, UK Health Security Agency (UKHSA) and other public health agencies across the UK to investigate an outbreak of Shiga toxin-producing E. coli (STEC) in the UK.

As of 18 June, the UKHSA reported 256 confirmed cases in the UK. All currently confirmed cases had symptom onset dates before 31 May. Although the rate of cases has now slowed, it is expect the figure to rise as NHS laboratories refer specimens to UKHSA for genomic sequencing which can link cases to this outbreak strain.

In total, 168 people are sick in England, 29 in Wales and 56 in Scotland. Northern Ireland has three cases, 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 227 cases to date, 38% were admitted to hospital.

Dr Colin Brown, Incident Director at UKHSA, said:

Symptoms of infections with STEC include severe and sometimes bloody diarrhoea, stomach cramps, vomiting and fever. While diarrhoea and vomiting can have a range of causes, there are simple steps you can take to reduce your risk and risk of infecting others.

Washing your hands with soap and warm water and using disinfectants to clean surfaces will help stop any further spread of infection. If you are unwell, you should not prepare food for others while unwell and avoid visiting people in hospitals or care homes to avoid passing on the infection in these settings. Do not return to work, school or nursery until 48 hours after your symptoms have stopped. If you are concerned about your symptoms, follow NHS.UK guidance on when to seek help and the steps you can take to avoid further spread to family and friends.

Darren Whitby, Head of Incidents at the FSA said:

Several sandwich manufacturers have now taken precautionary action to withdraw and recall various sandwiches, wraps, subs and rolls, as food chain and epidemiological links have enabled us to narrow down a wide range of foods consumed to a small number of salad leaves that have been used in these in these products.

This follows extensive investigations into the cause of an ongoing outbreak caused by shiga toxin-producing E.coli (STEC) which is being carried out by the FSA, FSS and UKHSA, working closely with the relevant enforcing authorities across Local Authorities). A full list of products implicated in the product recalls can be found in the product recall notices (PRINs).

This remains a complex investigation and we continue to work at pace with the relevant businesses and local authorities to ensure necessary steps are being taken to protect consumers.

Although we are confident in the source of the outbreak being linked to a small number of salad leaves, which we identified early on through extensive food chain analysis, work continues to identify the root cause of the outbreak with the growers, suppliers and manufacturers so that actions can be taken to prevent a re-occurrence. We will remain vigilant until the root cause of the outbreak is confirmed and we are keeping an open mind about possible causes of the outbreak. Information is being gathered at pace and is under constant review to ensure we minimise any further risk to consumers.