The UK Health Security Agency (UKHSA), Public Health Scotland (PHS), Food Standards Agency (FSA) and Food Standards Scotland (FSS) are working together with other partner agencies to investigate an outbreak of Shiga toxin-producing Escherichia coli (STEC) O145 identified through the analysis of whole genome sequencing (WGS) data.

As of 27 December 2023, 30 confirmed cases have been reported across England and Scotland since late July 2023, with most cases reported in December 2023. Fifteen cases are female (50%), with ages of all cases ranging from 7 to 81 years (median age of 35 years). For those with information available (n=19), 63% (n=12) have reported bloody diarrhoea, 58% (n=11) reported hospitalisation for their illness and 1 case developed HUS. One death has been associated with this outbreak.

Epidemiological and food chain investigations have identified links between some of the identified cases and a number of unpasteurised cheeses produced by a business in England.

As a precautionary measure, the FSA and FSS issued a product recall on 24 December 2023 for 4 cheeses. A further product was recalled on 27 December. UKHSA is continuing to follow up cases to identify any common links, including determining whether cases ate or came into contact with the recalled cheeses.

In addition to the above outbreak, UKHSA has also been working with partner agencies to investigate 3 other non-O157 STEC outbreaks across the UK since October 2023. These outbreaks have also been identified through WGS and include a different strain of STEC O145 and 2 outbreaks of STEC O26. The number of cases associated with these outbreaks varies from 15 to 44 reported cases. 

The driver of the general increase in non-O157 STEC case reporting has not yet been identified. However, analysis of the available information from questionnaires completed by cases, and the national distribution of cases, suggest that these identified outbreaks are all likely foodborne in origin and involve a variety of different sources. Investigations remain ongoing to identify the sources of contamination and implement risk management and public health protection actions.