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FSA probes E. coli outbreak with 5 sick; discusses foodborne disease


Officials in the United Kingdom are looking into an E. coli outbreak linked to chili sticks that has affected five people.

The Food Standards Agency (FSA), Food Standards Scotland (FSS) and UK Health Security Agency (UKHSA) are investigating the outbreak of Shiga toxin-producing E. coli (STEC) O157 with five cases. Four sick people live in England and one in Scotland. 

One person was hospitalized with illness linked to products from a Christmas market. Ongoing enquiries are concentrating on the supply of beef mince used in the product. 

At the end of December 2023, Chiltern Artisan recalled its chili sticks because E. coli had been found in some of the products. The use-by date is also not always displayed on the packaging, according to the recall notice.

In December, Chiltern Artisan issued a statement for people who had bought its chili snap sticks between Oct. 14 and Dec. 24, 2023.

According to a message sent to the firm from an environmental health officer at Buckinghamshire Council, none of the patients were known to have consumed chili sticks or have any known links to Chiltern Artisan and spice samples were negative.

Highlights of foodborne disease work
Meanwhile, at a board meeting this week the FSA discussed how it monitors rates of foodborne disease; develops policy and provides advice to ministers on mitigation; and issues guidance to local authorities on control measures.

One challenge is understanding when and how to intervene and the effect of interventions. The work of a careful supply chain can be undone by poor handling in the domestic kitchen; but incorrect management in the supply chain can lead to problems even if the consumer follows food hygiene practices.

It is estimated there are 2.4 million illnesses because of pathogens associated with foodborne disease annually in the UK. Of these, 16,400 patients receive hospital treatment and 180 result in death, costing the UK £10.4 billion ($13.2 billion). The third Infectious Intestinal Disease study is underway with results expected in 2027.

FSA’s approach to mitigating the risk includes horizon scanning and thresholds for the rate of foodborne infections that were set in 2018.

FSA and others, such as the UK Health Security Agency, monitor data and evidence from a range of sources to identify whether there are food safety problems that need an intervention. Examples include the Campylobacter Reduction Program and the response to Listeria monocytogenes detection in enoki mushrooms imported to the UK. After an outbreak of listeriosis, updated advice around cold smoked fish was published to better reflect the risk to vulnerable consumers. 

An Advisory Committee on the Microbiological Safety of Food (ACMSF) working group is being created to focus on Listeria monocytogenes strains. This group will develop recommendations for how strain-specific information can be incorporated into risk assessments and technical advice to inform policy decisions.

The Pathogen Surveillance in Agriculture, Food and Environment (PATH-SAFE) program was scheduled to finish this year but recently received a one year funding extension. This means the pathogen sequence data sharing platform can be extended from Salmonella to include STEC and Listeria.

Relooking at pathogen thresholds
Thresholds for Campylobacter, Salmonella, E. coli O157, and Listeria monocytogenes are being reassessed with changes put forward later this year. If confirmed lab reports for these pathogens exceed the relevant threshold then the FSA and other agencies will investigate the reasons behind the rise and determine an appropriate response following a review.

The Campylobacter threshold is 71,300 lab reports per year in the UK, for Salmonella it is 8,500 to 9,500, for E. coli O157 it is 800 to 1,500 and 150 to 250 for Listeria.

FSA previously had only been able to include fecal samples in confirmed Campylobacter and Salmonella laboratory reports. However, since 2022, it has had access to other results, such as blood and urine, through UKHSA. For Salmonella, it has led to an increase in cases and rates in the last couple of years have exceeded the threshold.

Confirmed lab reports for Campylobacter have increased since 2016, except for in the first COVID-19 year of 2020. However, levels are below the threshold agreed in 2018. Information on interventions along the broiler food chain are being reviewed. A report will be published in spring 2025 with interventions predicted to be effective at reducing Campylobacter cases and their cost.

Other work includes a survey on the microbiological contamination of sheep at slaughter in England and Wales and on AMR bacteria in raw dog and cat food on sale in the UK.

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