Public Health England urges public to practice good food hygiene as salad leaves linked to E. coli outbreak

Salad leaves

Public Health England is urging consumers to practice good food hygiene by ensuring salad items are washed thoroughly before eating, as cases in a national outbreak of the potentially deadly E. coli bug - with a possible link to salad leaves - rises to 109.

PHE says it is now carrying out “heightened surveillance” across the UK and has convened a national outbreak control team as new cases continue to emerge. Initially, cases appeared to be clustered throughout the Gloucestershire and South Gloucestershire area, but new cases have since been identified in Wales and in Scotland. PHE investigations have already identified a link between numerous cases and the consumption of salad leaves – in particular, rocket leaves – prior to the individuals becoming unwell. This link is yet to be officially confirmed. As a precautionary measure, PHE is urging consumers and food outlets to ensure all salad products are thoroughly washed before eating and to maintain good hygiene and food preparation practices.


What is E. coli?

The potentially deadly Escherichia coli O157 bug is a bacterial infection that can cause severe stomach pains, bloodied diarrhoea and, in some cases, kidney failure and death. The bug is found in the gut and faeces of animals – cattle in particular. It can be contracted via food, such as uncooked vegetables and salad vegetables which may still carry contaminated soil traces, or by having contact with infected animals and/or their faeces, and sometimes via exposure to ponds or streams that are adjacent to land used for grazing.

E. coli can also be contracted via contact with other people who have the infection – particularly if good handwashing procedure and hygiene practice is not strictly followed. Find out more about good handwashing protocol.

While preliminary investigations have revealed that several affected people ate salad items – including rocket leaves – prior to becoming unwell, Dr Isabel Oliver, director of PHE’s field epidemiology service, says PHE is not “ruling out other food items as a potential source”.

Dr Oliver adds: “We continue to stress the importance of good hand and food hygiene practices at all times. We urge people to remove any loose soil before storing vegetables and thoroughly wash all vegetables (including salads) that will be eaten raw unless they have been pre-prepared and are specifically labelled ‘ready to eat’. These measures may reduce the risk of infection from any E. coli contaminated vegetables, fruit and salad but will not eliminate any risk of infection completely. PHE is working alongside the Food Standards Agency and will provide any further necessary public health advice as investigations continue.

“It’s also vital to wash hands thoroughly using soap and water after using the toilet, before and after handling food and after contact with any animals and pets, including farm animals. Small children should also be supervised when washing their hands.”

The specific strain involved in this outbreak has been identified as phage type (PT) 34.

Koli Bacteria

Symptoms of E. coli infection

According to the NHS, the symptoms of E. coli infection include stomach pains, diarrhoea or bloody diarrhoea, sometimes accompanied by fever. Symptoms usually begin three or four days after exposure, but may be delayed by up to two weeks. The ensuing illness can last as long as two weeks.

There is no direct treatment for E. coli, but standard support for gastrointestinal illness – such as rest, plenty of clear fluids, appropriate oral rehydration solutions to combat the effects of diarrhoea and paracetamol for any accompanying pain or fever should be given until symptoms subside. Anti-diarrhoea medications should be avoided as these may prolong the illness by keeping the toxin in the body for longer. For more on E. coli, including detailed instructions on how to prevent E. coli spreading in the home, see the dedicated NHS Choices page

When to seek medical advice

In young children, bloody diarrhoea should always be investigated so seek medical advice from a GP or 111 immediately. You may be asked to provide a stool sample for tests.

According to the NHS, a small number of people may go on to develop haemolytic uraemic syndrome (HUS), a serious condition that can result in kidney failure and, potentially, death. This risk is said to highest in the under-fives.

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