E coli outbreak: UK health agency issues advice to public
Dr Bob Adak from the Health Protection Agency explains who is at risk from the new strain of E coli and how to avoid infection
The HPA advises anyone travelling to Germany to avoid eating lettuce, cucumber or tomatoes. Photograph: Michael Sohn/AP
The source of this outbreak has not yet been identified by the German authorities so we might see further cases in the UK in people who have recently spent time in Germany (the incubation period for this illness is 8-14 days). That is why the Health Protection Agency is advising anyone visiting Germany to avoid eating lettuce, cucumber and tomatoes, and to seek urgent medical advice if they have illness and bloody diarrhoea within two weeks of being there.
All of the cases in the UK are associated with recent travel to Germany. There have been no reports of transmission of the infection in this country and there is no evidence that any food is contaminated with this strain of E coli in the UK.
E coli bacteria usually cause diarrhoea which settles within seven days without treatment. There are many strains of the infection. Most people normally carry harmless strains of E coli in their intestine. Both the harmless strains and those that cause diarrhoea are acquired primarily through ingestion of contaminated food or water. Person-to-person and animal-to-human transmission is through the oral-faecal route.
Haemolytic uraemic syndrome (HUS), which we have seen cases of in the current outbreak, is a serious complication from this particular strain that affects the blood, kidneys and, in severe cases, the central nervous system. It is a serious illness that requires treatment in hospital and can be fatal.
The number of severe cases of HUS that have occurred in a short period is very unusual and the affected age groups are not typical: HUS is a more common complication from E coli infection in children. The reason for this is not yet known. The World Health Organisation is currently carrying out genetic sequencing of the bacterium, which will teach us more about this particular strain.
Good hygiene is very important in preventing person-to person spread and small children should be supervised with hand-washing after using the toilet and before eating.
Dr Bob Adak is head of gastroenterology at the Health Protection Agency