The latest UK Health Security Agency (UKHSA) annual data shows a 26% rise in Shiga toxin-producing Escherichia coli (STEC) infections in England in 2024 when compared to 2023. Overall, 2,544 culture-confirmed cases of STEC were reported in England during 2024 – an increase of 26.1% compared to 2023 (2018 cases). These included 564 cases of STEC serotype O157 and 1,980 cases of other STEC serotypes (non-O157).
STEC are bacteria that can cause gastroenteritis, with symptoms ranging from mild to bloody diarrhoea, stomach cramps, vomiting and dehydration. In severe cases, they can cause haemolytic uraemic syndrome (HUS) – a serious, life-threatening condition that predominantly affects the kidneys. STEC bacteria are spread through contact with animals or their faeces, consuming contaminated food or water, and from person to person.
The highest incidence of STEC cases in 2024 was in children aged 1 to 4 years (84 cases of STEC O157 and 273 cases of STEC non-O157). The higher incidence of confirmed STEC cases in children aged 1 to 4 years may be explained by a combination of factors such as less time to build immunity to infection, less developed hygiene practices, a greater likelihood of parents seeking healthcare when young children are symptomatic, and potential exposure to risk factors such as contact with farm animals, particularly at petting farms.
Travel related cases increased by 60.5% from 114 in 2023 to 183 in 2024. This increase in travel-related STEC cases may reflect changes in international travel patterns or improved ascertainment of travel history during investigations, although the underlying reasons remain uncertain.
In 2024, 2.1% of STEC O157 cases and 1.7% of STEC non-O157 cases developed HUS. There were 7 deaths among STEC cases – 2 from STEC O157 and 5 from non-O157.
Dr Gauri Godbole, Deputy Director, Gastrointestinal infections, Food Safety and One Health at UKHSA, said:
STEC cases rose by around a quarter in 2024. While this rise is partly due to one foodborne outbreak, we have been seeing STEC cases gradually increase since 2022 and therefore it’s important for people to take steps to prevent infection.
If you have any STEC symptoms, like mild to bloody diarrhoea, stomach cramps, vomiting and dehydration, wash your hands with soap and warm water and use bleach-based products to clean surfaces. Don’t prepare food for others if you have symptoms or for 48 hours after symptoms stop.
It is important for parents to make sure that young children wash their hands with soap and hot water and dry them thoroughly before eating where possible, especially after playing outdoors and visiting pet farms. If you are travelling abroad, it’s important to remember routine hygiene practices to reduce your chances of becoming unwell.
Rarely STEC can progress to cause kidney failure and life-threatening illness, particularly in young children and elderly. Please consult your GP or healthcare professional if you have blood in your stools or severe dehydration and continue to hydrate yourself.
Natasha Smith, Director of Food Policy at the Food Standards Agency (FSA), said:
Public safety is our highest priority. The FSA works closely with UKHSA and other partners to monitor and assess the latest foodborne disease data. We are working together to understand the reasons behind the rise in STEC cases, as well as trends in other pathogens, to help us take the necessary action to protect public health.
We’ve launched a new food safety campaign to help people stay safe – find out more on food.gov.uk.
We’re also working with local authorities and industry to support businesses meet their legal responsibility to make sure food is safe. Consumers can further protect themselves by checking Food Hygiene Ratings on food.gov.uk before eating out.
When preparing food at home, people can reduce their risk of food poisoning by following good hygiene practices and by following advice on the 4Cs of food hygiene: chilling, cleaning, cooking, and avoiding cross-contamination.
In 2024, UKHSA and partner agencies investigated 5 STEC outbreaks involving 467 cases, with 348 in England. All were caused by STEC non-O157. The sources for 3 of these outbreaks were contaminated beef, fresh fruit, and salad leaves. The largest outbreak was linked to contaminated salad leaves which resulted in 293 cases, including 196 cases in England. Of the 293 cases, 126 cases needed hospital care,11 developed complications of HUS, and 2 died.
STEC non-O157 cases have increased nearly 3 times since 2019, while O157 cases have returned to pre-pandemic levels. This increase in STEC non-O157 in 2024 is due to the outbreak linked to salad leaves. Increased detection by diagnostic laboratories using Polymerase Chain Reaction (PCR) in recent years has enabled better detection amongst human cases. STEC non-O157 infections usually peak in autumn, unlike O157 types which peak in summer, so UKHSA and FSA advise everyone to take care throughout the year.