Category Archives: STEC E.coli

Research – HUS reports down in Italy but stable in France; some linked to raw milk

Food Safety News

Italy and France have reported updated statistics on a potentially fatal complication of E. coli infection.

The complication, hemolytic uremic syndrome (HUS) is a type of kidney failure that can result in lifelong, serious health problems and death.

Italian data is from the start of September 2020 to the end of August 2021 when 49 cases were recorded. There were 84 cases from September 2019 to August 2020. French figures cover 2020 when 167 cases were reported.

Research – Consumption of Raw Flour in the United States: Results from the 2019 U.S. Food and Drug Administration Food Safety and Nutrition Survey

Journal of Food Protection


Several outbreaks of Shiga toxin–producing Escherichia coli infections in the past decade have been linked to flour and flour-associated products and have raised concerns that the consumption of raw flour represents a public health risk as a vehicle for foodborne pathogens. The extent to which consumers know and understand that they should not consume raw flour is unclear. In fall 2019, the U.S. Food and Drug Administration collected data on perceptions regarding uncooked flour and on self-reported consumption behaviors via the Food Safety and Nutrition Survey, a national probability survey of U.S. adults (≥18 years of age). Cross-tabulations and regressions were used to analyze the data (n = 2,171). Thirty-five percent of consumers reported having tasted or eaten something with uncooked flour in it in the previous 12 months. Responses differed significantly by sex, race, education, and age. On average, respondents indicated that uncooked flour is not likely to contain germs that can make people sick, with significant differences noted by demographic categories. Respondents rated raw homemade cookie dough as moderately likely to have germs that can make people sick, with significant demographic differences. These findings indicate that U.S. consumers are largely unaware that raw flour is risky to consume, and many people are consuming products that contain raw flour.

  • About one-third of consumers reported having consumed uncooked flour in the previous year.
  • Large demographic differences were found in reported consumption of uncooked flour.
  • Most U.S. consumers do not consider uncooked flour as risky to consume.

RASFF Alert – STEC E.coli O157 – Chilled Beef


Shigatoxin-producing Escherichia coli (O157 stx1+ stx2+ eae+ /25g) in chilled beef from Belgium in the Netherlands

Denmark – Outbreak of diarrhea-causing E. coli O157


The Statens Serum Institut is currently investigating an outbreak with a diarrhea-causing and toxin-producing E. coli bacterium. It began in December and currently includes 13 people with possible common source of infection.

Since December 3, 13 patients related to an outbreak with the diarrhea-causing and shiga toxin-producing E. coli bacterium (STEC) with the serotype O157: H7 have been identified. Of these, identical bacteria have been found in nine patients by whole genome sequencing at the Statens Serum Institut (SSI).

Three children with acute renal failure

Among the patients are three children who have developed haemolytic uraemic syndrome / acute renal failure (HUS), which may be a serious consequence of infection with STEC.

The sick are four men and nine women between the ages of 2 and 90. They come from all regions in the country, except Region North Jutland. The sick have not been traveling and have not participated in joint events in the time leading up to their illness.

Nine patients have been hospitalized in connection with the infection.

A serious outbreak

“It is a serious outbreak, as this type of toxin-producing E. coli can in some cases cause acute renal failure. We are paying particular attention when three children with acute renal failure were reported here in December. Patients with severe diarrhea, especially bloody diarrhea, should seek medical attention to get a correct diagnosis “, says Epidemiologist Luise Müller from SSI. She continues:

“As we do not yet know the source of this outbreak, the best advice we can give is to remember to fry minced meat and rinse fruit and vegetables thoroughly before eating it. It is also important to separate raw meat from ready-to-eat food, such as salad, which is not heat-treated before eating. ”

Looking for the source of infection

To find out what may have made the patients ill, interviews are conducted with patients or parents of patients to obtain information on food intake, institutional contact, animal contact and other relevant exposures.

The outbreak is being investigated by SSI in collaboration with the Danish Veterinary and Food Administration and the DTU Food Institute.

Read more

Read more about the outbreak on this outbreak site.

Read more about E. coli infection, among others STEC / VTEC.

Read more about Hemolytic uremic syndrome .

Read more about how to avoid STEC in your food on the Danish Veterinary and Food Administration’s website.

USA – Core Outbreak Table Updates


This week’s updates are:

  • A new outbreak of E. coli O121: H19 with an unidentified vehicle has been added. This outbreak does not appear to be ongoing, as the last illness onset occurred in November 2021. FDA has initiated traceback and other investigational activities in an effort to learn more about possible sources or routes of contamination.
  • The outbreak of Salmonella Javiana linked to 65 illnesses has ended. The information collected over the course of this investigation indicated cut cantaloupe was the likely source of this outbreak, however it appears that the products linked to outbreak illnesses are past shelf life and are no longer available for sale. The most recent illness occurred in November 2021. FDA’s outbreak investigation did not identify a specific product until after the product had expired and was no longer on the market, and there were no actionable steps for consumers to take to protect themselves.
  • For the outbreak of E. coli O157:H7 linked to spinach, the outbreak has ended and the FDA investigation has closed. This incident was archived in the 2021 Investigation Table.
1/10/2022 1050 E. coli
Not Yet
12/29/2021 1052 E. coli
Packaged Salad See Outbreak
12/20/2021 1039 Listeria
Packaged Salad See Outbreak
12/15/2021 1048 Listeria
Packaged Salad See Outbreak
11/24/2021 1044 Salmonella
Cut Cantaloupe 65
9/15/2021 1031 Salmonella
Red, Yellow,
and White Onions
See Outbreak

Sweden – Report on food poisoning in Sweden during 2020. 


The report describes how many people become ill from the food, which are the most common infectious agents and foods that cause the disease cases, where in the food chain the designated foods are contaminated, which countries of origin were indicated for the designated foods, what contributing factors were identified, seasonal variation and changes in recent years. The results from the report provide information to those who have an interest or need for this type of knowledge in their profession and not least to show and give feedback on the valuable work performed by those who investigate, report and otherwise study food poisoning.

Summary Reported Foodborne Illness in Sweden 2020
This Report compiles food poisonings reported to the Swedish Food Agency in 2020. A new online form for submitting reports to the Swedish Food Agency was launched in January 2020, aiming to raise the quality of reported data. In 2020, the Covid-19 pandemic was ongoing also, which affected the number of food poisoning outbreaks during the year.
By food poisoning is meant here an illness caused by eating food containing harmful bacteria, parasites, viruses or toxins. The main purpose of the compilation is to support food poisoning investigations in several ways:
by giving the present position of the most recent food poisonings;
by presenting data that can be used to connect different pathogens to different kinds of foods.by making it possible to follow the development of different combinations;
by making it possible to implement risk management measures as effectively as possible.
The Swedish Food Agency regulation LIVSFS 2005:7 instructs municipal control authorities, in co-operation with health professionals, the County Administrative Board and the Public Health Agency of Sweden, to conduct epidemiological investigations of foodborne outbreaks.
The results must be reported to the Swedish Food Agency without delay. Health Agency and Swedish Food Agency in consultation supplement the control authorities’ reports with reports on local and national outbreaks.
The Report is based on 173 reported events of suspected or confirmed food poisoning with a total of 1,314 cases of illness. In 160 of the reports it was stated that two or more persons were infected from the same source. When compared to the 2019 compilation, we can note that both the number of reports and cases of illness were almost halved in 2020.
This reduction may be due to the restrictions and recommendations introduced in connection to Covid-19 pandemic. For example, there were fewer people using restaurant services, better hand hygiene among people handling food and the cancellation of major public events where food may have been served.
Most reports indicated that the cause was unknown (71%), however for 44% of the reported cases virus was cited as the cause. This is due to 23 outbreaks with 571 cases of illness where the cause was virus. Norovirus continues to cause major outbreaks (22 food poisoning outbreaks with a total of 513 cases), followed by campylobacter which was reported in 4 outbreaks with 158 cases, Vibrio parahaemolyticus, an unusual foodborne pathogen in Sweden, was associated with one outbreak of 50 cases of illness.
The food categories that had the most reported cases of illness were bakery products (210 cases), chicken (155 cases) and foods from the sea (164 cases).Bakery products were a source of infection in outbreaks where norovirus and STEC (Shigatoxin-producing E. coli) were the cause -200 cases and 10 cases, respectively.

Chicken was a source of infection in outbreaks where Campylobacter was the cause -155 cases.
When the source of infection was food from the sea, norovirus in oysters was the cause most cases of illness (124 cases), followed by Vibrio parahaemolyticus in seagrass (50 cases) and histamine in fish (34 cases).
The number of food poisoning reports was highest during the first quarter: between January to March there were 63 reports in, with a total of 634 cases of illness. This is due to both a number of oyster-related outbreaks early in the year and fewer outbreaks occurred during the rest of the year due to restrictions and hygiene recommendations during the covid-19 pandemic. For almost 65% of the disease cases, the source of contamination was food contaminated early in the production chain, e.g. industrial facilities, from which the food was then widely distributed (industry 30 %, primary production 3% and other 31.5%). In order to reduce the number of food poisonings, it is therefore important to have good systems for food safety in primary production and such facilities.
The most commonly mentioned contributing factor was incorrect storage with respect to time and temperature. This factor was listed in 21 reports. For example, this may refer to inappropriate temperature when keeping food heated, or not low enough temperature in cold storage. The second most common factor was “a contaminated ingredient”, as stated in 11 reports.
There is often no information about the country of origin of the implicated food products. This may be due to the fact that this information is optional in the reporting form. It can be also difficult to know in which country viruses or bacteria contaminated a food product.
The reporting authority usually does not have access to information about whether patients have received hospital care. However in 5 reports, it was stated that a total of 7 people received hospital care. No deaths were reported.

Click to access l-2021-nr-23-rapporterade-misstankta-matforgiftningar-2020.pdf

Denmark – Deadly E. coli O157 outbreak sickens 13 in Denmark

Food Safety News

Officials in Denmark are investigating a deadly outbreak of Shiga toxin-producing E. coli (STEC) O157 that has affected more than a dozen people.

The outbreak began in December 2021 and includes 13 patients with a possible common source of infection, said the Statens Serum Institut (SSI). Nine people have been hospitalized and an elderly patient has died.

Since early December, 13 patients have been detected and samples from nine of those sick are closely related after an analysis by whole genome sequencing at the Statens Serum Institut. This means they were likely infected by a common source.

Norway – The Norwegian Zoonoses Report 2020


The occurrence of most zoonotic pathogens in animals was stable in 2020 compared to previous years. The occurrence in humans, however, decreased in 2020 due to the COVID-19 situation. The decrease was highest in campylobacteriosis, salmonellosis and E. coli (EHEC/VTEC) infections, mainly due to less travel associated cases. Introduction The Zoonosis Report is published annually in Norway in accordance with the requirements of the EU Council Directive 2003/99/EC. In addition, data on specified zoonoses in feed, animals and food are reported to the European Food Safety Authority (EFSA). Corresponding data from humans are reported to the European Center for Disease Control (ECDC).

These two European institutions compile an annual European zoonosis report based on the received data: Norwegian Veterinary Institute (NVI) is responsible for reporting of Norwegian data to EFSA, while the Norwegian Institute of Public Health (NIPH) reports Norwegian data to ECDC. The Zoonosis Report is written by the NVI in collaboration with the Norwegian Food Safety Authority (NFSA) and NIPH.

Click to access 2021_63%20Zoonoserapporten%202020.pdf

CPS – Research project Funding 2022 – Salads


Assessing Romaine lettuce “Forward Processing” for potential impacts on EHEC growth, antimicrobial susceptibility, and infectivity

Consumption of Romaine lettuce has been linked to multiple foodborne illness outbreaks due to contamination of pathogenic Escherichia coli strains. Recently, these outbreaks have occurred in the United States every year since 2016, causing great damage to consumer health and economic wellbeing of the fresh produce industry. The pathogen strains isolated from these outbreaks showed great similarity by genomic analyses. These outbreaks showed a pattern of heavy concentration especially in northeastern USA, prompting questions from the leafy green industry that the practice of “forward processing” could be linked to the outbreaks. “Forward processing” is a practice that the raw lettuce commodity is transported in trucks to facilities far away from the production area for washing and packaging, and regional marketing. We propose to work closely with the leafy green industry to comprehensively assess the forward processing for its effects on the integrity and safety of the raw commodity and the packaged products. In addition, the forward processing conditions will be simulated in the laboratory with the pathogenic E. coli strains. Emphases will be on how these conditions would affect the physiology of the pathogenic strains as well as other microorganisms on the raw commodity and packaged products. The findings in the research could provide important information that can be used by the leafy green industry for improving the forward processing practice and reducing the risks of fresh produce such as Romaine lettuce.


Quantifying risk associated with changes in EHEC physiology during post-harvest pre-processing stages of leafy green production

The goal of this project is to determine if the time between harvest and end use of romaine lettuce impacts E. coli O157:H7 pathogenicity and detectability resulting in increased health risk. Laboratory scale experiments with inoculated lettuce undergoing simulated harvest and cooling will be used to measure changes in E. coli O157:H7 stress tolerance and virulence. Input from industry partners including temperature data from commercial romaine harvesting and cooling, and details on supply chain logistics, will be combined with the laboratory scale experimental data and used to model risk associated with specific harvest and handling practices. The resulting quantitative tool will be publicly available and allow for growers and producers to determine any practices that should be implemented to reduce the potential for O157 transmission on romaine lettuce.

Belgium – QUESO IBERICO of the ALBERT HEIJN brand – Listeria monocytogenes and STEC E.coli


Recall of Albert Heijn
Product: QUESO IBERICO of the ALBERT HEIJN brand (with DDM 5-01-2022, 6-01-2022, 7-01-2022, 8-01-2022, 12-01-2022 ).
Problem: possible presence of Listeria monocytogenes and E.coli

In agreement with the AFSCA, Albert Heijn withdraws from sale the product ‘AH queso iberico’ (with DDM 5-01-2022, 6-01-2022, 7-01-2022, 8-01-2022, 12-01 -2022) and reminds consumers.

A presence of Listeria monocytogenes and E.coli is possible in this product. Its consumption can therefore present a health risk, in particular for young children, the elderly, people with weakened immune systems and pregnant women.

Albert Heijn asks his customers not to consume this product and to return it to the point of sale where it was purchased. The product will be refunded or exchanged there. Please contact a doctor if you have any health problem.

Product description

– Product category: cheese
– Product name: AH QUESO IBERICO
– Dates of minimum durability (DDM): 5-01-2022, 6-01-2022, 7-01-2022, 8 -01-2022, 12-01-2022
– Type of packaging: plastic packaging
– Sales period: until 06-01-2022 (included)
– Weight: 118 g

For any further information , please contact Albert Heijn on 0800 777 05.