Gov UK
Updated 18 April 2024
The main points of the 2021 annual report are:
Overall, 1,181 confirmed cases of STEC were reported in England during 2021, a decrease of 2% compared to 2020.
A total of 365 confirmed cases of Shiga toxin-producing Escherichia coli (STEC) O157 were reported in England in 2021, no change compared to 2020. A total of 1,234 confirmed cases of Shiga toxin-producing Escherichia coli (STEC) non-O157 were reported in England in 2021, an increase of 46% compared to 2020.
The lowest annual incidence of STEC O157 was in the East Midlands region (0.41 per 100,000 population) and the highest in the North East region (1.02 per 100,000 population). The lowest incidence of STEC non-O157 was in the Yorkshire and Humber region (0.62 per 100,000 population) and the highest in the London region (4.21 per 100,000 population).
Children aged 1 to 4 years had the highest annual incidence of infection due to STEC O157 (2.3 per 100,000 population, 95% confidence interval (CI) 1.78 to 3.02). Children aged under 1 years had the highest incidence of infection due to STEC non O157 (7.08 per 100,000 population, 95% confidence interval (CI) 7.01 to 7.21).
Around a third (36%, 127 out of 365) of confirmed STEC O157 cases in England were hospitalised and 2% (6 out of 365) were reported to have developed haemolytic uraemic syndrome (HUS). Where information is available, two-thirds (65%, n=274 out of 431) of confirmed STEC non-O157 cases in England were hospitalised; and 1% (14 out of 1,234) of all STEC non-O157 were reported to have developed HUS).
A further 443 specimens in England were positive for stx genes on PCR at the Gastrointestinal Bacteria Reference Unit (GBRU), indicating STEC, but an organism was not cultured therefore a STEC serogroup could not be ascertained.
The most commonly isolated non-O157 STEC serogroup was STEC O26 (n=145 out of 786, 18%).
Four outbreaks of STEC in England involving 52 cases, ranging from 10 to 19 cases, were investigated in 2021: 2 involved STEC O157 and suspected vehicles were identified and 2 involved STEC O26 outbreaks and no vehicles were identified.
Since 2018, the number of STEC O157 notifications has declined and the number of STEC non-O157 has increased two-fold (218%). Overall, there is an increase in STEC notifications, and the burden placed on public health and clinical services is also increasing, especially given the two-fold increase in hospitalisation reported in 2021 for non-O157 cases.
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