VTEC is an important public health challenge in Scotland, as it continues to cause outbreaks of infection, severe illness and, in some cases, death, particularly among the very young. Clinical aspects of infection VTEC can be asymptomatic, or cause a spectrum of illness ranging from mild diarrhoea, bloody diarrhoea and haemorrhagic colitis. Haemolytic uraemic syndrome (HUS), a consequence of VTEC which can lead to kidney failure is more likely in those aged under 16 or over 60 years.
With over 200 cases of E. coli O157 each year, Scotland has consistently recorded the highest rates of infection per 100,000 head of population in the UK since the late 1980s. Non-domestic animals, particularly ruminants, are the main reservoir of the organism, which rarely causes disease in livestock. Infection occurs when humans ingest organisms originating from animal faeces, most directly by contact with grazing animals or their environments, or contaminated food or water.
Two large outbreaks of E. coli O157 infection (Wishaw 1997 and South Wales 2005) resulted from poor cross-contamination controls by butchers, which lead to the spread of the pathogen to ready to eat food from contaminated raw meat. The FSA has developed guidance on the steps for food businesses to take in order to control cross-contamination between raw foods that are a potential source of E. coli O157 and ready-to-eat foods. You can read more on cross-contamination guidance here.
In response to recommendations made by the report of the Public Inquiry into the 2005 South Wales outbreak, the FSA in Scotland hosted an international E. coli research workshop in November 2011 that identified the research needed to improve understanding of E. coli O157 supershedding by cattle and potential on-farm intervention strategies for reducing colonisation and transmission.
In November 2013, Scottish Government’s VTEC/E. coli O157 Action Plan for Scotland was published. This sets out 86 recommendations designed to tackle VTEC/E. coli O157 infection in Scotland. FSS is a member of the multi-agency action group that considered ways to disrupt the transmission routes for VTEC from source to humans and has sole or joint responsibility for 23 of the recommendations. These cover VTEC controls at primary production, monitoring of contamination at abattoirs, implementation of the cross-contamination guidance and robust enforcement of controls at butchers and caterers across Scotland, communication of food hygiene messages to consumers, and research to improve our understanding of the pathogen and risks in the foodchain.