not your usual food poisoning

by Professor Peter Borriello

Not only is everyone familiar with the problem of food poisoning, most people have at some time or another suffered from it. The terms salmonella and campylobacter are now as well known as 'Delhi Belly' and 'Montezuma's Revenge'.

A few years ago people became familiar with a new germ, VTEC (Verotoxigenic Escherichia coli). Although E. coli was one of the first germs ever described (over 100 years ago) this particular type was discovered as recently as the late 1970s. It came to prominence in this country following an outbreak in 1996 in Scotland, which led to 512 cases and 17 deaths in elderly patients. The cause was contaminated meat and gravy and people were infected at a reception, in a nursing home, and in the community at large.

Although this outbreak was associated with meat – one of the foods people most commonly associate with food poisoning – other foods have been known to cause large outbreaks. These include bean sprouts in Japan, which affected over 5000 children in 1996 causing three deaths, and apple juice in America, which caused 66 infections and one death that same year. Other outbreaks in the UK have resulted from the consumption of unpasteurised milk and cheese. In the summer months undercooked food from barbeques can be a risk for contracting E. coli, beefburgers in particular. This can be avoided by ensuring that meat is cooked thoroughly until any juices run clear.

So, where does the germ come from? It originates in animals, such as cattle and sheep, and can therefore be a contaminant of meat and raw milk. Ready-to-eat foods such as cooked meats, salad vegetables and fruit can be contaminated by contact with raw foods or animal manure. As such, it is transmitted from animals to humans and is classed as a zoonosis. Sometimes, this transmission can be direct and has happened when children handle young animals at petting farms on school or family visits. Thorough hand washing after such visits is essential, particularly before eating, and children should also ensure they don't put their hands near their mouths during the visit.

As there is still no specific treatment for the disease, the symptoms must be managed to help patients to recover. VTEC produces two very powerful toxins (poisons), similar to ricin. Amongst many other effects the toxins can cause severe bloody diarrhoea and poison the kidneys and can also lead to brain damage and a complication known as Haemolytic Uraemic Syndrome. If patients suffer from an infection with bloody diarrhoea it is recommended they contact their GP. In some cases VTEC can lead to death, which is particularly tragic when it happens in young children. Fortunately, care when dealing or playing with animals on farms and good food hygiene ensures that cases of the disease are kept low.

help and info

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organisations

Health Protection Agency Central Office
The Adelphi Building
John Adam Street
The Strand
London WC2N 6HT
Tel: 020 7339 1300
E-mail: webteam@hpa.org.uk
Website: www.hpa.org.uk
The Health Protection Agency is an independent body that protects the health and well being of everyone in England and Wales. The Agency plays a critical role in protecting people from infectious diseases and preventing harm when hazards involving chemicals, poisons and radiation occur. Also prepares for new and emerging threats, such as a bio-terrorist attack or a virulent new strain of disease. A factsheet on VTEC is available on the website at www.hpa.org.uk/infections/topics_az/ecoli/O157/facts.htm

HUSH (Haemolytic Uraemic Syndrome Help)
The UK E. coli Support Group
PO Box 159
Hayes UB4 8XE
Tel: 0800 731 4679
E-mail: hush@ecoli-uk.com
Website: www.ecoli-uk.com
A charitable organisation set up in 1997 following the outbreak of E. coli 0157 in Central Scotland. This tragedy brought together families from throughout the UK whose lives were affected by the bacterium and HUSH was formed.

Heather Preen Trust
42 Kendal Rise Road
Rednal
Birmingham B45 9PX
E-mail: juliepreen@aol.com
Established to raise awareness about E. coli and help find a cure for HUS. Their aims are to raise awareness of E. coli, provide educative information to children, parents and professionals relating to E. coli and to raise funding for medical research into improving identification, treatment and potential cures for E. coli poisoning.

websites

Institute of Food Science & Technology
www.ifst.org/hottop1.htm
Information on VTEC food poisoning and its prevention.

reading

Preventing Food Poisoning – Good Hygiene at Home from The Food Standards Agency
An informative leaflet on good food preparation practice, available to download for free from www.food.gov.uk/multimedia/pdfs/prevfoodpoison.pdf.

(July 2004, resources updated January 2005)