Outbreak of Escherichia coli O157 phage type 2 infection associated with eating precooked meats

Fourteen cases of Escherichia coli O157 infection were reported to the consultant in communicable disease control in Sunderland Health Authority in August 1995. E. coli O157 phage type 2, Vero cytotoxin 2 was isolated from the faeces of ten cases. Nine of the isolates were indistinguishable by Vero cytotoxin subtyping and analysis of chromosomal DNA. Two cases with haemolytic uraemic syndrome were confirmed serologically and two cases remained unconfirmed. A case control study showed infection with E. coli O157 to be associated with having eaten precooked meats from a single shop. Environmental investigations at the shop showed that cooked meats were stored close to raw beef, raw meats were left on preparation surfaces, and the same staff served both raw and cooked meats. This outbreak draws attention to standards of food preparation and handling in outbreaks of E. coli O157, the issue of cross contamination, and the need to improve local surveillance of haemolytic uraemic syndrome.