Since its establishment in January this year, the Food Safety Authority of Ireland (FSAI) has already published a number of scientific reports prepared by its Scientific Sub-committees. One in particular has received widespread attention from both media and the food industry.

Range of Haemolytic Uraemia Syndrome (HUS) symptom

Verocytotoxin-producing Escherichia coli (VTEC) of which E. coli O157:H7 is a member, has emerged in the last decade as a global public health concern. In Ireland the number of reported cases of E. coli O157 has risen dramatically from 8 in 1996, to 76 last year. The incidence rate in 1998 was 2.1 per 100,000. This is high by comparison with other European countries. The prevention and control of VTEC infections is a priority, and as a result the Authority convened an expert working group to assist its Microbiology Sub-Committee in the development of a programme for the control of VTEC in Ireland. The result of this was a report entitled The Prevention of E. coli O157:H7 Infection – A Shared Responsibility.

Escherichia coli (E. coli) is the name given to a large family of bacteria commonly found in the gut of humans and animals. While the majority of E. coli are harmless, some types can cause illness. The E. coli O157:H7 strain causes serious illness in humans ranging from diarrhoea to kidney failure, and even death.

Human infection with VTEC has been increasing since the early 1980s and has been reported from over 30 countries on six continents. Some of the reported increase is undoubtedly due to improved surveillance, since some laboratories now examine all stool samples for VTEC, while others test only bloody stool samples.

Livestock are the reservoir for most VTEC, with cattle being the principal source of E. coli O157:H7. A recent study in the UK showed that VTEC was isolated from 752 (15.7%) of 4800 cattle. There is limited information on the prevalence of VTEC in the animal population in Ireland. VTEC has been isolated from cattle and is excreted in their faeces. VTEC is also present in the intestines of other animals including sheep, goats, deer, horses, dogs and cats. Seagulls, pigeons and geese are also known to carry the organism.

Cases of E.coli O157:H7 infection per 100,000 population in England and Wales, Northern Ireland and Republic of Ireland 1996-1998.

The Authority’s report highlights the need for a shared approach and responsibility throughout the food chain to control the incidence of this bacteria. The Authority is keen to communicate the potential for serious disease and notes the number of large-scale outbreaks worldwide. These include a large beef burger related outbreak in the USA; a Japanese school lunch outbreak involving over 9,000 children in 1996 and an outbreak in Scotland in 1996, which resulted in 501 cases and 21 deaths in elderly people.

It would be naïve to think that a major outbreak of E. coli O157 couldn’t occur in Ireland. At present there is no way to eradicate the germ in livestock so control measures must be taken from "farm to fork" to reduce the risk of spreading the infection and prevent people from becoming ill. The FSAI’s detailed report provides comprehensive recommendations for every section of the food chain.

Farmers, Industry, Caterers Have a Responsibility

The report recommends that campaigns should be undertaken to raise farmers’ awareness of the serious nature of the illness and their role in its control. In addition, it suggests that advice be made available to farmers on the best animal husbandry practices required to produce clean livestock; only cattle meeting the standards of cleanliness of categories 1, 2 and 3 of the Clean Livestock Policy of the Department of Agriculture and Food should be supplied to the abattoir, and fruit and vegetables should be produced under a food safety management system based on HACCP (hazard analysis and critical control point).

Also amongst the many recommendations are specific steps that should be undertaken by meat processors including abattoirs and retailers. Recommendations include a clean carcass initiative in abattoirs to ensure that faecal contamination from the hides and skins of animals is not passed onto the meat; batch numbers to be placed on minced meat and minced meat products for traceability to source in the event of an outbreak; all high risk meat products to be labelled with clear cooking instructions; and training of staff in food hygiene.

The Authority has also called on Government to make E. coli O157:H7 a notifiable infection immediately it is identified by both laboratories and doctors.

Codes of Best Practice/Effective Labelling

The report calls for the food processing industry, hotels, restaurants and everyone in the commercial catering business and the retail sector to fulfil their statutory obligation to implement a food safety management system based on HACCP and adopt the recognised Codes of Best Practice for their sector. They must also ensure staff are adequately trained.

Even with the very best practices, raw meat may still contain some E. coli O157 and the report calls for clear labelling to alert consumers and to provide instructions on handling and cooking.

Consumers – the Last Line of Defence

The report states that consumers, and those preparing and cooking food in domestic and commercial kitchens, must assume that raw meat may contain germs and pay particular attention to a number of crucial areas. Raw meat needs to be refrigerated to prevent any E. coli O157 present from multiplying. Transferring E. coli O157 from raw meat directly or via hands or utensils to other foods that will not be cooked before eating must be avoided by proper hygiene practices; and high risk meats, such as mince and burgers, should be thoroughly cooked until the juices run clear.