Shiga toxin-producing Escherichia coli: guidance, data and analysis

The characteristics, diagnosis, management, surveillance and epidemiology of Shiga toxin-producing Escherichia coli (STEC).

Shiga toxin-producing Escherichia coli (STEC), previously known as Vero cytotoxin-producing Escherichia coli (VTEC), are a group of bacteria that cause infectious gastroenteritis. Historically the most frequently reported STEC strain to cause illness in England was STEC O157; however, in recent years reports of non-O157 STEC infections have increased. In England around 1,500 cases of STEC (O157 and non-O157) are reported each year.

Symptoms can range from mild gastroenteritis through to severe bloody diarrhoea.

Sometimes people with STEC infection can develop haemolytic uraemic syndrome (HUS), a serious condition affecting the blood, kidneys, and the central nervous system, which can also result in death.

The main reservoir for STEC is cattle and other ruminants. Transmission to humans occurs through:

  • consumption of contaminated food or water
  • contact with animals or their faeces
  • contact with a contaminated environment
  • person-to-person spread, often resulting in multiple people in one household becoming infected

Outbreaks of STEC occur every year. UKHSA uses whole genome sequencing to identify groups of people with the same strain of STEC and then investigates these outbreaks at the national level with partner agencies. This enables controls to be implemented and stops more people becoming unwell. Most large outbreaks of STEC are foodborne, commonly identified food vehicles include meat (for example, under-cooked burgers), salad vegetables or dairy products.

For guidance on other non-STEC E. coli infections, see Escherichia coli (E. coli): guidance, data and analysis.

Diagnosis and management

Data submission

Local teams should use this questionnaire to report cases of Shiga toxin-producing Escherichia coli (STEC).


Outbreak investigation

Updates to this page

Published 1 August 2014
Last updated 27 June 2024 + show all updates
  1. Added 'Shiga toxin-producing E. coli outbreak O145: May to June 2024' to outbreak investigation.

  2. Updated guidance on emergence of non-O157 strains.

  3. Added Shiga toxin-producing Escherichia coli (STEC): diagnosis and notification.

  4. Added 'Shiga toxin-producing Escherichia coli outbreak: August 2017'.

  5. Added 'Shiga toxin- producing Escherichia coli (STEC): public health management and questionnaire'.

  6. Updated nomenclature from Vero cytotoxin-producing Escherichia coli (VTEC) to Shiga toxin-producing Escherichia coli (STEC).

  7. First published.