Listeria cases being investigated
An investigation is underway into cases of listeria linked to sandwiches.
Latest update
The multi-agency team investigating cases of listeriosis linked to sandwiches and salads can confirm that, since the last update, there has been another death linked to this outbreak. The total number of deaths linked to this outbreak is 6.
The individual who sadly died was one of the 9 previously confirmed cases. The individual is considered to have acquired listeriosis from Good Food Chain products while at Western Sussex Hospitals NHS Foundation Trust.
Public Health England continues to test all samples of listeria on an ongoing basis to check if they are linked to this outbreak. To date, we have tested 34 samples and none are linked to the outbreak.
There have been no new cases of listeriosis linked to this outbreak. Our investigations continue and the public should be reassured that the risk continues to be low.
Previous updates
26 June 2019
As part of the multi-agency response into cases of listeriosis linked to sandwiches and salads, Public Health England (PHE) is testing all recent samples of listeria to check if they are linked to this outbreak.
To date, PHE has analysed 29 samples from people with listeriosis within the time frame the incident is thought to have occurred. As previously reported, there are 9 confirmed cases linked to this outbreak. The remaining 20 cases are not linked to this outbreak. As part of our routine surveillance work, separate investigations are being undertaken for these cases and, as is standard, PHE will continue to analyse all samples that are sent to our National Infection Service laboratories.
The date of onset of symptoms for the 9 previously confirmed cases falls between 20 April and 2 June and evidence suggests that all individuals ate the affected products in hospitals before the withdrawal took place on the 25 May 2019. No cases of listeriosis linked to this outbreak have been confirmed in people outside of hospital settings and therefore the risk to the public remains low.
Dr Nick Phin, National Infection Service, Public Health England, said:
Swift action to remove the affected products from the supply chain has ensured that there is a low risk to patients and the public. Public Health England is carrying out a thorough genomic analysis of all listeriosis cases reported in England and can confirm that so far, there are no further cases linked to this outbreak across the UK. Our investigations continue and the public should be reassured that the risk to the public continues to be low.
The multi-agency team has communicated with all relevant local authorities, reiterating guidance for health and social care organisations on reducing the risk of vulnerable groups contracting listeriosis. This is in addition to the clinical advice that was communicated to the NHS following the withdrawal of affected products.
The Food Standards Agency (FSA) is leading the investigation into the food supply chain to identify the source of the listeria strain linked to the hospital cases with the support of local authorities.
For more details see FSA update.
17 June 2019
On 14 June 2019, Public Health England, the Food Standards Agency (FSA) and the NHS confirmed that, following a retrospective analysis of Listeria cases, an additional 3 cases including 2 deaths were linked to this outbreak.
Now that discussions between affected families and NHS clinicians have taken place, we can confirm that the individuals that sadly died were diagnosed and treated at:
- Manchester University NHS Foundation Trust: 2 cases (confirmed on 7 June)
- Aintree University Hospital NHS Foundation Trust (confirmed on 7 June)
- University Hospitals of Derby and Burton NHS Foundation Trust
- University Hospitals of Leicester NHS Trust
The following Trusts have diagnosed listeria cases linked to this outbreak, though with no associated deaths:
- Western Sussex Hospitals NHS Foundation Trust: 2 cases
- Frimley Health NHS Foundation Trust
- East Kent Hospitals University NHS Foundation Trust
NHS England and NHS Improvement and the FSA can confirm that the Good Food Chain supplied affected product lines to the following 43 NHS Trusts, plus one independent provider. The outbreak investigation continues and the public health risk remains low.
- North West Anglia NHS Foundation Trust
- East Suffolk and North Essex NHS Foundation Trust
- The Princess Alexandra Hospital NHS Trust
- Chelsea and Westminster NHS Foundation Trust
- Homerton University Hospital NHS Foundation Trust
- Imperial College Healthcare NHS Trust
- Kings College Hospital NHS Foundation Trust
- Kingston Hospital NHS Foundation Trust
- Lewisham and Greenwich Hospital NHS Trust
- Oxleas NHS Foundation Trust
- Royal Brompton and Harefield Hospital NHS Foundation Trust
- Birmingham Women’s and Children’s NHS Foundation Trust
- Black Country Partnership NHS Foundation Trust
- Leicester Partnership NHS Trust
- Midlands Partnership NHS Foundation Trust
- University Hospitals Coventry and Warwickshire NHS Trust
- University Hospitals Derby and Burton NHS Foundation Trust
- University Hospitals of Leicester NHS Trust
- University Hospitals of North Midlands NHS Trust
- Worcestershire Acute Hospitals NHS Trust
- Walsall Healthcare NHS Trust
- The Royal Wolverhampton NHS Trust
- Aintree University Hospitals NHS Trust
- Barnsley Hospital NHS Foundation Trust
- Bolton Hospital NHS Foundation Trust
- Calderdale and Huddersfield NHS Foundation Trust
- Doncaster and Bassetlaw Teaching Hospitals NHS Trust
- East Cheshire NHS Trust
- Manchester University NHS Foundation Trust
- Mersey Care NHS Foundation Trust
- North West Boroughs Healthcare NHS Foundation Trust
- Warrington and Halton Hospitals NHS Foundation Trust
- Wirral University Teaching Hospital NHS Foundation Trust
- The Walton Centre NHS Foundation Trust
- Ashford and St Peter’s Hospitals NHS Foundation Trust
- Buckinghamshire Healthcare NHS Foundation Trust
- East Kent Hospitals NHS Foundation Trust
- Frimley Health NHS Foundation Trust
- Oxford University Hospitals NHS Foundation Trust
- Surrey and Borders Partnership NHS Foundation Trust
- Western Sussex Hospitals NHS Foundation Trust
- Royal Berkshire Hospital NHS Foundation Trust
- Weston Area Health NHS Trust
- Virgin (Farnham Hospital) - independent provider
As we have made clear from the outset, the health risk to the public remains low and individuals should only seek medical attention if they develop symptoms. Further information on listeriosis.
14 June 2019
Since the multi-agency investigation began into listeria cases linked to sandwiches and salads, Public Health England (PHE) has been analysing previously known cases of listeria from the past 2 months to see if they are linked to this outbreak. Whilst any risk to the public remains low, PHE’s Whole Genome Sequencing analysis has identified an additional 3 cases of listeria linked to this outbreak. This brings the total number of confirmed cases to nine. All of the cases of listeria infection were in hospital patients in England.
Sadly, one of the seriously ill 6 patients PHE confirmed last week has since died.
One of the patients confirmed today as linked to the outbreak had already died. This brings the number of deaths linked to this outbreak to 5.
The affected sandwiches and salads were withdrawn from hospitals when the links to the listeria infections were first identified and the multi-agency team then advised NHS organisations not to provide any Good Food Chain products to vulnerable patients. Evidence suggests that all individuals ate the affected products before the withdrawal took place in hospitals on the 25 May 2019. The food chain investigations continue.
Sandwiches and salads linked to the patients have been withdrawn and the supplier, The Good Food Chain, has voluntarily ceased production while the investigation continues. This business had been supplied with meat produced by North Country Cooked Meats which subsequently produced a positive test result for the outbreak strain of listeria. This business and North Country Quality Foods who they distribute through, have also voluntarily ceased production.
Dr Nick Phin, Public Health England, said:
To date, there have been no patients linked to this incident outside healthcare organisations, but we continue to investigate. Swift action was taken to protect patients and any risk to the public is low. PHE is continuing to analyse all recent and ongoing samples of listeria from hospital patients to understand whether their illness is linked to this outbreak.
PHE is working very closely with the Food Standards Agency, NHS England and Improvement, as well as partner organisations in Scotland and Wales, to investigate this outbreak.
Dr Colin Sullivan, Chief Operating Officer at the FSA said:
Our sympathies remain with the families of the patients who have tragically passed away. We have taken action along with local authorities to minimise the risk based on the evidence so far. The FSA will continue to investigate the cause of the outbreak to prevent a reoccurrence.
Whole Genome Sequencing is a laboratory tool used to investigate the DNA sequence of bacteria. Using this technology, we can identify matches between samples taken from patients with listeria and the food products under investigation to confirm whether patients are linked to the outbreak.
For more on the food investigation, please visit the FSA website.
Further information on listeriosis.
7 June 2019
Public Health England (PHE), The Food Standards Agency (FSA), Public Health Wales (PHW), Food Standards Scotland (FSS), Health Protection Scotland (HPS) and a number of local authorities are currently investigating the source of listeria infections linked to pre-packed sandwiches.
Sandwiches and salads linked to the cases have been withdrawn and the supplier, The Good Food Chain, has voluntarily ceased production while the investigation continues. This business had been supplied with meat produced by North Country Cooked Meats which subsequently produced a positive test result for the outbreak strain of listeria. This business and North Country Quality Foods who they distribute through, have also voluntarily ceased production.
The cases of listeria infection were in 6 seriously ill hospital patients in England. Three of these patients have sadly died. Currently there are no cases in Scotland or in Wales. Listeria infection in healthy people is usually either unnoticed or may cause very mild illness. However, it can have more serious consequences for some people, particularly those with pre-existing health conditions and pregnant women. The health risk to the public remains low and individuals should only seek medical attention if they develop symptoms.
The sandwiches and salads affected are no longer being produced while investigations continue and the affected products were withdrawn from hospitals when the links to the listeria infections were first identified.
Dr Nick Phin, Deputy Director at the National Infection Service at PHE said:
Our thoughts are with the families of those patients who have died. We, along with the FSA, colleagues in local authorities and the NHS have worked quickly to determine the likely cause of this outbreak and taken action to reduce the risk to the public’s health.
To date, there have been no associated cases identified outside healthcare organisations, and any risk to the public is low.
Dr Colin Sullivan, Chief Operating Officer at the FSA said:
Our sympathies are with the families of those patients who have tragically passed away.
We have taken action along with local authorities to minimise the risk based on the evidence so far. The FSA will continue to investigate how the outbreak occurred and if further steps are required to protect vulnerable groups.
Information on Listeriosis
Listeriosis is a rare infection and for most people, it goes unnoticed or there are mild symptoms of gastroenteritis that usually last a short time without the need for treatment.
The time between exposure to the organism and the development of the illness can be up to 70 days.
Occasionally, a more serious infection develops and spreads to the bloodstream or brain. This can happen in people who have serious underlying health conditions and can also occur in pregnant women. Pregnant women and people with underlying health conditions can find more information on the NHS website.
Severe listeriosis is more likely to affect the elderly, very young babies, pregnant women and those with a weakened immune system. People in these groups should seek immediate medical attention if they experience symptoms of infection. For advice on avoiding listeriosis during pregnancy, please visit the NHS website.
Food products are permitted to be out of temperature control for limited periods, providing there is no risk to food safety, to accommodate the practicalities of transport and storage.
Background
As of 7 June 2019, the Trusts that have had cases who have died are Manchester University NHS Foundation Trust and Aintree University Hospital NHS Foundation Trust.
We typically see on average 166 annual cases of listeriosis in England and Wales (based on annual case numbers from 2008 to 2018). There was an average of 46 deaths in the preceding six years per year (2010 to 2016).
Following a product withdrawal, PHE and Health Protection Scotland have written to their respective NHS Trusts and Boards to ensure that they are following appropriate food storage and handling protocols and to provide clinical guidance.
Last updated 1 August 2019 + show all updates
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Added latest update.
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Added latest update on the multi-agency response into cases of listeriosis linked to sandwiches and salads in hospitals.
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Updated with NHS Trusts.
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Added latest update on the number of cases.
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First published.