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Investigation continuing into foods linked to listeria infections in UK hospitals
Good progress is being made in the continuing investigation into the food supply chain, to identify the source of the listeria strain linked to the recent hospital cases - which have so far resulted in two deaths. The Food Standards Agency is leading the investigation, with the support of Food Standards Scotland and local authorities.
Products directly linked to the cases were identified and these were withdrawn from the food chain on the same day as the link was established. This strain was traced back to a producer which withdrew all their ready-to-eat foods on a precautionary basis. Investigations are continuing to try and determine the point of origin of the listeria strain.
All confirmed cases to date have been linked to sandwiches produced by The Good Food Chain, which voluntarily ceased production on 5th June and withdrew all products which remained in date. Evidence suggests that all individuals ate the affected products in hospitals before the withdrawal took place on 25th May. 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.
The same strain of listeria was identified in meat produced by North Country Cooked Meats used by The Good Food Chain. North Country Cooked Meats, and its distributor North Country Quality Foods, voluntarily stopped distributing on 3rd June and a withdrawal of all ready-to-eat products has been carried out on a precautionary basis. The products supplied by North Country Quality Foods to other businesses have not led to any reported cases to date. Both North Country Cooked Meats and North Country Quality Foods remain closed.
The investigation is now focused on identifying the source of the listeria infections. It is examining the supply chain of North Country Cooked Meats and looking at historical detections of listeria, including those within permitted legal limits. Further testing of products and environments for listeria is also being conducted to identify whether a match to the outbreak strain can be found.
Following extensive testing and verification by Stafford Borough Council, The Good Food Chain is no longer part of the ongoing investigation into the source of the outbreak. With the investigation now focusing on suppliers further up the food supply chain, The Good Food Chain can restart production.
However, to ensure public health continues to be protected, an enhanced set of food safety measures are now in place and the local authority will continue to carry out strict monitoring and oversight of the company for the next three months, with further supervision to be determined by inspection findings. The business will have to reapply for accreditation before it can directly supply the NHS again.
These measures include:
* The business has been verified as meeting food safety legislation and as following best practice for manufacturing, cleaning and environmental standards
* The site has undergone a comprehensive deep-cleaning process. Extensive environmental swabbing indicates the site is clear of potential sources of any strain of Listeria monocytogenes, including the outbreak strain
* The food safety hazard plan has been reviewed and will continue to be verified to ensure it is fit for purpose once production restarts
Enhanced oversight will be carried out by Stafford Borough Council which includes additional product sampling, environmental testing and enhanced incoming supply verification.
Public Health England and Health Protection Scotland are 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 nine confirmed cases linked to this outbreak. The remaining 20 cases are not linked to this outbreak. As part of the 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.
"Swift action to remove the affected products from the supply chain has ensured that there is a low risk to patients and the public," says Dr Nick Phin, National Infection Service, Public Health England.
"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 individuals that sadly died were diagnosed and treated at:
* Manchester University NHS Foundation Trust: 2two cases (confirmed on 7th June)
* Aintree University Hospital NHS Foundation Trust (confirmed on 7th 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: two 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:
* 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
Councillor Jonathan Price, the Cabinet Member for Environment at Stafford Borough Council, says of the efforts made to pinpoint the cause of the outbreaks:
"We have worked tirelessly with the Good Food Chain and are reassured that its manufacturing processes, cleaning procedures and environmental standards meet those we expect for producing ready to eat foods."
"But our work does not stop there as the health of the public is our top priority.
"So we will continue collecting environmental swabs from surfaces at the business, taking samples of food, and working with The Good Food Chain to ensure it has control measures in place to thoroughly assess those supplying products to the company."
There are on average 166 annual cases of listeriosis in England and Wales (based on annual case numbers from 2008 to 2018) and there was an average of 46 deaths in the preceding six years per year (2010 to 2016).
27th June 2019