Public health officials have issued a warning to hospitals to be on red alert due to a listeria outbreak that is causing fatalities among patients. The Listeria bacterium has an incubation period of up to 70 days, meaning the NHS is expecting more patients to die from the infection listeriosis.
The number of deaths caused by patients eating pre-packed sandwiches and salads while in hospital rose from three to five, with evidence suggesting that patients had eaten the products before the 25th May.
Now, according to the latest announcement from Public Health England (PHE), the number of confirmed cases has risen to nine and involves eight NHS trusts across the country. Health secretary Matt Hancock said he is “incredibly concerned” by this issue and has now ordered a “root and branch” review of hospital foods.
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Contamination at the supplying food chain
Products from The Good Food Chain, which had been supplying 43 trusts, have now been withdrawn and their manufacture halted. PHE says the foods were withdrawn from hospitals as soon as it was realized that they were causing infections:
We've taken steps to make sure the product is no longer distributed, and therefore the public and the NHS patients are safe."
Nick Phin, Deputy Director, The National Infection Service at PHE
More deaths last week
Last week, PHE announced that three more patients had died as a result of the outbreak, two at the Manchester Royal Infirmary and one at Aintree Hospital.
The Manchester University NHS Foundation Trust has offered its "deepest condolences to the bereaved families,” with a spokesperson expressing "sincere regret" that two of its patients had contracted listeria.
According to the trust, which would not clarify exactly when the deaths occurred, says the sandwiches were ordered from the patient menu. A PHE spokesperson has said that the first patient developed symptoms on the 25th April and the latest case was reported on 15th May.
Aintree Hospital has said that it was advised by PHE about the issue with the supply chain on 24th May, at which point all of the supplier’s products were immediately removed.
Who supplied The Good Food Chain?
According to PHE, the Good Food Chain acquired products from North Country Cooked Meats, which voluntarily ceased production after producing a positive test result for the outbreak strain of listeria.
The Good Food Chain says it was a production facility in Stone, Staffordshire that had been contaminated and North Country Cooked Meats has said it is "currently co-operating fully with the environmental health and the Food Standards Agency in their investigations."
In a statement, The Good Food Chain has also said it is cooperating "fully and transparently with the Food Standards Agency and other authorities" and that it hopes the inquiry would be pursued with "urgency,” so that the wider industry can learn any lessons as soon as possible.
Another case in Ashford
A woman who has recently been infected at the William Harvey Hospital in Ashford, Kent, has said she is lucky to be alive.
Tanya Marston, aged 38, was due to be discharged from hospital last month when her temperature suddenly rose. Her blood was tested for listeria and she was given intravenous antibiotics after the test result was found to be positive.
Marston says she counts herself very lucky that the spike in temperature led to the infection being identified: "I'm really grateful that they took the blood cultures. If that hadn't been done, I could be one of these people that has died."
She added that she is wondering what opportunities may have been missed to get to the point where people are poisoned by the food that hospitals are giving them.
Paul Stevens, medical director at East Kent Hospitals University trust, says Marston probably acquired the bug from the sandwiches she was given to eat.
Identifying those most at risk
Listeria usually goes unnoticed or only causes mild symptoms in healthy individuals; it is people with weakened immune systems, pregnant women and the elderly who are more likely to develop serious symptoms.
Mild symptoms including a raised temperature, nausea, chills would usually resolve independently after a few days. However, this outbreak has involved patients who had already been seriously ill were therefore at a much greater risk of severe symptoms developing. In such cases, the bacteria can damage organs and spread to the brain and bloodstream.
A wide range of foods can become contaminated including soft cheeses, pre-packed salads, sliced meats, sandwiches and unpasteurized milk. To reduce the risk of infection, the NHS recommends ensuring that food is chilled in the fridge, fully heated when it is served and not eaten after the use-by-date displayed.
The government received safety warnings five years ago
The government was warned by the Food Standards Agency (FSA) about failings in hospital food safety five years ago when it reported that 32 hospitals had failed to meet food safety standards in 2014. The agency warned that sandwiches were being left “out of temperature control” for “extended periods,” stored in fridges that were not cold enough and kept on trolleys in warm wards before being served.
PHE says it has now been investigating cases that have arisen over the past two months to see if they are linked:
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."