§ The Countess of Marasked Her Majesty's Government:
In how many cases of E.coli 0157 reported to the Communicable Disease Surveillance Centre during the week ending 19 September 1997 was the source of infection traced; and, if it was traced to a food product sold commercially, in how many instances was an order under Section 9 or Section 13 of the Food Protection Act 1990 enforced. [HL2444]
§ Baroness Jay of PaddingtonDetails of suspected sources of infection for sporadic cases and family outbreaks ofE.coli 0157 are not routinely reported. Information is available on four localised outbreaks with which some of the cases reported during the week ending 19 September 1997 were associated. None of these outbreaks was associated with the consumption of a commercially available food product; three outbreaks were associated with contact with livestock on farms, and the fourth with food served at a wedding reception. Information requested with regard to the use by food authorities of powers in Section 9 of the Food Safety Act 1990 is not available centrally. No order under Section 13 of the Food Safety Act was made for any case of E.coli 0157 reported in the week ending 19 September 1997.
§ The Countess of Marasked Her Majesty's Government:
Whether all hospital laboratories routinely test specimens from patients suffering from severe diarrhoea for E.coli 0157; and, if they do not, whether they will issue a specific instruction to do so. [HL2446]
§ Baroness Jay of PaddingtonIn its 1995Report on Verocytotoxin Producing Escherichia coli, the Government's independent expert Advisory Committee on the Microbiological Safety of Food (ACMSF) recommended that all clinical laboratories routinely examine all diarrhoeal stool specimens for E.coli 0157. The Public Health Laboratory Service (PHLS) issued instructions to its laboratories to comply with this recommendation. The Department of Health also wrote at the time of the publication of the report to all Regional Directors of Public Health, Regional Epidemiologists, District Directors of Public Health, Consultants in Communicable Disease Control and medical microbiologists, highlighting the ACMSF's recommendation. Decisions on the testing of clinical specimens rest with local laboratory managers.
§ The Countess of Marasked Her Majesty's Government:
Whether any mechanism is in place to trace the source of an outbreak of infection by E.coli 0157 where an unusual number of cases is reported to the Communicable Disease Surveillance Centre at any particular time, but from different geographical locations, which could be attributed to a widely distributed food product. [HL2447]
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§ Baroness Jay of PaddingtonAll isolates ofE.coli 0157 identified by the Public Health Laboratory Service (PHLS), National Health Service or private laboratories in England and Wales should be referred to the PHLS Laboratory of Enteric Pathogens (LEP) for confirmation and subtyping. LEP analyse subtyping data in order to identify, at an early stage, any clusters of cases in time, space or age group that may indicate that an outbreak is in progress. Data on such clusters are always referred to the Communicable Disease Surveillance Centre, so that epidemiological investigations can be rapidly initiated.
Investigations are usually conducted in collaboration with public health specialists at regional and district levels with a view to rapidly establishing if cases within clusters identified by LEP are linked by exposure to a common event, by the consumption of a common foodstuff or by a common water source. Whenever outbreaks of this type are identified, all relevant information is shared with the Department of Health to initiate public health interventions as quickly as possible.
§ The Countess of Marasked Her Majesty's Government:
Whether any laboratory in the United Kingdom has pulsed-field gel electrophoresis facilities for DNA analysis of E.coli 0157; and, if not, whether they would fund the necessary equipment in order to expedite strain typing of the organism so that sources may be traced in the event of a widely dispersed national outbreak of infection. [HL2448]
§ 0157. Baroness Jay of PaddingtonPulsed field gel electrophoresis of Verocytotoxin producingE.coli 0157 (VTEC) has been carried out in the Laboratory of Enteric Pathogens (LEP) of the Central Public Health Laboratory since 1995. The LEP is internationally recognised as a leading centre for the typing of E.coli