E. coli may become notifiable disease after farm outbreak

Cases linked to family attraction in Surrey rise to 57 as lawyer prepares class action against owners

Kate Youde,Jonathan Owen,Susie Mesure
Sunday 20 September 2009 00:00 BST

E. coli could be upgraded to a "notifiable disease" – on a par with infections like smallpox and measles – to speed up detecting outbreaks.

News of the development came as the number of cases of E. coli O157 linked to Godstone Farm in Surrey yesterday reached 57. The count is three times the normal rate of 15 to 20 cases that the Health Protection Agency (HPA) attributes to open or petting farms in England and Wales each year.

The Department of Health began consulting before the latest scare on whether the potentially fatal illness – cases of which have almost trebled in the past two decades – should be re-classified as part of changes made to the list of notifiable diseases under the Public Health Act. A change in status would mean doctors would have a statutory duty to alert the relevant authorities if they suspected cases of the illness.

Jenny Morris, principal policy officer at the Chartered Institute of Environmental Health, said: "We should be looking at the widening of the notifiable disease system [in relation to E. coli O157]. This would allow us to pick things up early, to act early and prevent others falling ill."

The HPA reported that 10 children linked to the outbreak at Godstone Farm, which closed last Saturday, were "stable and improving" in hospital. None was said to be seriously ill.

A leading personal injury lawyer, Jill Greenfield, a partner at Field Fisher Waterhouse, has received instruction from a family involved and expects a class action. In 2001, she represented Tom Dowling, who was awarded damages of £2.6m after he contracted E. coli as a four-year-old during a school trip to a north London farm in 1997, which resulted in his becoming quadriplegic and brain damaged. His was the third case of E. coli at the farm within a few months.

World of Country Life in Exmouth, Devon, on Friday became the fourth open farm to close in the wake of the Godstone Farm outbreak after the HPA found a potential link to three cases of E. coli. White Post Farm in Nottinghamshire remains shut, after two visitors suffered from the same strain of the illness. Godstone Farm's sister farm, Horton Park Children's Farm, is also closed. An HPA spokeswoman said it was "very unusual" for four farms to be closed in a week. Cases of E. coli O157 in England and Wales have soared from 361 in 1991 to 950 in 2008. Open farming was linked to around 2 per cent of last year's outbreaks.

Professor Hugh Pennington, an expert on E. coli, said: "I'm really unhappy about under-fives touching ruminants, because it's impossible to make sure they don't have manure on their coats and it's really difficult to stop them putting their fingers straight in their mouths." He added that farms "must review their processes", including putting up "bold" signs explaining why children should wash their hands, changing their layout if necessary and keeping track of where manure goes.

"We owe it to the kids to protect them from what is a serious problem," he said. "E. coli O157 is a very unusual bug in that it can kill and it's not treatable. Once a child is infected, you just have to wait and see what happens." The expert warned that "we may see some more" cases, adding those that might not be reported were probably coming to light as parents were taking sick children to the doctor with samples being sent for testing.

The Department of Health will report on the consultation findings later this year.

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