💡 This article is part of our Food Safety Help Centre – a practical resource for schools and education providers who want clear, confident answers when it comes to food safety.
Childhood Exposure to E.coli May Lead to Long-term Illnesses Like Cancer
Here's how school caterers can strengthen food safety and protect children's futures.
A new study suggests that exposure to E.coli toxin in childhood could damage DNA and potentially trigger cancer decades later. This discovery adds new urgency for caterers and food providers to tighten food safety and hygiene controls — especially when serving children in childcare centres and schools.
In April 2025, Cancer Research UK reported that a specific strain of E.coli producing a toxin called colibactin may be contributing to the rise in bowel cancer among under-50s.
Previously, in February 2025, a separate team of scientists published findings from a long-term study in Wales. They followed individuals exposed (and unexposed) to E.coli O157 for over three decades. Their results showed that those exposed were twice as likely to suffer long-term health complications. For individuals who developed haemolytic uremic syndrome (HUS), the risk rose to eight times higher. Read the study summary here.Â
Preventing E.coli contamination to reduce the risk of food poisoning is extremely important. But it may also play a vital role in safeguarding long-term health — especially for the youngest and most vulnerable in our care.
Prevention is better (and cheaper) than cure.
Importance of the E.coli Fact Sheet
If you are a caterer (especially a school caterer),  then read on to learn what you must know about the harmful strains of E.coli.  Above all, why it is vital that you know about the E.coli Fact Sheet from the Food Standards Agency.Â
But first, we need to talk about E.coli outbreaks – to help you visualise the problem.
Major E.coli Outbreak UK 2024
In the UK, July 2024, the number of confirmed cases in the E. coli outbreak rose to 288.  Cases were distributed as follows: 191 in England, 62 in Scotland, 31 in Wales, and 4 in Northern Ireland.
Over 120 people were hospitalised.  Sadly one death was linked to the outbreak.
The UK Health Security Agency identified pre-packaged sandwiches, wraps, and salad products containing lettuce as the source of the contamination. Lettuce was likely contaminated through the use of polluted water during growth, harvesting, or processing stages.
The incident has highlighted weaknesses in the food supply chain.  It reminds us of the need for rigorous food safety management practices at ALL levels where food is produced, processed, distributed, sourced, and consumed infection
Which Foods Were Suspected And Recalled?
Throughout June, three companies recalled food products due to a potential link to the E.coli outbreak. The companies were Greencore Group, who issued a product recall on 14 June, closely followed by Samworth Brothers Manton Wood and THIS!.
The products recalled by Greencore included sandwiches, wraps and salads sold at Sainsbury’s, Asda, Aldi, Morrisons, Co-op and Boots. Samworth Brothers Manton Wood recalled various Tesco and One Stop sandwiches and wraps. THIS! requested that customers return its vegan chicken and bacon wraps, which were only available at WH Smith.Â
The financial cost of product recalls can be staggering. Legal action has been started against Asda and Tesco. More civil action is likely to follow.
What Was The Source of Contamination?
Contaminated products were traced back to prepackaged food items supplied by a major food processor and distributed through multiple supermarket chains.Â
It highlights the need for:
– food safety rules to be followed by all businesses throughout the supply chain.
– rigorous food safety management at all levels
– monitoring by enforcement officers to ensure food laws are being complied with.
Are Incidents of E.coli Becoming More Common?
In the UK, there has been a rise in cases involving all foodborne pathogens, including Shiga toxin-producing E. coli (STEC). Â
A spike in E.coli infections in England in 2022 indicates an increase in almost 80 percent from the year before.
This upward trend is not isolated to the UK.  Globally, E. coli outbreaks are occurring elsewhere. For example, Alberta, Canada had an outbreak of Shiga toxin in the Autumn 2023. There were 356 cases; 23 were severe and required dialysis; 39 were hospitalised. No deaths were attributed to the outbreak.Â
In the Canadian case, E.coli contamination came from a kitchen facility that supplied food to children’s daycare facilities. Fueling Minds, the Company responsible for the source of the outbreak was charged by the City of Calgary for operating without a business license.Â
A class-action lawsuit was filed against the company on behalf of those affected. Â It demonstrates the serious consequences for any food business that put profits first – before protecting health. Â Preventing E.coli infection is something that food businesses must take seriously.
An E.coli Outbreak Can Happen To Any Business
McDonald’s experienced an E.coli outbreak in the US in December 2024, linked to onions used in their Quarter Pounder burgers. According to Bill Marler — a US personal injury lawyer who specialises in food-borne illness cases — it was the first case he’d seen involving McDonald’s in over 30 years. It’s a stark reminder that no brand, no matter how big, is immune to the risks of E.coli when handling food.
What Is E.coli Infection?
E. coli stands for Escherichia coli, a zoonotic pathogen that causes E.coli infection. Zoonotic bacteria are harmful because they can pass between humans and animals.Â
These pathogenic bacteria can cause life threatening ill health (such as bloody diarrhoea and kidney failure) and even death. The strain of E. coli linked to the UK 2024 E.coli outbreak was identified as STEC O145. This strain, and E.coli 0157 produces a poisonous toxin (known as Shiga toxin).  More importantly, outbreaks caused from this bacteria are often linked to contaminated food and water.
How Much E.coli Is Unsafe?
E.coli that produce Shiga toxin (STEC) can cause serious illness with only a small number of harmful bacteria. Â
Therefore, rigorous food safety measures are essential to prevent E.coli infection.Â
Where is E.Coli Bacteria Found?
E.coli bacteria are naturally present in the intestines of humans and animals, especially ruminant animals, such as cattle and sheep. Some are harmless. Â
Harmful types, such as E.coli 0157,  can potentially contaminate meat during the slaughtering process at an abattoir, meat cutting plant, or butchers shop. Â
Therefore, all raw or undercooked meat must be considered to be contaminated, especially burgers, ground beef, sausages and minced meats.Â
E.coli can also be found in soil.  This means that unwashed vegetables, fruit and salad (e.g. lettuce) must be assumed to be contaminated too.
How Does E.Coli Get Into The Body?
E.coli bacteria can enter the body from eating or drinking contaminated food or water. Â Bacteria picked up on hands after touching something contaminated in the environment can be transferred into the mouth.Â
How Is E. coli Spread?
E. coli is excreted from the body in faeces. Lack of handwashing or poor handwashing practice after going to the toilet can spread bacteria to other surfaces, equipment or onto food via the hands of a food handler.Â
E.coli can also be spread through touching infected animals or their infected faeces. For example, a child could pick it up during a school trip to a farm (from petting animals), or from touching contaminated surfaces where bacteria are present.Â
In addition, it is possible to contract E.coli from swimming or playing in contaminated water, such as ponds or streams.
Infection can also be spread from person to person contact.
Who Is At Risk From E.coli Infection?
Anyone can pick up E.coli infection. However, some people are more susceptible to the illness. Â
Vulnerable groups include young children and babies, the elderly, pregnant women and people with a weakened immune system (e.g. someone receiving medical treatment for diabetes).Â
Consequently, school caterers must take extra precautions – because children can become seriously ill from this infection, not just in the short-term. Â But in the longer-term too.
What Are The Symptoms of E. coli Infection?
The effect on some people can be mild. Â However, for others, Â E.coli infection can be very serious and sometimes fatal.Â
Some people are left with permanent kidney or brain damage.
E. coli symptoms typically begin 3 to 4 days after exposure, known as the onset time, though they can appear as soon as 1 day or as late as 1 week. Common E. coli symptoms include:
- Diarrhoea, ranging from mild and watery to severe and bloody,
- Stomach cramps, pain, or tenderness,
- Nausea and vomiting,
- More severe symptoms in vulnerable groups can cause infected people to have meningitis.
Possible New E. coli Treatment - Aurodox
On 1st April 2025 it was announced that scientists from the University of Glasgow have made an important step towards developing a potential new treatment for this deadly E.coli (STEC) bug.
What Do Caterers Need To Know About E.coli?
In Wales, whether you’re running a school kitchen, nursery, or care setting, this is not the time to wait for new guidance. The core food safety principles already in place can protect lives — but only if applied properly and consistently.
Here’s where to focus:
1. Review Your HACCP Today
Don’t assume your food safety system is still fit for purpose. Check your Safer Food Better Business pack (SFBB) or HACCP plan with fresh eyes.Â
Are controls for E.coli prevention clearly laid out?Â
More importantly, are those E.coli control measures being put into practice?
Check that cross-contamination measures are being followed.
Make sure that cooking temperature checks are being recorded — not skipped.
If unsure when to review your HACCP Plan – read our article.
2. Update and Train Staff on the Dangers of E.coli
Make sure your team understands that E.coli isn’t just a diarrhoea bug. The risks are much more severe.  Moreover, those risks may include long-term health impacts like kidney disease, and now possibly cancer.Â
Everyone — from head chefs, dinner ladies to lunchtime supervisors — must know how to prevent E.coli contamination. Â
Train staff on personal hygiene often – observe their handwashing practice to ensure it’s being done correctly – at the right moments.
Do not just pay lip-service to food safety compliance.
Make sure your staff know how to spot early signs of a problem – and what to do when problems are identified.
3. Check Your Suppliers and Food Storage
If you’re using raw ingredients like leafy veg, cheese, raw meat, poultry or fish, be especially careful. Review your supply chain and check that:
The cold chain is maintained during delivery.
You’re getting produce from approved, traceable suppliers.
Staff are checking deliveries on arrival — not just signing the docket.
- Â Â Â Raw and ready-to-eat food is segregated in storage.
4. Know the Essential E.coli Information For Caterers
The Food Standards Agency (FSA) first introduced the E. coli 0157 Cross-Contamination Guidance in 2011.  This came as a result of the E.coli outbreak in 2005 in South Wales. The document was written to prevent further E.coli outbreaks happening again.
Control measures outlined in the guidance are intended to minimise cross-contamination during all stages of food handling, storage and preparation.
School caterers must embed these control measures into their day-to-day practice.Â
There is a lack of knowledge about the E.coli Guidance. This is especially the case with small and micro-businesses, including multi-cultural businesses in the catering and retail sectors.
You can download the guidance here:Â Â The E.coli 0157 Cross-Contamination Guidance.
Prefer a Short Summary - E.coli Guidance Fact Sheet
The Food Standards Agency have written a short, easy to consume summary which school caterers can use:
Download the E.coli Guidance Fact Sheet from our resource library here.
What To Do Next?
As a school caterer you must retrain all your food handlers to improve their awareness on E.coli and the control measures to protect young children.
You may also like to read our previous article:Â Top Reasons Why Your Business Needs A Food Safety Consultant. Â A food safety consultant can help you set up systems and processes in your business to ensure your staff correctly comply with these vital E.coli control measures.
Related: Even top-tier kitchens aren’t immune — read how a Michelin-starred chef was arrested after a norovirus outbreak, and what it means for food safety at every level. Read the full story here »Â
Need more free food safety resources – go to our Food Centre Help Centre.
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