Marked increase in people hospitalised due to foodborne illnesses

CIEH says capacity of local government EH teams must be strengthened and the EH infrastructure “bolstered” to help address the rise in foodborne illnesses

Hospital admissions for food-related illness such as salmonella, E coli and campylobacter are at their highest level for decades, according to new NHS data.

Between April 2022 and March 2023 there were 1,468 admissions for salmonella infections in England – roughly three in every 100,000 people and a 76% increase from 2013 when figures were at an all-time low (834 admissions). Admissions for campylobacter, an infection associated with eating or handling raw or undercooked meat and touching pet faeces, reached over 4,340 – a rate of nine in 100,000 people, up from three in 100,000 in 2000.

But it’s unclear why there has been an increase in these gastrointestinal illnesses. Experts blame the weakening regulatory focus, reduced standards in importation checks post-Brexit and local authority cuts.

A recent spike in salmonella food poisoning, in which over 200 people fell ill with a variant linked to poultry and eggs from Poland, is under investigation by the Food Standards Agency (FSA). Although impossible to separate food-related admissions from those caused by other factors, studies show an average of 80-90% of salmonella cases are attributable to food, while an FSA study found 67% of cases of salmonella and campylobacter and 60% of E. coli cases are linked to food.

Professor Robin May, FSA Chief Scientific Adviser says overall hospitalisations for gastrointestinal disease in England are lower than before the Covid pandemic, and although there has been an increase in the proportion of patients with a diagnosed salmonella or campylobacter infection being treated in hospital, more data is needed to understand the reasons why.

“It’s important to understand that an increase in a particular infection from a pathogen is not necessarily indicative of a change in overall disease,” said Professor May. “We need to know more about where that disease is coming from – whether that is from food or from other transmissions such as animal to person or person to person – so we can do our best to minimise it.”

“…the battle against such outbreaks begins with strengthening the capacity of local government Environmental Health teams.”

The increase could also be related to improved detection methods: “Advancements in the use of molecular diagnostics at frontline laboratories over the last decade have increased GI pathogen diagnosis leading to more hospital admissions being recorded as attributable to specific pathogens, including salmonella,” explained Amy Douglas, Lead Epidemiologist at UKHSA. “Better diagnostics also help the clinical management of patients.

Louise Hosking, Executive Director of Environmental Health at CIEH said, "Facing an unprecedented rise in foodborne illness hospital admissions, it's clear that the battle against such outbreaks begins with strengthening the capacity of local government Environmental Health teams.

“We must also address the insufficient numbers entering the profession, which threatens the future pipeline and our ability to protect public health effectively. By bolstering the Environmental Health infrastructure and enhancing awareness of its critical role, we can create a resilient and effective defence against foodborne diseases.”

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