England Saw 2,500 STEC Cases in 2025, Holding Steady with Previous Year
England reported 2,457 culture-confirmed cases of Shiga toxin-producing Escherichia coli (STEC) in 2025, a 3.4 percent decrease from 2024, according to the UK Health Security Agency’s (UKHSA) annual surveillance report.
The modest decline was partly attributed to the previous year’s elevated numbers, driven by a STEC O145 outbreak that accounted for 293 cases in 2024.
Of the culture-confirmed cases reported in 2025, 568 were STEC O157 and 1,889 were non-O157 STEC. STEC O157 cases increased slightly by 0.7 percent compared to 2024, while total non-O157 STEC notifications, including PCR-positive but culture-negative cases, rose 3.2 percent to 2,850. Among culture-confirmed non-O157 infections, STEC O146 was the most frequently identified serogroup, accounting for 280 cases (14.8 percent).
Clinical Demographics and HUS Outcomes
Children continued to experience the highest rates of infection. As in 2023 and 2024, children aged 1–4 years had the highest incidence of STEC O157 infection, while infants younger than one year had the highest incidence of non-O157 STEC in 2025.
Among cases with available clinical information, approximately one-quarter of both STEC O157 (26.1 percent) and culture-confirmed non-O157 STEC (27.7 percent) patients were hospitalized. No deaths were reported among STEC O157 cases, while three deaths occurred among non-O157 STEC cases.
The proportion of patients who developed hemolytic uremic syndrome (HUS) remained low. HUS was reported in 1.2 percent of STEC O157 cases and 1.1 percent of all reported non-O157 STEC cases. UKHSA also noted that the proportion of STEC O26 cases progressing to HUS declined to 5.7 percent in 2025 from 8.4 percent in 2024.
Two National STEC Outbreaks in 2025 Went Unsolved
Only two national STEC outbreaks involving 19 laboratory-confirmed cases were investigated in 2025, both caused by non-O157 STEC. One outbreak involved STEC O26 and the other STEC O145. Investigators were unable to identify a confirmed or suspected food vehicle for either outbreak.
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The STEC O145 outbreak represented a re-emergence of a strain previously linked to outbreaks involving 44 cases during 2022–2023 and 293 cases in 2024. Although earlier investigations had identified Apollo leaf lettuce as the likely vehicle in previous outbreaks, no source was identified for the 2025 cases.
Rising Trend of STEC Cases Eased in 2025
UKHSA said the relatively stable number of STEC notifications in 2025 marked a departure from the steady annual increases observed since 2021, when larger outbreaks contributed substantially to case counts. However, the agency noted that continued expansion of PCR testing in hospital laboratories is expected to improve detection of non-O157 STEC, which remains under-ascertained in England because molecular testing has not yet been adopted by all diagnostic laboratories.
