Scotland Updates Foodborne Illness Reduction Strategy; Challenged by Highest STEC O157 Rate in UK
Food Standards Scotland (FSS) has outlined its plans to reduce the national incidence of foodborne illness over the next three years, prioritizing Campylobacter, Listeria monocytogenes, and Shiga toxin-producing Escherichia coli (STEC), as well as its related research objectives.
In a September FSS Board Meeting paper, the agency provided an update on the status of foodborne illness in Scotland and its work to reduce pathogen transmission through the food chain. FSS’ foodborne illness strategy focuses on five pathogens responsible for the greatest disease burden: Campylobacter, Salmonella, STEC, L. monocytogenes, and norovirus.
Foodborne Illness Incidence Stayed Stable Over Last Ten Years
Laboratory-reported cases of infectious intestinal disease caused by common foodborne pathogens have remained relatively stable in Scotland from 2015 to 2024, excluding the COVID-19 pandemic period. Campylobacter accounted for the greatest number of reported cases, averaging approximately 6,000 annually, while the country sees approximately 20 listeriosis cases per year. For the ten-year period, the average annual number of norovirus and Salmonella infections recorded in Scotland were approximately 1,400 and 700, respectively. Total STEC cases ranged between 215 and 460 cases per year (approximately 300 annual cases on average).
Progress Needed on Reducing Campylobacter, STEC Infections
Although the UK food industry has reduced Campylobacter contamination on fresh chicken, FSS said human infections have not declined correspondingly. Previous FSS-funded source attribution studies indicated that the majority of clinical Campylobacter cases in Scotland are linked to chicken. FSS and the UK Food Standards Agency (FSA) are working to better understand poultry and non-poultry transmission sources and identify effective interventions.
Additionally, Scotland continues to report the highest rate of STEC O157 infection in the UK, and non-O157 infections have increased in recent years, exceeding O157 cases in Scotland since 2023. Reported STEC cases peaked in 2022 due to two non-foodborne E. coli O157 outbreaks in nurseries (440 total cases), and again in 2024 during a national E. coli O145 outbreak associated with salad leaves (460 total cases). FSS said that ruminant-derived foods and environmentally contaminated fresh produce are an important STEC transmission risk; although STEC O157 prevalence in cattle is similar across Great Britain, Scottish herds more commonly carry strains associated with severe human illness, which may contribute to Scotland's higher infection rates.
FSS has been working with Public Health Scotland (PHS) on a study linking patient epidemiological, exposure, clinical, hospitalization, and prescribing data with genomic information from STEC isolates collected during 2015–2023. The agency plans to publish epidemiological reports on STEC and Salmonella infections in early 2027.
Scotland Decides Not to Pursue Its Own Pathogen Surveillance Thresholds
FSS also decided against pursuing Scotland-specific pathogen surveillance thresholds—used to flag increases in reported infectious intestinal diseases and determine when investigation or action may be warranted in the country—and will instead continue to use the UK-wide threshold approach.
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In 2023, the FSS Board had agreed to explore establishing Scotland-specific thresholds for foodborne pathogens. After consultation with PHS and FSA, FSS concluded that Scotland-specific thresholds “would not be appropriate” because of the integrated UK food supply chain and difficulties identifying statistically meaningful changes for pathogens with low incidence, such as L. monocytogenes.
FSS Sets Foodborne Illness Research Priorities Amid Reduced Budget
Over the next three years, FSS plans to review interventions used on Scottish poultry farms and at slaughter to control Campylobacter. The agency also intends to conduct research to rank foods associated with L. monocytogenes risk and develop guidance on “safer alternatives” for high-risk consumers.
Additional priorities include research on consumer handling and preparation of raw pet food, which FSS identified as a high-risk product for foodborne pathogens and antimicrobial resistance (AMR); continued food safety messaging for at-risk populations; and further development of technical guidance and tools for priority food sectors.
FSS also plans to continue supporting a One Health approach to pathogen surveillance. Its work under the four-year UK Pathogen Surveillance in Agriculture, Food, and the Environment Program (PATH-SAFE), which concluded in 2025, generated whole genome sequencing (WGS) data for approximately 6,000 E. coli isolates from animal, environmental, food, and clinical sources in Scotland. The data have supported the development of artificial intelligence (AI)-powered models intended to help predict pathogen sources and identify preventive risk management interventions.
FSS acknowledged that its planned activities will need to be prioritized amid a reduced research budget. The agency said future investments will be evaluated based on public health risk, areas where FSS can make a unique contribution, and opportunities to use evidence and expertise from partner organizations.
