One person has died from an infection with Shiga toxin-producing E.coli (STEC) linked to a type of lettuce used in sandwich products.

Head of incidents at the Food Standards Agency (FSA), Darren Whitby, said the lettuce is the “likely cause” of the E.coli outbreak, which has seen 19 further cases confirmed.

The UK Health Security Agency (UKHSA) said it identified two individuals in England who died within 28 days of infection with the STEC outbreak strain.

Based on the information available from health service clinicians one of these deaths is likely linked to their STEC infection.

Both individuals had underlying medical conditions. The deaths occurred in May.

Currently, the total cases of STEC stand at 275 in the UK, with 182 in England, 58 in Scotland, 31 in Wales and four in Northern Ireland (evidence suggests they acquired their infection in England).

Earlier this month, a number of retailers including Aldi, Asda and Tesco, recalled pre-made sandwiches, wraps and salads amid E.coli concerns.

E.coli had not been detected in the products, but they were recalled as a precaution due to the “possible presence” of E.coli organisms.

Whitby said: “Earlier this month, we confirmed that several sandwich manufacturers had taken precautionary action to withdraw and recall various sandwiches, wraps, subs and rolls after food chain and epidemiological links enabled us to narrow down a wide range of foods to a type of lettuce used in sandwich products as the likely cause of the outbreak.

“This remains a complex investigation and we continue to work with the relevant businesses and the local authorities to ensure necessary steps are being taken to protect consumers.

“Although we are confident in the likely source of the outbreak being linked to lettuce, work continues to confirm this and identify the root cause of the outbreak with the growers, suppliers and manufacturers so that actions can be taken to prevent a re-occurrence.”

STEC infection

Incident director at UKHSA, Amy Douglas, said: “We’re pleased that fewer cases have been reported, however we still expect to see a few more cases linked to this outbreak as further samples are referred to us for testing.

“Symptoms of infections with STEC include severe and sometimes bloody diarrhoea, stomach cramps, vomiting and fever.

“While diarrhoea and vomiting can have a range of causes, there are simple steps you can take to reduce your risk and the risk of infecting others.”

Douglas said washing hands with soap and warm water and using disinfectants to clean surfaces will help stop any further spread of infection.

“If you are unwell, you should not prepare food for others while unwell and avoid visiting people in hospitals or care homes to avoid passing on the infection in these settings.

“Do not return to work, school or nursery until 48 hours after your symptoms have stopped. If you are concerned about your symptoms, follow NHS.UK guidance on when to seek help and the steps you can take to avoid further spread to family and friends.