The chair of the Assembly’s health committee has launched a stinging attack on public health authorities who adopted a “hit and miss” approach to what has become Northern Ireland's biggest ever E coli outbreak.
As the number of victims from the outbreak rises speculation surrounds a restaurant in north Belfast.
West Belfast MLA Sue Ramsey told the Department of Health’s deputy chief medical officer, Dr Elizabeth Mitchell: “Some people are calling it hit and miss.”
South Down MLA Jim Wells also asked if something was “missed” in tests carried out at Flicks restaurant in August, after four E coli cases were linked back to the north Belfast eaterie.
As of 3pm yesterday, there were 29 confirmed cases and 202 probable cases presenting symptoms of E coli 0157. There are no confirmed cases in children.
Fifteen people have been hospitalised — most have been discharged.
The outbreak first came to light last Thursday when three family members who had come down with suspected E coli 0157 on October 4 were linked to a second case highlighted that day. All the individuals had eaten at Flicks.
The restaurant closed voluntarily at 6.30pm that evening.
Sue Ramsey said: “Living in the real world, if there is an outbreak of E coli in August, and now there’s an outbreak but we are not able to identify the strain, maybe it's a lesson that people need to learn from this — that we do not have that hit and miss approach.”
E coli has yet to be detected in Flicks restaurant — making the source of the outbreak unclear.
Dr Carolyn Harper, director of the Public Health Agency, said: "The PHA has activated a full public health response to this outbreak and the situation is being managed and monitored very closely.
Investigations are continuing and final conclusions will emerge when all cases have been identified and analysed to identify any common links. The management of Flicks are cooperating with the investigation.
The PHA has advised that anyone who ate at Flicks restaurant since 24 September and has symptoms of diarrhoea (especially bloody diarrhoea) and/or abdominal pain should contact their GP urgently for medical advice.
Dr Harper added: "It is vital that everyone follows some simple rules to prevent the spread of E. coli – not just those with symptoms, but everyone should wash their hands after using the toilet and before eating or preparing food.
"Raw and cooked food should be kept completely separate, raw meat should be cooked through and vegetables and fruit should be washed thoroughly before eating. Escherichia coli bacteria are commonly found in the intestines of humans and animals. There are many different types of E. coli, and while some live in the intestine quite harmlessly, others may cause a variety of diseases. The bacterium is found in faeces and can survive in the environment.
“Symptoms caused by E. coli O157 can include diarrhoea, which can range from mild to profuse watery or bloody diarrhoea, tummy cramps, nausea or vomiting.”
Belfast City Council — which has emergency powers to close a restaurant through a court order where there is an imminent risk to public health — has said that “no such risk was established” at Flicks restaurant in August.
A spokeswoman said: “A thorough inspection of the premises was carried out, with more than 30 food and environmental samples taken. All of these samples were tested and found to be free of E.coli 0157.”
There are various types of E.coli 0157 and the PHA confirmed yesterday that the type of E. coli 0157 in cases in October is different from the type found in August cases associated with the same restaurant.
These results are from a first phase of typing tests which showed the cases in August to be Type 8. The confirmed cases in October are Type 54. The PHA said it is too early to draw definitive conclusions at this stage.
The four cases of E. coli O157 in August, linked to Flicks restaurant, were investigated thoroughly at the time. All tests on the restaurant were negative. Further environmental health inspections were conducted, all of which were satisfactory, and enhanced surveillance to monitor for cases was also put in place. The current cases came to light through that enhanced monitoring.
There were no cases of E. coli associated with Flicks restaurant in the six week period between the end of August and 9 October.