The aim of public health management of VTEC cases is to undertake prompt action to prevent further cases associated with a primary source and interrupt secondary transmission. The VTEC operational manual and VTEC support document provide detailed guidance to support appropriate action by HPUs to protect public health from the consequences of infection with VTEC.

VTEC reporting and notification

Laboratories are required to notify presumptive isolates of VTEC to local HPUs (effective since 1st October 2010).
HUS, infectious bloody diarrhoea and food poisoning are notifiable by registered medical practitioners under the Health Protection (Notification) Regulations 2010 .
A VTEC Enhanced Surveillance Questionnaire should be completed by the HPU or environmental health officers for presumptive cases of VTEC and sent to the VTEC team at Colindale.

Public health investigations aim to:

• Suggest a possible source or vehicle of infection;

• Identify any associated cases resulting from secondary spread or a common exposure;

• Identify any vulnerable contacts;

• Advise source-specific control measures, and

• Advise control of secondary spread.

A detailed case history for the seven days prior to illness is to be obtained using the VTEC Enhanced Surveillance Questionnaire.The questionnaire includes information on demographic details, clinical condition and laboratory investigations, potential sources or vehicles of infection (e.g. travel, food, water, animals, environmental), household or other close contacts, and whether they are in high-risk groups. Investigations should enable HPUs to determine if there are other associated cases or possible links.

Control measures

Cases and contacts should be given appropriate verbal and written information about VTEC and good hygiene practice.
Control of the source of infection is dependent on what source is suspected. Details for open farms and nursery/school settings are provided in the VTEC operational manual and in Guidance on Infection Control in Schools and other Child Care Settings (PDF, 163 KB). These documents also include guidance regarding exclusions, microbiological clearance and other infection control issues.