E. coli O157 Outbreak in Flanders, Belgium: A Wake-Up Call for Nursing Homes
An alarming outbreak of E. coli O157 has struck nursing homes in Belgium’s Flanders region. Since mid-August 2025, dozens of residents and one staff member have fallen ill. The outbreak resulted in eight deaths and prompted urgent investigations into the source and scope of the contamination.
Scope of the Outbreak
Health authorities confirmed 48 cases across eight nursing homes in Flanders, all linked to the same strain of Shiga-toxin producing E. coli O157. The peak occurred between August 20 and 22, with the first infections reported around August 17. One staff member also became infected. Investigations extended to Brussels and Wallonia, where suspected cases and deaths have emerged. Brussels recorded an additional patient, now recovered, while Wallonia saw 14 more infections and one confirmed death. Total confirmed cases across regions reached 63.
Tracing the Source
Health agencies, including the Flemish Department of Care, the Federal Agency for the Safety of the Food Chain (FASFC), and Sciensano, Belgium’s public health institute, began comprehensive investigations. Inspectors visited affected nursing homes to collect leftover food samples and trace food supply chains. That work sought to identify common suppliers or food items distributed in all affected facilities. Samples sent to the national reference laboratory are expected to confirm or rule out suspected sources. Authorities emphasize that no new food-borne cases have emerged recently, suggesting human-to-human transmission may now be the primary cause of continuing illness.
Human Impact
Seven of the eight deaths occurred in Flanders; one occurred in Wallonia. Many of those affected were elderly and already in fragile health, making it difficult to determine whether E. coli was the direct cause of death or accelerated existing conditions. A single case in Brussels was reported around August 19; that individual recovered and no longer faced medical danger.
Why the Outbreak Still Matters
Shiga-toxin producing E. coli O157 can cause severe gastrointestinal illness, including bloody diarrhea and kidney failure due to hemolytic uremic syndrome (HUS). Nursing home residents face heightened risk because advanced age and preexisting conditions weaken their ability to recover. The clustering of infections tied to a single bacterial strain strongly suggests exposure to a contaminated food vehicle. That possibility raised concern because frozen or processed foods sometimes escape routine screening.
Authorities caution against jumping to conclusions. Early conclusions in Europe’s 2011 E. coli outbreak wrongly blamed tomatoes and cucumbers. That outbreak affected thousands and was eventually linked to contaminated sprouted seeds. Investigators emphasize the need for thorough, evidence-based analysis.
Public Health Measures Underway
Investigations include gathering historical consumption records and menus. Inspectors are assessing cleaning protocols, food handling practices, and supply disruptions. Authorities have increased screening in nursing homes to identify infections early. Enhanced infection prevention procedures aim to limit human-to-human spread. Nursing home staff are being briefed on identifying and isolating symptomatic residents quickly and maintaining high standards for hand hygiene. Communication with general practitioners and hospitals in affected regions ensures that suspected new cases receive prompt testing and treatment.
Lessons Learned
This outbreak underscores the importance of prompt, coordinated responses in institutional settings. Shared food supply chains across multiple facilities can lead to simultaneous exposure. Rigorous testing and traceability are vital in elderly care facilities. Public health agencies reiterate that safe food handling, supplier vetting, and rapid detection are necessary to protect vulnerable populations. Outbreaks among the institutionalized elderly often result in more severe outcomes and sometimes death. Transparent communication and evidence-based response play key roles in managing public trust and containing outbreaks.
Final Note
The E. coli O157 outbreak in Belgian nursing homes during September 2025 reflects a serious and tragic crisis. With dozens of cases and eight deaths recorded, the event highlights the vulnerability of long-term care settings to foodborne pathogens. Authorities are investigating suspected food-associated contamination while taking steps to prevent further spread. Lessons from this incident will inform future prevention strategies and strengthen protocols for food safety and infection control in nursing homes across Europe and beyond.
