Virulent and Multidrug-Resistant STEC Non-O157:H7 in Raw Milk in Khyber Pakhtunkhwa Pakistan: The Need for Proper Quality Surveillance and Assurance Plans

Safir Ullah; Sana Ullah; Muhammad Jamil Khan

doi:doi:10.11648/j.ajnhs.20250601.12

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Virulent and Multidrug-Resistant STEC Non-O157:H7 in Raw Milk in Khyber Pakhtunkhwa Pakistan: The Need for Proper Quality Surveillance and Assurance Plans

Safir Ullah^*

, Sana Ullah, Muhammad Jamil Khan

Published in American Journal of Nursing and Health Sciences (Volume 6, Issue 1)

Received: 27 March 2025 Accepted: 16 April 2025 Published: 9 May 2025

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Abstract

Shiga toxin-producing Escherichia coli (STEC), particularly the non-O157:H7 strains, present a major and growing public health threat in Khyber Pakhtunkhwa, Pakistan. This region, like many others in the country, has a high rate of raw milk consumption, which is often unpasteurized. Raw milk serves as a potential vehicle for STEC transmission due to its susceptibility to contamination at various stages of production, handling, and distribution. These strains of E. coli are highly virulent, and their ability to produce Shiga toxins makes them particularly unsafe. Infections caused by STEC can result in severe foodborne illnesses, such as hemolytic uremic syndrome (HUS), which primarily affects young children and the elderly. A key concern adjoining STEC is their increasing resistance to multiple antibiotics. Multidrug resistance complicates the treatment process, and increasing the possibility of complications. Moreover, these pathogens often go undetected due to inadequate testing facilities and limited public awareness, especially in rural and semi-urban areas. Given these risks, there is an urgent need to implement effective quality surveillance and assurance strategies in the dairy sector. Regular monitoring and microbial testing of milk at both the farm and market levels are essential to detect contamination early. In addition, promoting better hygiene practices among dairy workers and ensuring the cleanliness of equipment can significantly reduce the risk of contamination. Pasteurization of milk should be strongly encouraged to reduce pathogenic microorganisms before consumption. In addition, antibiotic stewardship must be emphasized in dairy farming to prevent the misuse of antibiotics, which contributes to the rise of resistant bacterial strains. By adopting these preventative measures and strengthening regulatory oversight, the health risks associated with STEC in raw milk can be significantly reduced, ultimately safeguarding public health in the region.

Published in	American Journal of Nursing and Health Sciences (Volume 6, Issue 1)
DOI	10.11648/j.ajnhs.20250601.12
Page(s)	16-18
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

STEC, Raw Milk, HUS, KPK

References

[1]	Kaper, J. B., et al. (2004). Enterohemorrhagic Escherichia coli: An emerging foodborne pathogen. Infectious Disease Clinics of North America, 18(3), 1-35.
[2]	Nataro, J. P., &Kaper, J. B. (1998). Diarrheagenic Escherichia coli. Clinical Microbiology Reviews, 11(1), 142-201.
[3]	Scallan, E., et al. (2011). Foodborne illness acquired in the United States—major pathogens. Emerging Infectious Diseases, 17(1), 7-15.
[4]	Jayarao, B. M., et al. (2006). Prevalence of Escherichia coli O157:H7 in milk and milk products. Journal of Dairy Science, 89(3), 787-795.
[5]	Bielaszewska, M., et al. (2012). Shiga toxin-producing Escherichia coli in foodborne outbreaks. Emerging Infectious Diseases, 18(6), 918-926.
[6]	Munoz, M. A., et al. (2010). Shiga toxin-producing E. coli in raw milk and its public health implications. Journal of Dairy Science, 93(3), 1020-1030.
[7]	Eppinger, M., et al. (2011). Genome sequences of the O26 and O111 Shiga toxin-producing Escherichia coli strains. PLoS One, 6(4), e19348.
[8]	Chakraborty, S., et al. (2011). Prevalence of non-O157 Shiga toxin-producing Escherichia coli in cattle in India. Journal of Food Protection, 74(10), 1725-1730.
[9]	He, D., et al. (2017). Antibiotic resistance in Shiga toxin-producing Escherichia coli. Microorganisms, 5(1), 4.
[10]	Marshall, B. M., & Levy, S. B. (2011). Food animals and antimicrobial resistance. Veterinary Research, 42(1), 1-14.

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Ullah, S., Ullah, S., Khan, M. J. (2025). Virulent and Multidrug-Resistant STEC Non-O157:H7 in Raw Milk in Khyber Pakhtunkhwa Pakistan: The Need for Proper Quality Surveillance and Assurance Plans. American Journal of Nursing and Health Sciences, 6(1), 16-18. https://doi.org/10.11648/j.ajnhs.20250601.12

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ACS Style

Ullah, S.; Ullah, S.; Khan, M. J. Virulent and Multidrug-Resistant STEC Non-O157:H7 in Raw Milk in Khyber Pakhtunkhwa Pakistan: The Need for Proper Quality Surveillance and Assurance Plans. Am. J. Nurs. Health Sci. 2025, 6(1), 16-18. doi: 10.11648/j.ajnhs.20250601.12

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AMA Style

Ullah S, Ullah S, Khan MJ. Virulent and Multidrug-Resistant STEC Non-O157:H7 in Raw Milk in Khyber Pakhtunkhwa Pakistan: The Need for Proper Quality Surveillance and Assurance Plans. Am J Nurs Health Sci. 2025;6(1):16-18. doi: 10.11648/j.ajnhs.20250601.12

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@article{10.11648/j.ajnhs.20250601.12,
  author = {Safir Ullah and Sana Ullah and Muhammad Jamil Khan},
  title = {Virulent and Multidrug-Resistant STEC Non-O157:H7 in Raw Milk in Khyber Pakhtunkhwa Pakistan: The Need for Proper Quality Surveillance and Assurance Plans
},
  journal = {American Journal of Nursing and Health Sciences},
  volume = {6},
  number = {1},
  pages = {16-18},
  doi = {10.11648/j.ajnhs.20250601.12},
  url = {https://doi.org/10.11648/j.ajnhs.20250601.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajnhs.20250601.12},
  abstract = {Shiga toxin-producing Escherichia coli (STEC), particularly the non-O157:H7 strains, present a major and growing public health threat in Khyber Pakhtunkhwa, Pakistan. This region, like many others in the country, has a high rate of raw milk consumption, which is often unpasteurized. Raw milk serves as a potential vehicle for STEC transmission due to its susceptibility to contamination at various stages of production, handling, and distribution. These strains of E. coli are highly virulent, and their ability to produce Shiga toxins makes them particularly unsafe. Infections caused by STEC can result in severe foodborne illnesses, such as hemolytic uremic syndrome (HUS), which primarily affects young children and the elderly. A key concern adjoining STEC is their increasing resistance to multiple antibiotics. Multidrug resistance complicates the treatment process, and increasing the possibility of complications. Moreover, these pathogens often go undetected due to inadequate testing facilities and limited public awareness, especially in rural and semi-urban areas. Given these risks, there is an urgent need to implement effective quality surveillance and assurance strategies in the dairy sector. Regular monitoring and microbial testing of milk at both the farm and market levels are essential to detect contamination early. In addition, promoting better hygiene practices among dairy workers and ensuring the cleanliness of equipment can significantly reduce the risk of contamination. Pasteurization of milk should be strongly encouraged to reduce pathogenic microorganisms before consumption. In addition, antibiotic stewardship must be emphasized in dairy farming to prevent the misuse of antibiotics, which contributes to the rise of resistant bacterial strains. By adopting these preventative measures and strengthening regulatory oversight, the health risks associated with STEC in raw milk can be significantly reduced, ultimately safeguarding public health in the region.
},
 year = {2025}
}

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TY  - JOUR
T1  - Virulent and Multidrug-Resistant STEC Non-O157:H7 in Raw Milk in Khyber Pakhtunkhwa Pakistan: The Need for Proper Quality Surveillance and Assurance Plans

AU  - Safir Ullah
AU  - Sana Ullah
AU  - Muhammad Jamil Khan
Y1  - 2025/05/09
PY  - 2025
N1  - https://doi.org/10.11648/j.ajnhs.20250601.12
DO  - 10.11648/j.ajnhs.20250601.12
T2  - American Journal of Nursing and Health Sciences
JF  - American Journal of Nursing and Health Sciences
JO  - American Journal of Nursing and Health Sciences
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EP  - 18
PB  - Science Publishing Group
SN  - 2994-7227
UR  - https://doi.org/10.11648/j.ajnhs.20250601.12
AB  - Shiga toxin-producing Escherichia coli (STEC), particularly the non-O157:H7 strains, present a major and growing public health threat in Khyber Pakhtunkhwa, Pakistan. This region, like many others in the country, has a high rate of raw milk consumption, which is often unpasteurized. Raw milk serves as a potential vehicle for STEC transmission due to its susceptibility to contamination at various stages of production, handling, and distribution. These strains of E. coli are highly virulent, and their ability to produce Shiga toxins makes them particularly unsafe. Infections caused by STEC can result in severe foodborne illnesses, such as hemolytic uremic syndrome (HUS), which primarily affects young children and the elderly. A key concern adjoining STEC is their increasing resistance to multiple antibiotics. Multidrug resistance complicates the treatment process, and increasing the possibility of complications. Moreover, these pathogens often go undetected due to inadequate testing facilities and limited public awareness, especially in rural and semi-urban areas. Given these risks, there is an urgent need to implement effective quality surveillance and assurance strategies in the dairy sector. Regular monitoring and microbial testing of milk at both the farm and market levels are essential to detect contamination early. In addition, promoting better hygiene practices among dairy workers and ensuring the cleanliness of equipment can significantly reduce the risk of contamination. Pasteurization of milk should be strongly encouraged to reduce pathogenic microorganisms before consumption. In addition, antibiotic stewardship must be emphasized in dairy farming to prevent the misuse of antibiotics, which contributes to the rise of resistant bacterial strains. By adopting these preventative measures and strengthening regulatory oversight, the health risks associated with STEC in raw milk can be significantly reduced, ultimately safeguarding public health in the region.

VL  - 6
IS  - 1
ER  -

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Author Information

Safir Ullah

Veterinary Research Diseases Investigation Center (VR&DIC) Chitral, Khyber Pakhtunkhwa, Pakistan

Contact Email

http://orcid.org/0000-0002-9622-5217
Sana Ullah

Veterinary Research Diseases Investigation Center (VR&DIC) Chitral, Khyber Pakhtunkhwa, Pakistan

Contact Email
Muhammad Jamil Khan

Department of Allied Health Sciences, Iqra National University, Phase Two Hayatabad, Peshawar, Khyber Pakhtunkhwa, Pakistan

Contact Email

http://orcid.org/0000-0002-0721-2191

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APA Style

Ullah, S., Ullah, S., Khan, M. J. (2025). Virulent and Multidrug-Resistant STEC Non-O157:H7 in Raw Milk in Khyber Pakhtunkhwa Pakistan: The Need for Proper Quality Surveillance and Assurance Plans. American Journal of Nursing and Health Sciences, 6(1), 16-18. https://doi.org/10.11648/j.ajnhs.20250601.12

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ACS Style

Ullah, S.; Ullah, S.; Khan, M. J. Virulent and Multidrug-Resistant STEC Non-O157:H7 in Raw Milk in Khyber Pakhtunkhwa Pakistan: The Need for Proper Quality Surveillance and Assurance Plans. Am. J. Nurs. Health Sci. 2025, 6(1), 16-18. doi: 10.11648/j.ajnhs.20250601.12

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AMA Style

Ullah S, Ullah S, Khan MJ. Virulent and Multidrug-Resistant STEC Non-O157:H7 in Raw Milk in Khyber Pakhtunkhwa Pakistan: The Need for Proper Quality Surveillance and Assurance Plans. Am J Nurs Health Sci. 2025;6(1):16-18. doi: 10.11648/j.ajnhs.20250601.12

Copy | Download

@article{10.11648/j.ajnhs.20250601.12,
  author = {Safir Ullah and Sana Ullah and Muhammad Jamil Khan},
  title = {Virulent and Multidrug-Resistant STEC Non-O157:H7 in Raw Milk in Khyber Pakhtunkhwa Pakistan: The Need for Proper Quality Surveillance and Assurance Plans
},
  journal = {American Journal of Nursing and Health Sciences},
  volume = {6},
  number = {1},
  pages = {16-18},
  doi = {10.11648/j.ajnhs.20250601.12},
  url = {https://doi.org/10.11648/j.ajnhs.20250601.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajnhs.20250601.12},
  abstract = {Shiga toxin-producing Escherichia coli (STEC), particularly the non-O157:H7 strains, present a major and growing public health threat in Khyber Pakhtunkhwa, Pakistan. This region, like many others in the country, has a high rate of raw milk consumption, which is often unpasteurized. Raw milk serves as a potential vehicle for STEC transmission due to its susceptibility to contamination at various stages of production, handling, and distribution. These strains of E. coli are highly virulent, and their ability to produce Shiga toxins makes them particularly unsafe. Infections caused by STEC can result in severe foodborne illnesses, such as hemolytic uremic syndrome (HUS), which primarily affects young children and the elderly. A key concern adjoining STEC is their increasing resistance to multiple antibiotics. Multidrug resistance complicates the treatment process, and increasing the possibility of complications. Moreover, these pathogens often go undetected due to inadequate testing facilities and limited public awareness, especially in rural and semi-urban areas. Given these risks, there is an urgent need to implement effective quality surveillance and assurance strategies in the dairy sector. Regular monitoring and microbial testing of milk at both the farm and market levels are essential to detect contamination early. In addition, promoting better hygiene practices among dairy workers and ensuring the cleanliness of equipment can significantly reduce the risk of contamination. Pasteurization of milk should be strongly encouraged to reduce pathogenic microorganisms before consumption. In addition, antibiotic stewardship must be emphasized in dairy farming to prevent the misuse of antibiotics, which contributes to the rise of resistant bacterial strains. By adopting these preventative measures and strengthening regulatory oversight, the health risks associated with STEC in raw milk can be significantly reduced, ultimately safeguarding public health in the region.
},
 year = {2025}
}

Copy | Download

TY  - JOUR
T1  - Virulent and Multidrug-Resistant STEC Non-O157:H7 in Raw Milk in Khyber Pakhtunkhwa Pakistan: The Need for Proper Quality Surveillance and Assurance Plans

AU  - Safir Ullah
AU  - Sana Ullah
AU  - Muhammad Jamil Khan
Y1  - 2025/05/09
PY  - 2025
N1  - https://doi.org/10.11648/j.ajnhs.20250601.12
DO  - 10.11648/j.ajnhs.20250601.12
T2  - American Journal of Nursing and Health Sciences
JF  - American Journal of Nursing and Health Sciences
JO  - American Journal of Nursing and Health Sciences
SP  - 16
EP  - 18
PB  - Science Publishing Group
SN  - 2994-7227
UR  - https://doi.org/10.11648/j.ajnhs.20250601.12
AB  - Shiga toxin-producing Escherichia coli (STEC), particularly the non-O157:H7 strains, present a major and growing public health threat in Khyber Pakhtunkhwa, Pakistan. This region, like many others in the country, has a high rate of raw milk consumption, which is often unpasteurized. Raw milk serves as a potential vehicle for STEC transmission due to its susceptibility to contamination at various stages of production, handling, and distribution. These strains of E. coli are highly virulent, and their ability to produce Shiga toxins makes them particularly unsafe. Infections caused by STEC can result in severe foodborne illnesses, such as hemolytic uremic syndrome (HUS), which primarily affects young children and the elderly. A key concern adjoining STEC is their increasing resistance to multiple antibiotics. Multidrug resistance complicates the treatment process, and increasing the possibility of complications. Moreover, these pathogens often go undetected due to inadequate testing facilities and limited public awareness, especially in rural and semi-urban areas. Given these risks, there is an urgent need to implement effective quality surveillance and assurance strategies in the dairy sector. Regular monitoring and microbial testing of milk at both the farm and market levels are essential to detect contamination early. In addition, promoting better hygiene practices among dairy workers and ensuring the cleanliness of equipment can significantly reduce the risk of contamination. Pasteurization of milk should be strongly encouraged to reduce pathogenic microorganisms before consumption. In addition, antibiotic stewardship must be emphasized in dairy farming to prevent the misuse of antibiotics, which contributes to the rise of resistant bacterial strains. By adopting these preventative measures and strengthening regulatory oversight, the health risks associated with STEC in raw milk can be significantly reduced, ultimately safeguarding public health in the region.

VL  - 6
IS  - 1
ER  -

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