A global research team led by Dr Victor Oluwatomiwa Ajekiigbe, a public health researcher, has warned that consumer behaviour, unsafe fast-food preparation practices, and poor hygiene awareness are contributing to recurring Escherichia coli (E. coli) outbreaks and therefore called for stronger collaboration among food businesses, regulators, and the public to reduce the burden of foodborne diseases.
The warning is based on a new scientific review led by Dr Victor Oluwatomiwa Ajekiigbe, a medical doctor, public health researcher, and research leader at Imperial Research Academy and Helix Biogen Institute, together with an international team of researchers.
The study examines how modern lifestyles and increasing dependence on fast food have changed eating habits while exposing consumers to greater risks of bacterial contamination.
Although most E. coli strains naturally live in the human digestive system without causing harm, the researchers noted that dangerous strains, such as E. coli O157:H7, can cause severe illness, including bloody diarrhoea, kidney failure, and, in some cases, death.
According to Dr Ajekiigbe and his research team, the rapid growth of the fast-food industry-driven by urbanisation, busy work schedules, and demand for convenience-has created new food safety challenges. Improper cooking, poor hygiene among food handlers, cross-contamination, and inadequate food storage remain major causes of E. coli transmission.
The research found that contaminated ingredients can enter the food chain at several stages, from farms and processing plants to restaurant kitchens. Even small amounts of harmful bacteria can trigger widespread outbreaks because of the low infectious dose of some E. coli strains.
The study reviewed several major outbreaks over the past four decades, including the 1993 Jack in the Box hamburger outbreak, the 2011 European outbreak linked to contaminated fenugreek sprouts, the 2018 romaine lettuce outbreak, and the 2024 McDonald’s outbreak linked to slivered onions used in Quarter Pounder burgers.
The 2024 outbreak affected 104 people across 14 U.S. states, leading to 34 hospitalisations, four cases of severe kidney complications, and one death. Investigators traced the contamination to fresh onions supplied to affected restaurants.
Dr Ajekiigbe said the findings highlight the importance of strengthening food safety systems, improving hygiene practices, and increasing public awareness to reduce the risk of foodborne disease outbreaks.
The research team said these outbreaks show how contaminated ingredients and weak food safety controls can quickly develop into major public health emergencies.
Beyond industry practices, the study found that consumer behaviour also plays an important role in both the spread and prevention of foodborne diseases. Following major outbreaks, many consumers avoid affected food products, choose restaurants with stronger food safety records, and pay closer attention to food labels and hygiene standards.
However, Dr Ajekiigbe and his colleagues cautioned that misinformation on social media can affect public understanding of food safety, leading to unnecessary panic or false confidence in products believed to be safer.
The researchers said preventing future E. coli outbreaks requires shared responsibility. They recommended that fast-food businesses strengthen hygiene practices, maintain proper cooking temperatures, prevent cross-contamination, and implement recognised food safety systems. Consumers should also practice good hand hygiene, cook food thoroughly, prevent cross-contamination at home, and choose restaurants with good food safety standards.
The research team also called for stronger enforcement of food safety regulations, particularly in developing countries where weak sanitation systems and limited regulatory oversight increase contamination risks. They recommended regular inspections, improved supplier monitoring, mandatory food safety training for food handlers, and rapid product recalls when contamination is suspected.
Dr Ajekiigbe and his team concluded that foodborne diseases remain a major global public health challenge. Citing estimates from the World Health Organisation, they noted that about 600 million people develop foodborne illnesses each year, resulting in approximately 420,000 deaths. They stressed that reducing future E. coli outbreaks will require stronger food safety practices, effective regulation, and greater public awareness.