Research – France – Update on ongoing investigations into serious cases of haemolytic uraemic syndrome (HUS) in children. Reminder of food risk prevention recommendations. STEC E.coli

Sante Publique

Public Health France and the National Reference Center (CNR) Escherichia coli (Institut Pasteur – Paris), with its associated laboratory (Microbiology Laboratory of the Robert Debré Hospital – Paris), are continuing investigations concerning the increase in the number of cases haemolytic uremic syndrome (HUS) and severe Escherichia coli infection, reported since early February 2022.

Update and ongoing investigations

As of March 11, 2022, 26 cases of HUS or serious infection, linked to E. coli bacteria with similar characteristics, have been identified. These cases occurred in 9 regions of metropolitan France: New Aquitaine (6 cases), Hauts-de-France (5 cases), Ile-de-France (4 cases), Pays de la Loire (4 cases), Brittany (3 case), Bourgogne-Franche-Comté (1 case), Grand Est (1 case), Provence-Alpes-Côte-D’azur (1 case) and Auvergne-Rhône-Alpes (1 case). The sick children, aged 1 to 15 years with a median age of 8 years, presented symptoms between 01/18/2022 and 02/23/2022. Two children died. In addition, 22 additional cases are under investigation.

Public Health France, in conjunction with the CNR, the General Directorate for Food, the General Directorate for Competition, Consumption and the Repression of Fraud, and in coordination with the General Directorate for Health, are continuing investigations into all cases of pediatric HUS reported since January 1, 2022 on national territory in order to identify a possible common source of contamination and to put in place appropriate measures (for example withdrawal-recalls of incriminated products). 

At this stage, the epidemiological investigation has not made it possible to incriminate a particular source of contamination. The health authorities are therefore renewing the general recommendations for the prevention of food risks, in particular for children under 16 years of age.

Recommendations to prevent HUS

The E. coli responsible for HUS are present in the intestines of many ruminant animals (cows, calves, goats, sheep, deer, etc.) and are eliminated by the excrement which can then contaminate the environment (water, manure, soil) and foods. These bacteria tolerate cold well (survival in a refrigerator or freezer), but are destroyed by cooking.

The transmission of the bacterium can be avoided by simple gestures, in particular in children under 16 and the elderly:

  • hand washing should be systematic before meal preparation;
  • meats, and especially minced beef, but also minced meat preparations, must be well cooked through (and not pink through the core);
  • raw milk, cheeses made from raw milk and dairy products made from raw milk should not be consumed by children under 5 years of age; prefer cooked pressed cheeses (such as Emmental, Comté, Gruyère, Beaufort), processed cheese spreads and pasteurized milk cheeses;
  • flour-based preparations (pizza/cookie dough/cake/pie, etc.) should not be eaten raw or undercooked;
  • vegetables, salad, fruit and aromatic herbs, in particular those that are going to be eaten raw, must be carefully washed before consumption, after peeling if necessary;
  • raw foods should be kept separate from cooked or ready-to-eat foods;
  • cooked meals and leftover food must be quickly put in the refrigerator and sufficiently reheated and consumed quickly;
  • kitchen utensils (especially when they have previously been in contact with raw food), as well as work surfaces, must be thoroughly washed;
  • children should not drink untreated water (well water, torrent, etc.) and avoid swallowing it when swimming (lake, pond, etc.);
  • finally, it is necessary to avoid the contact of very young children (under 5 years old) with cows, calves, sheep, goats, deer, etc., and their environment; in case of contact with these animals, hand washing must be systematic.

The health authorities, who are monitoring the evolution of the situation on a daily basis, are fully mobilized to identify the source of this contamination and put in place the appropriate health measures as quickly as possible to avoid the occurrence of new cases. 

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