Category Archives: HUS

USA – Researchers say raw milk infected people in Tennessee; one baby developed kidney failure

Food Safety News

A new report describes how raw, unpasteurized milk in Tennessee likely caused infections in people, including infants, one of whom developed kidney failure.

The report from the Center for Infectious Disease Research & Policy (CIDRAP) discusses two babies who developed E. Coli infections after being fed raw milk from a cow-sharing arrangement in Tennessee.

Often called “herd-shares,” such arrangements get around bans on raw milk sales by legally allowing people to buy part of a herd or of a single animal so that they can consume unpasteurized milk. Participants in herd-share operations pay a farmer to care for and milk the animals.

The babies discussed in the new CIDRAP report developed diarrhea between July 25 and Aug. 1, 2022. Testing revealed Shiga toxin-producing E. coli (STEC). Both households received raw milk from participants in the same cow share. The baby who developed kidney failure (hemolytic uremic syndrome) was hospitalized for 27 days.

Research – Italy sees most HUS cases for decades – STEC E.coli

Food Safety News

Italy has reported the highest annual total of Hemolytic Uremic Syndrome (HUS) cases since records began.

From January to December 2022, 91 cases were recorded. This is the most observed in a single year since the start of surveillance in 1988. HUS is a severe complication associated with E. coli infection that causes kidney failure and can result in lifelong, serious health problems and death.

The number is still lower than in France, which recorded 128 HUS cases in 2021. This was the lowest figure since 2017 and was down from 167 in 2020. Data for 2022 is not yet available but a rise is expected due to an outbreak linked to Nestlé Buitoni Fraîch’Up brand frozen pizzas.


Flour is a natural product and a valuable foodstuff.

However, Shiga toxin-producing Escherichia coli (STEC) were detected in multiple flour samples (wheat, spelt and rye) during routine food monitoring in Germany in 2018. Escherichia (E.) coli are bacteria that occur naturally in the intestines of animals and humans and the detection of E. coli in food is a strong indicator of a faecal contamination.

Bacteria from the faeces or stool can be shed into the environment and subsequently contaminate various animal- and plant-based foods. Direct transmission between animals and humans and from humans to humans are also possible. Certain toxin producing variants of E. coli can cause serious diseases in animals and humans.

E. coli variants that can form Shiga toxins are of particular importance for humans. These are abbreviated as STEC. STEC, which cause diseases in humans, are referred to as entero-hemorrhagic E. coli (EHEC). The symptoms of an infection with STEC are initially gastrointestinal.

The possible severity of the disease ranges from watery to bloody diarrhea. In adults, the course of the disease can also proceed without symptoms. A particularly severe complication is the hemolytic-uremic syndrome (HUS). HUS is a disease that manifests in acute kidney failure, blood coagulation disorders and destruction of the red blood cells and can lead to death in individual cases. This form of the disease affects particularly sensitive groups of people, such as young chil-dren.

Research – The European Scientific Conference on Applied Infectious Disease Epidemiology (ESCAIDE)



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Page 72  – International outbreak of Salmonella Typhimurium linked to a chocolate factory in 2022: Belgian findings

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Page 194 – Cholera Outbreak Investigation, Kamarhati-Municipality, North-24-Parganas District, West Bengal, India 2021

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Page 212 – Outbreak of Legionnaires’ disease linked to unregistered cooling towers, West Midlands, England, July-September 2020



Research – France – Haemolytic-uremic syndrome surveillance data in 2021

Sante Publique

In 2021, the overall annual incidence of pediatric HUS was lower than that observed for the past four years.

Even if this decrease in annual incidence is observed in children under three years of age, the incidence in this age group remains high and much higher than that observed in older children. As every year, regional heterogeneity is observed. In 2021, the Bourgogne-France-Compté and Auvergne-Rhône-Alpes regions were particularly affected.

In 2021, serogroup O26 remains the majority, followed by serogroup O80. After several years of decrease in the share of cases due to O157, a slight increase in the number of O157 strains is observed in 2021.

Research – Europe sees large drop in E. coli infections in 2020

Food Safety News

There was a big fall in the number of Shiga toxin-producing E. coli (STEC) infections in Europe in 2020, according to recently published data.

In 2020, 4,824 confirmed STEC infections were reported. This is down from 8,339 in 2019. STEC infection is mainly acquired through consumption of contaminated food or water and contact with animals or their feces.

Data on STEC infections were reported by 29 countries. Notification is voluntary in Belgium, France, Luxembourg, and Spain or based on another type of system in Italy.

Germany with 1,409 and Ireland with 734 had the most infections, accounting for 44 percent of all cases. The highest country-specific notification rates were in Ireland, Malta, Denmark, and Norway.

Research – Sporadic Occurrence of Enteroaggregative Shiga Toxin–Producing Escherichia coli O104:H4 Similar to 2011 Outbreak Strain


We describe the recent detection of 3 Shiga toxin–producing enteroaggregative Escherichia coli O104:H4 isolates from patients and 1 from pork in the Netherlands that were genetically highly similar to isolates from the 2011 large-scale outbreak in Europe. Our findings stress the importance of safeguarding food supply production chains to prevent future outbreaks.

Shiga toxin–producing Escherichia coli (STEC) is a zoonotic pathogen that causes illness ranging from mild diarrhea to haemolytic uremic syndrome and death. During 2011, an exceptionally large outbreak caused by serotype O104:H4 STEC occurred in Europe, mainly in Germany and France, that was associated with sprouts grown from imported fenugreek seeds (1). Besides the ability to produce Shiga toxin, specifically stx2a, the strain had the genetic characteristics and phylogenetic backbone of an enteroaggregative E. coli (EAEC) pathotype (2) but lacked other classical STEC virulence markers eae and hlyA (3). In addition, the outbreak strain carried plasmid-borne blaCTX-M-15 and blaTEM-1 genes. The epidemiologic investigation revealed that a contaminated batch of fenugreek seeds imported into the European Union from Egypt was the most probable source of the pathogen causing the outbreak (4).

After the 2011 outbreak in Germany and France, only a few sporadic cases of infection with Shiga toxin–producing EAEC O104:H4 were reported, most related to travel to Turkey or North Africa (5–8). We describe the sporadic occurrence of Shiga toxin–producing EAEC O104:H4 isolates in the Netherlands, originating from 2 clinical cases from 2019 and 2020 and 1 food isolate from 2017. In addition, we report a clinical case from Austria in 2021.

French E. coli outbreak linked to cucumbers from Belgium

Food Safety News

More than 30 people were sick in France in late 2021 as part of an outbreak traced to contaminated cucumbers.

In September 2021, the Hauts-de-France Regional Health Agency was notified of a suspected foodborne outbreak among students in the Lille area. Two hospitalized children were diagnosed with hemolytic uremic syndrome (HUS). HUS is a severe complication associated with E. coli infection that causes kidney failure. The agency asked Santé publique France for support in investigating the incident.

In total, 35 cases of gastroenteritis, half of whom had bloody diarrhea and fever, were identified. Ten people were hospitalized.

Identified cases were 29 children in four schools and five elderly adults who received meals through a local delivery program. One case was the parent of a pupil. Five children and one adult had meals delivered to them at home.

The median age of patients was 8 with a range of 4 to 89 years old and almost two thirds were female.

School cafeterias and the meal delivery service were all supplied by the same municipal canteen.

France – Food produced or distributed by the farm: milk, yoghurts, fresh or mature cheeses (brousse, ricotta, pecorino, tomme…). – STEC E.coli

Gov france

Identification information of the recalled product

  • Product category Feed
  • Product subcategory Milk and dairy products
  • Product brand name Unbranded
  • Model names or references Various products
  • Identification of products
    see attached product list
  • Products List Product_list.pdf Attachment
  • Marketing start/end date Until 07/22/2022
  • Storage temperature Product to be stored in the refrigerator
  • Further information Over the period at risk, the products sold by the Aupillon farm were mainly distributed in the Var and Bouches-du-Rhône, in retail stores and restaurants. The points of sale affected by the distribution of suspect products proceed to withdraw them and inform consumers by means of small posters put up at the points of sale concerned.
  • Geographic area of ​​sale Departments: BOUCHES-DU-RHONE (13), VAR (83)
  • Distributors Various retailers.

Practical information regarding the recall

  • Reason for recall Contamination of products by E.COLI STEC bacteria and epidemiological link with cases of pediatric HUS in PACA and OCCITANIE.
  • Risks incurred by the consumer Toxigenic Shiga Escherichia coli (STEC)

France – French E. coli outbreak linked to dairy

Food Safety News

At least a dozen children have been sickened in France with officials linking illnesses to a dairy company.

Since early June, 12 cases of haemolytic uremic syndrome (HUS) have been reported in the Provence-Alpes-Côte d’Azur and Occitanie regions. HUS is a severe complication associated with E. coli infection that causes kidney failure and sometimes death.

Seven boys and five girls aged 11 months to 9 years old are sick. They fell ill from June 4 to July 18.

In France, Shiga toxin-producing E. coli (STEC) surveillance is only based on HUS in children younger than 15, so it only catches the most severe cases.

Santé publique France, the Directorate General for Food (DGAL) and Directorate General for Health (DGS) are part of the investigation.