French E. coli outbreak linked to dairy

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

Since early June, 12 cases of hemolytic 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.

Link to dairy company
The National Reference Center for E. coli at Institut Pasteur in Paris has found five of the children have been infected by E. coli O26 with the same characteristics, meaning the source is likely to be the same.

This bacteria has also been detected in a product made by Fromagerie de L’ Aupillon, based in the commune of Trets in the Bouches-du-Rhône region.

All production dates of items made by the company have been recalled and withdrawn. This includes milk, yogurts and cheese. They were mainly distributed in Var and Bouches-du-Rhône, in the Provence-Alpes-Côte d’Azur region at retailers and restaurants.

Officials asked people who have the products to not consume them. They added those who had visited the farm or bought unpasteurized milk-based products should pay particular attention to the development of any E. coli-related symptoms.

The outbreak comes as Santé publique France reiterated preventive measures against E. coli as every year during summer an increase in foodborne infections, including pediatric HUS, is observed.

The agency advised washing hands before meal preparation, thorough cooking of meat, raw milk products should not be given to those under the age of 5, flour-based items should not be eaten raw or undercooked and kitchen utensils and surfaces must be cleaned to avoid cross contamination.

The risk of developing HUS is higher for older people or young children. HUS occurs in 5 to 8 percent of STEC cases.

About E. coli infections
Anyone who has eaten any of the implicated products and developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible exposure to the bacteria. Specific tests are required to diagnose the infections, which can mimic other illnesses.

The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications.

About 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication, known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor. 

Many people with HUS recover within a few weeks, but some suffer permanent injuries or death. This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients. 

People who experience HUS symptoms should immediately seek emergency medical care. People with HUS will likely be hospitalized because the condition can cause other serious and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.

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