Current Status and Ongoing Investigations

As of March 11, 2022, 26 cases of HUS or severe infection linked to E. coli bacteria with similar characteristics have been identified. These cases occurred in 9 regions of metropolitan France: Nouvelle-Aquitaine (6 cases), Hauts-de-France (5 cases), Île-de-France (4 cases), Pays de la Loire (4 cases), Brittany (3 cases), Bourgogne-Franche-Comté (1 case), Grand Est (1 case), Provence-Alpes-Côte d’Azur (1 case), and Auvergne-Rhône-Alpes (1 case). The affected children, aged 1 to 15 with a median age of 8, developed symptoms between January 18, 2022, and February 23, 2022. Two children have died. Additionally, 22 further cases are currently under investigation.

Santé publique France, in conjunction with the CNR, the Directorate General for Food, the Directorate General for Competition, Consumer Affairs, and Fraud Control, and in coordination with the Directorate General for Health, is continuing its investigation into all cases of pediatric HUS reported since January 1, 2022, throughout the country in order to identify a possible common source of contamination and implement appropriate measures (such as recalls of implicated products).

At this stage, the epidemiological investigation has not identified a specific source of contamination. Therefore, health authorities are reiterating general recommendations for food safety, particularly for children under 16 years of age.

Recommendations for Preventing HUS

The E. coli responsible for HUS are present in the intestines of many ruminant animals (cows, calves, goats, sheep, deer, etc.) and are excreted in feces, which can then contaminate the environment (water, manure, soil) and food. These bacteria are cold-tolerant (they survive in a refrigerator or freezer) but are destroyed by cooking.

Transmission of the bacteria can be prevented by simple precautions, particularly among children under 16 and the elderly:

• Hands must be washed thoroughly before preparing meals;

• meat, especially ground beef, as well as ground meat products, must be thoroughly cooked through (not pink in the center);

• 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; opt for hard, cooked cheeses (such as Emmental, Comté, Gruyère, Beaufort), spreadable processed cheeses, and cheeses made from pasteurized milk;

• flour-based preparations (pizza dough, cookie dough, cake batter, pie crust, etc.) should not be eaten raw or undercooked;

• Vegetables, lettuce, fruits, and herbs—especially those to be eaten raw—must be thoroughly washed before consumption, after peeling if necessary;

• Raw foods must be stored separately from cooked or ready-to-eat foods;

• Cooked dishes and leftovers must be promptly refrigerated, thoroughly reheated, and consumed quickly;

• Kitchen utensils (especially if they have previously come into contact with raw foods), as well as countertops, must be thoroughly washed;

• Children should not drink untreated water (well water, stream water, etc.) and should avoid swallowing it while swimming (in lakes, ponds, etc.);

• Finally, very young children (under 5 years of age) should avoid contact with cows, calves, sheep, goats, deer, etc., and their surroundings; if contact with these animals occurs, hands must be washed immediately.

Health authorities, who are monitoring the situation on a daily basis, are fully mobilized to identify the source of this contamination and implement appropriate public health measures as quickly as possible to prevent new cases from occurring.