Highlights from the Midi-Pyrénées Regional Health Agency

Cluster of gastroenteritis cases at a gathering in the Lot On August 21, the Midi-Pyrénées Regional Health Agency (ARS) received a report of a cluster of acute gastroenteritis cases that occurred during a gathering of a Vedic-inspired spiritual movement, with approximately 400 people present at a campground in Varaire (Lot) or in nearby lodgings, requiring the intervention of the emergency medical services (SAMU). An investigation was launched jointly by the ARS (CVGS and DT46), the Midi-Pyrénées Regional Health Agency (Cire), and the Lot Departmental Directorate for Health, Safety, and Public Health (DDCSPP). In total, about thirty cases were identified, of which 17 were hospitalized at the Cahors Medical Center, including several severe cases of dehydration. For 11 patients, stool cultures revealed the presence of the same strain of fluoroquinolone-resistant Shigella flexneri, and for 8, the presence of rotavirus.

The majority of cases occurred in clusters within a 24-hour period. Nearly 80% of the cases had consumed the same meal on August 19 at the restaurant located on the site, compared to 14% of the healthy individuals (controls) interviewed by phone (a significant difference). This is most likely a foodborne illness, the most probable cause of which would be poor hygiene during the preparation or serving of the meal, leading to the widespread contamination of a dish. Not all results of the bacteriological samples (food, cooks) are known, and the investigation is still ongoing to confirm this hypothesis. Person-to-person transmission appears highly unlikely given the clustering of cases over time. Other potential exposures, such as drinking water or swimming, have been ruled out.

This incident highlights the risk of fecal-oral transmission of enteric infections. Hygiene measures (general hygiene, hand hygiene) are the primary means of preventing this risk. They are all the more essential during large gatherings where facilities are sometimes inadequate, and they primarily concern the occupational hygiene of food service staff.