Highlights from the Midi-Pyrénées Regional Health Agency - Cluster of Hemolytic Uremic Syndrome (HUS) Cases in Aquitaine, May–June 2012

The Bordeaux University Hospital reported four cases of HUS requiring hospitalization between June 14 and 20, 2012, involving children residing in the departments of Pyrénées-Atlantiques (2 cases) and Gironde (2 cases). An epidemiological investigation, coordinated by the InVS/Cire Aquitaine in collaboration with the Aquitaine Regional Health Agency (ARS), was immediately launched. The onset dates of symptoms (diarrhea) for the four HUS cases fell between June 6 and June 16. An infection with the E. coli O157 bacterium was confirmed in one of the children. Tests are still underway for the other three children.

The investigation revealed that three of the children had consumed fresh Jean Rozé brand ground beef purchased at Intermarché stores. It is likely that the fourth case is not linked to this outbreak, as consumption of ground beef from this brand was not reported.

The traceability investigation identified a common manufacturer located in Lot-et-Garonne. The ground beef was fresh with a short best-by date of a few days and had been distributed across four regions (Aquitaine, Limousin, Midi-Pyrénées, Poitou-Charentes). A recall of the identified ground beef was issued, and a press release was published on June 23 to inform consumers who may have frozen these products that they should not consume them and should return them to the point of sale where they were purchased.

HUS is a disease most commonly caused in children by a bacterium belonging to the Escherichia coli (E. coli) family, certain strains of which are more virulent and produce toxins called "shigatoxins" (STEC: shigatoxin-producing E. coli). Contamination can occur through the ingestion of contaminated food (undercooked meat, raw milk products, raw vegetables and fruits), through soiled hands after touching animals carrying the bacteria or their environment, or through contact with an infected person who excretes the bacteria in their stool.

STEC infections initially present with diarrhea (often bloody), abdominal pain, and sometimes vomiting. In 5 to 8% of cases (after about a week), these symptoms can progress to HUS. The child then exhibits signs of severe fatigue, pallor, decreased urine output that becomes darker in color, and sometimes seizures.