French authorities have revealed that at least four babies have been sickened by Salmonella linked to powdered milk made in Spain.

The four confirmed patients, aged between 2 months and 10 months, fell ill between August and the end of December 2018. Three other cases are being investigated to determine if they are linked to the outbreak.

The French National Public Health Agency (Santé publique France) said three babies were hospitalized but all have now left hospital.

Preliminary results of the investigation suggest that Modilac branded products made in Spain are the source of the Salmonella. Modilac products manufactured in France and sold in supermarkets have not been implicated in the outbreak.

Sodilac, the company that markets these items, has withdrawn and recalled its range of infant nutrition products based on rice proteins and all infant formula made at a Spanish production site that is believed to be the origin of contamination.

Products distributed to consumers in pharmacies and several charitable organizations, or sold online, are recalled regardless of batch or date of manufacture. The recalled products are:

The National Salmonella Reference Center at the Institut Pasteur identified four Salmonella Poona cases in infants with strains belonging to the same genomic cluster, meaning they are genetically linked.

Another three cases of Salmonella Poona in babies have been found and analysis is ongoing to determine if they also belong to the same cluster as the initial four cases. One of the three probable cases was hospitalized but has since recovered.

Initial investigation interviews with the parents of the four infants confirmed with Salmonella infections showed consumption, in the days preceding symptoms, of powdered milk from the same brand produced by the same factory in Spain. The babies did not have any other foods or drinks in common. Investigations are continuing with Spanish authorities and the manufacturer.

The seven babies consist of five boys and two girls living in five different French regions. At the time of symptoms, and they were sick between August 2018 and Jan. 10 this year.

In another outbreak in November 2017, the National Salmonella Reference Center reported an excessive number of salmonellosis cases in infants. Identification of eight Salmonella agona cases in eight days started an investigation that lead to Lactalis infant formula. The outbreak sickened 38 babies in France, two in Spain and one in Greece last year. Recalled formula was distributed to more than 80 countries.

The Salmonella center receives nearly 10,000 strains of Salmonella every year, including around 400 to 600 from babies less than 1 year old. From 2016 to 2018, it identified 50 strains of Salmonella Poona per year.