French authorities are investigating an E. coli outbreak linked to cheese after young children developed hemolytic uremic syndrome (HUS). Some Saint-Félicien and Saint Marcellin cheese has been recalled.

The 13 cases of HUS that developed after E. coli O26 infection have occurred in young children since March 21. The patients are from several regions in the country. HUS is a severe complication of E. coli infection that causes kidney failure and can occur a week or more after the onset of diarrhea.

Notification of Shiga toxin producing E. coli (STEC) infections is voluntary in France and based on HUS surveillance in children under 15 years old. STEC identification in stool samples is not routinely performed by medical labs.

French authorities said preliminary investigations found several children ate Saint-Félicien and Saint Marcellin cheeses before onset of their symptoms. Among these, three have a possible link with the consumption of Saint Félicien and Saint Marcellin cheese manufactured by Fromagerie Alpine, based in Romans-sur-Isère, a town in the Drôme department in South-eastern France in the Auvergne-Rhône-Alpes region.

Epidemiological, microbiological and food traceability investigations are continuing to determine the source of infection.

Santé publique France, the national public health agency, and the National Reference Center (CNR) for E. coli, Shigella and Salmonella at the Pasteur Institute are continuing enhanced surveillance of HUS to detect possible new cases.

The implicated cheeses were distributed across France with different brand names. Saint-Félicien 180-gram and Saint Marcellin 80-gram packages with lot numbers from 032 to 116 have been recalled. Affected brand names are Fromagerie Alpine, Carrefour, Reflet de France, Leclerc, Lidl, Auchan, Rochambeau, Prince des bois, Sonnailles and Prealpin.

General precautionary advice from health authorities is that raw, unpasteurized milk and cheese made from it should not be eaten by young children. Older adults, pregnant women and other people with weakened immune systems, such as cancer patients, are also at high risk of contracting bacterial infections from raw dairy products.

Previous cheese recalls
The current situation is the latest in a string of French cheese recalls initiated because of various pathogens that can cause illnesses in people. Since the beginning of March, there have been 14 alerts from the Rapid alert System for Food and Feed (RASFF) for problems with French cheese, although some of those relate to the same incident.

Earlier this month, Fromagère de la Brie recalled cheese from more than 30 countries after two listeriosis cases were confirmed in France.

In another incident, Jacquin recalled Pouligny Saint-Pierre raw goat’s milk cheese from more than 10 countries because of E. coli O26. A different raw goat’s milk cheese with the brand name “EARL Le Moulin de la Fosse,” which was sold from April 2-20 in markets at Châteauroux, was recalled due to potential contamination with E. coli O157.

In March, a company called LHT informed consumers that E. coli O26 was found in a batch of its “Crottin de Chavignol” cheese with the best-before date of April 5, 2019. Hardy Affineur also recalled Valençay and Petit Valençay raw goat’s milk cheese with best-before dates ranging from March 1 to 26, because of E. coli O157.