Five people are sick in France, two seriously, and one in Belgium after drinking a brand of raw fermented milk.

In France, four children and one adult have been infected by Shiga toxin-producing E. coli (STEC) O26:H11. They fell ill between the end of March and the beginning of April this year.

Santé publique France has been investigating two cases of Hemolytic Uremic Syndrome (HUS) in the Hauts-de-France and Île-de France regions. The latter was in the context of a family outbreak. The suspected food was fermented raw milk. HUS is a severe complication associated with E. coli infections that causes kidney failure.

“The sequencing of the strains isolated within these outbreaks confirmed the same genomic profile. Food investigations made it possible to identify, for the case in Hauts-de-France, the place of purchase and to sample milk on sale at the time of the inspections. It was fermented raw milk made in Belgium,” agency officials told Food Safety News.

Samples of this milk taken from Hauts-de-France have been tested by the National Reference Laboratory (NRL). The NRL is carrying out sequencing to see if there is a link based on results and comparison with human strains, with the help of the National Reference Center (CNR).

This past week, fermented raw milk of the brand Ferme Dumortier was recalled in France. The farm is based in Rekkem, Belgium. The announcement covers all lots sold since mid-March. The drink comes in a 2-liter bottle with a red or green cap. It was distributed in some L’Oasis stores in Lille.

Belgian angle
The Federal Agency for the Safety of the Food Chain (FASFC) told Food Safety News there is one adult sick in Belgium.

“There is a match between the strain from the sick person identified in Belgium and that analyzed by France. The link between the product consumed and the disease can therefore be established,” said an agency spokeswoman.  

In Belgium, a traceability investigation conducted by the agency is in progress. Production at the company has been temporarily stopped to allow officials to do this work. STEC was not detected in 10 samples and swabs taken by FASFC and analyzed by Sciensano, the national public health institute of Belgium.

In a general warning, French health authorities said that, as a precaution, raw milk and cheeses made from raw milk should not be consumed by young children, particularly those under the age of 5. This recommendation should also be followed by pregnant women, immunocompromised people, and the elderly.

about E. coli infections
Anyone who has eaten any of the implicated products and developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible food poisoning. Specific tests are required to diagnose the infections, which can mimic other illnesses.

The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications, according to the Centers for Disease Control and Prevention (CDC).

about 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication, known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor. 

Many people with HUS recover within a few weeks, but some suffer permanent injuries or death. This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients. 

People who experience HUS symptoms should immediately seek emergency medical care. People with HUS will likely be hospitalized because the condition can cause other serious and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.