The number of children sick in a severe E. coli outbreak in France linked to raw milk cheese has risen to 11.

The 11 hemolytic uremic syndrome (HUS) cases were reported in late 2023. HUS is a severe complication associated with E. coli infections that causes kidney failure. Santé publique France surveillance on HUS only covers children younger than 15 years old in the country, so there could be other sick people in the outbreak.

Five young children attending the Minimes crèche in Toulouse had to be hospitalized in November. Stool cultures revealed Shiga toxin-producing E. coli (STEC) infection. Cheese has tested positive for E. coli O26.

The other six children with HUS infected with the outbreak strain are unrelated to the crèche and live in different regions.

Speaking to different French media outlets, the parents of two girls, Élise, aged 7, and Clara, 18 months old, revealed how their children had been affected and their ongoing health issues.

French authorities act
In November and December, an investigation was carried out by Santé Publique France, the National Reference Center for E. coli, the General Directorate of Food (DGAL), and the General Directorate of Health (DGS) following the identification of children suffering from HUS, infected with a common strain and who lived across the country.

The investigation led to a withdrawal and recall of raw milk cheese in mid-December. This covered cheeses such as morbier, raclette, and tomme, manufactured by Route des Terroirs. The cheese was distributed throughout France and manufactured until Oct. 11, 2023.

Epidemiological, microbiological, and traceability work found a link between some patients and Morbier cheese produced by Route des Terroirs. However, officials added they haven’t ruled out other sources of contamination.

Health authorities said raw milk and cheeses made from raw milk should not be consumed by young children, particularly those under 5, pregnant women, and immunocompromised people.

In 2022, there were 37 STEC outbreaks in France, more than half the total reported in Europe. A total of 473 cases were recorded, up from 298 in 2021.

Overall, 252 HUS cases were recorded compared to 128 in 2021. This included 57 confirmed and two probable patients in the Nestlé Buitoni frozen pizza outbreak.