Since the beginning of February 2022, public health authorities have observed an increase in the number of cases of hemolytic-uremic syndrome (HUS), a consequence of a serious infection with the bacterium Escherichia coli in the child. No track has been ruled out to explain this recent increase and the occurrence of a serious complication likely to jeopardize the vital prognosis of the children affected.
Escherichia coli and hemolytic uremic syndrome (HUS)
Hemolytic-uremic syndrome (HUS) is the leading cause of acute renal failure in children under three years old.. A potentially serious disease in children and the elderly, it generally results from a food-borne infection, the foods most frequently involved being:
- Minced meats;
- Products made from raw milk (milk, cheese, yoghurts, etc.).
The bacterium responsible for the infection is a subtype of the bacterium Escherichia coli, which secretes specific toxins, shigatoxins. The ingestion of contaminated food, raw or undercooked, causes the infection of the child, who develops characteristic symptoms:
- Diarrhea often bloody;
- Vomiting ;
- Abdominal pain ;
- In severe forms (about 10% of cases): hemolytic anemia (with destruction of red blood cells), a drop in blood platelets and acute renal failure.
Increase in cases of Escherichia coli infection in children since February 2022
Usually, between 100 and 165 children are affected each year in France by HUS linked to an infection by E. coli. But since the beginning of February 2022, the number of cases seems to be experiencing an unusual and as yet unexplained increase. As of February 24, 2022, 13 cases had been identified in five French regions (New Aquitaine, Hauts-de-France, Ile de France, Brittany and Pays de la Loire). Of the 13 children affected, one child died of HUS complications. Faced with this trend, the public health authorities have launched investigations into the 31 cases of HUS that have occurred since the beginning of 2022 in France. The objective of these investigations is to highlight a possible link between all the affected children.
The investigations focus on two areas:
- Family surveys to identify possible exposures to a new source of contamination;
- A microbiological study on strains ofE. coli having infected the children to highlight similar characteristics between them.
Towards the identification of a new source of contamination?
At this stage, the experts are not ruling out any leads and are considering several sources of contamination for children:
- Ingestion of contaminated food, eaten raw or undercooked;
- Contact by soiled hands;
- Contact with a sick person.
Faced with the severity of the symptoms and the major risk of renal complications, it is essential for families to know the preventive measures against such a food infection :
- Hand washing before preparing and eating meals;
- Rinsing with water all fruits and vegetables eaten raw;
- The cleaning of kitchen utensils and the kitchen;
- Separation of raw and cooked foods;
- Thorough cooking of meats;
- The preservation in appropriate conditions of cooked meals and leftover meals;
- The consumption of drinking water.
For children affected by HUS, management requires hospitalization for the administration of symptomatic treatments, dialysis and blood transfusions.
Estelle B., Doctor of Pharmacy
Sources
– Hemolytic-uremic syndrome (HUS). solidarites-sante.gouv.fr. Accessed March 1, 2022.
– Enterohaemorrhagic Escherichia coli (EHEC). anses.fr. Accessed March 1, 2022.