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On 24–25 October 2005 a cluster of five haemolytic uraemic syndrome (HUS) cases was reported in southwest France. An investigation was undertaken to identify the outbreak source and implement control measures. Cases were defined as individuals with HUS or diarrhoea with isolation of Escherichia coli O157:H7 in stools or a positive antibody response to E. coli O157 lipopolysaccharide, resident in southwest France with symptom onset after 19 September 2005. Sixty-nine identified patients had symptom onset between 5 October and 3 November 2005, including 17 cases of HUS. One brand of frozen beef burgers produced on 22 August 2005 was consumed by all patients in the week before symptom onset. E. coli O157:H7 strains from patients, patients' burgers and the manufacturing plant were genetically related. This is the largest community-wide outbreak of E. coli O157:H7 in France to date and the first associated with consumption of contaminated frozen beef burgers.
A family cluster of three cases of Escherichia coli O157 infection was identified in France. Two cases developed haemolytic–uraemic syndrome. The source was fresh unpasteurized goats' cheese, produced by an independent producer. Three E. coli O157 strains, isolated from one HUS case and faeces of one cow and one goat, were indistinguishable by toxin type and PFGE pattern.
We conducted a study to determine the incidence of haemolytic uraemic syndrome (HUS) in
children in France and to assess the role of Shiga-toxin-producing Escherichia coli (STEC)
infection in the aetiology of HUS. In collaboration with the Société de Néphrologie
Pédiatrique we undertook a retrospective review of all cases of HUS hospitalized from January
1993 to March 1995 and a 1-year prospective study (April 1995–March 1996) of
epidemiological and microbiological features of cases of HUS. The polymerase chain reaction
(PCR) procedure was used to detect stx, eae, e-hlyA genes directly from case stool samples.
Serum samples from cases were examined for antibodies to lipopolysaccharide (LPS) of 26
major STEC serogroups. Two hundred and eighty-six cases were reported. The average
incidence per year was 0·7/105 children < 15 years and 1·8/105
children < 5 years. During the prospective study, 122/130 cases were examined for evidence of STEC infection using PCR
and/or serological assays and 105 (86%) had evidence of STEC infection. Serum antibodies to
E. coli O157 LPS were detected in 79 (67%) cases tested. In conclusion, this study showed that
STEC infection is an important cause of HUS in children in France, with a high proportion
related to the O157 serogroup.
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