Another child has died and more than 20 other infants are part of an E. coli outbreak in France.

Santé publique France and the National Reference Center for E. coli, Shigella and Salmonella at Institut Pasteur are investigating an increase of hemolytic uremic syndrome (HUS) and severe E. coli infection reported since early February. HUS is a type of kidney failure that can result in lifelong, serious health problems and death.

A total of 26 cases of HUS or serious infection, linked to E. coli bacteria with similar characteristics, have been identified. This means they likely came from the same source. Officials have yet to clarify the strain or strains of E. coli involved.

The sick children, aged from 1 to 15 years old with a median age of 8, showed symptoms between Jan. 18 and Feb. 23. Health officials reported that two of the children have now died.

Six patients live in Nouvelle Aquitaine, five in Hauts-de-France, four in Ile-de-France and Pays de la Loire, three in Bretagne and one each in Bourgogne-Franche-Comté, Grand Est, Provence-Alpes-Côte-D’azur and Auvergne-Rhône-Alpes.

Ongoing search for source of infection
French authorities also revealed that another 22 cases are under investigation.

In France, Shiga toxin-producing E. coli (STEC) surveillance is based on HUS in children younger than 15, so it only catches the most severe cases.

Santé publique France, the Directorate General for Food (DGAL), Directorate General for Competition, Consumption and the Repression of Fraud (DGCCRF), and Directorate General for Health are analyzing all cases of pediatric HUS reported in 2022 to see if there is a link between them and if they find a common source of contamination, action such as a recall and withdrawal of contaminated products will be taken.

The epidemiological investigation has yet to find a source of contamination. This work includes surveying parents on the risk exposures of their children, such as the foods consumed.

As the source of infection has not been found, officials reminded people of the general recommendations, in particular for children younger than 16 years old.

These include proper handwashing and thoroughly cooking meat. Also, raw milk and dairy products, such as cheeses, made from raw milk should not be consumed by children younger than 5 years of age. Uncooked foods should be kept separate from cooked or ready-to-eat foods.

About E. coli infections
Anyone who has 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.

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