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French Agency for Food, Environmental and Occupational Health & Safety

Infections from Shiga toxin-producing Escherichia coli in France: update on the situation and recommendations to consumers

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News of 29/06/2011

29 June 2011

Episodes of human infections, caused by bacteria from the family of Shiga toxin-producing Escherichia coli, have been observed in northern France and the Bordeaux area. Despite causing similar symptoms (bloody diarrhoea and haemolytic uremic syndrome), the bacteria involved and the source of the contamination are distinct. Here is an update on the situation and some recommendations …

Two distinct episodes

Around 15 June, some ten cases of bloody diarrhoea and/or haemolytic uremic syndrome (HUS) were reported in northern France, all occurring in children. The investigation undertaken by the health services was able to link these infections to the consumption of minced meat contaminated with Escherichia coli O157:H7, a bacterium found naturally in the intestines of warm-blooded animals and cattle in particular. The health authorities immediately withdrew all suspect batches of this meat.

Every year, around a hundred infections of this type occur in France. They are most often linked to meat contaminated at the slaughterhouse, either by contact between meat and soiled hides or because of an accident during evisceration of the animal (withdrawal of the digestive tract). Infection then occurs on the surface of the meat cut from the carcasses. Due to the production process for minced meat (chopping and mixing), contamination can then reach the heart of a greater or lesser number of the resulting beefburgers. During these extremely rare contamination events, and when contaminated beefburgers are undercooked, these pathogens can survive.

On 22 June, cases of bloody diarrhoea and HUS also occurred in adults, mostly women, in the Bordeaux area. While causing symptoms similar to the first episode, these cases had a different source.
The investigation very quickly identified the cause of this contamination: the consumption of sprouted seeds (mainly fenugreek) at a local fair. The authorities immediately withdrew the incriminated batch of sprouts.
The cases observed in Bordeaux were due to E. Coli O104:H4, the bacterium responsible for the recent outbreak that began in Germany in May and June.

The expected consequences

One of the challenges of the ongoing investigations concerns the search for a possible common source for the German and French episodes. A European traceability survey coordinated by the European Food Safety Authority (EFSA) with the support of the health authorities of the Member States of the European Union is currently trying to identify this possible common source.
At this stage of the investigation, EFSA has determined that fenugreek seeds imported from Egypt in 2009 and/or 2010 may be involved in both outbreaks. However, there remains some uncertainty, since E. coli O104:H4 has not yet been isolated from these seeds. Identifying pathogenic bacteria in seeds is particularly difficult because just a very small number of bacteria are needed to cause disease. In addition, these are dried foods, which means that these bacteria are in a dormant state, not conducive to their multiplication and thus their identification.

With regard to European cooperation on the analytical methodologies, ANSES is in permanent contact with its German, English, Italian and Dutch counterparts, as well as with EFSA, the National Reference Laboratory in Lyon, and the European Union Reference Laboratory (EURL) located in Italy. The EURL has set up a working group designed to share and implement all the analytical resources optimised for the detection of E. coli O104 in sprouted seeds or seeds intended for sprouting.
Finally, ANSES is also mobilising its expert capabilities to assess the risks that may be related to the cultivation and consumption of seeds or seeds intended for sprouting, in order to clarify the recommendations to consumers.

A reminder of the recommendations to consumers with regard to this family of bacteria

STECs are sensitive to temperature. Cooking food is therefore the best way to prevent the risk of infection. For beefburgers, it is worth reiterating the importance of maintaining an internal temperature of 70°C for 2 minutes when cooking. It is therefore recommended that beefburgers, especially those intended for young children, be cooked until well done.
With regard to sprouted seeds, vigilance is required. If in doubt about the origin of any seeds or sprouted seeds, and whether they may come from the suspect batches, consumers are asked not to eat the seeds or sprouts from these seeds, and to return them as soon as possible to the place of purchase. Furthermore, to guard against any risk, consumers are strongly recommended not to grow sprouts for their own consumption and not to eat seeds or sprouted seeds without first having cooked them.
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