As part of its surveillance missions, Public Health France monitors, in conjunction with the National Reference Center for Escherichia coli, shigella, salmonella and clinicians from the pediatric SHU surveillance network, the evolution of infections in order to detect clusters of infections and initiate investigations.
What is hemolytic uremic syndrome?
Hemolytic-uremic syndrome (HUS) is secondary to infection with Escherichia coli producers of Shiga-toxins (STEC). This rare but serious complication mainly affects the kidney and occurs in 5 to 8% of cases.
The risk of developing HUS is higher at the extreme ages of life, especially in young children.
Each year, about 160 children are affected by HUS. Since 1996, Public Health France has set up a surveillance system for this disease with the nephro-paediatrics services.
The infection manifests within 3-4 days after contamination (10 days maximum), with diarrhea often accompanied by blood, abdominal pain and sometimes vomiting which can progress, after about a week, to HUS in 5 in 8% of cases. People with HUS, especially children, then show signs of great fatigue, pallor, a decrease in the volume of urine, which becomes darker, and sometimes seizures. Treatment in hospital may include, among other things, blood transfusions and/or dialysis. It is therefore necessary to consult a doctor immediately in the event of suggestive symptoms.
What are the preventive measures?
Bacteria E.coli responsible for HUS are present in the intestines of many ruminant animals (cows, calves, goats, sheep, etc.) and are eliminated by excrement which can then contaminate the environment (water, manure, soil) and food. These bacteria tolerate cold well (survival in a refrigerator or freezer), but are destroyed by cooking them through.
The transmission of the bacterium can be avoided by simple gestures, in particular in children under 16 and the elderly:
In the kitchen
- Hand washing should be systematic before meal preparation;
- Meat, and especially minced beef, but also minced meat preparations, must be well cooked through (and not pink or rare);
- Raw milk, cheeses made from raw milk and dairy products made from raw milk should not be consumed by children under 5 years of age (prefer cooked pressed cheeses (such as Emmental, Comté, Gruyère, Beaufort), processed cheese spreads and pasteurized milk cheeses);
- Flour-based preparations (pizza/cookie dough/cake/pie/pancake, etc.) should not be eaten raw or undercooked;
- Vegetables, salads, fruits and aromatic herbs, in particular those which are going to be eaten raw, must be carefully washed before consumption, after peeling if necessary;
- Raw foods should be kept separate from cooked or ready-to-eat foods;
- Cooked meals and leftover food must be quickly put in the refrigerator and sufficiently reheated before consumption;
- Kitchen utensils (especially when they have previously been in contact with raw foods such as meat or cheese), as well as work surfaces, must be thoroughly washed to avoid the risk of cross-contamination.
During activities and leisure
- Children should not drink untreated water (well water, river, torrent, etc.) and avoid swallowing it when swimming (lake, river, pond, etc.);
- Avoid contact of very young children (under 5 years old) with cows, calves, sheep, goats, etc., and their environment; in the event of contact with these animals, hand washing (water and soap) must be systematic before the child puts his fingers to his mouth.
