Santé publique France and the National Reference Center (CNR) for E. coli and its associated laboratories (Institut Pasteur, Paris, and the Microbiology Laboratory at Robert Debré Hospital, Paris), in collaboration with the Directorate General for Food and the Directorate General for Competition, Consumer Affairs, and Fraud Control, and in coordination with the Directorate General for Health, have been investigating since February 10, 2022, an increase in the number of pediatric cases of hemolytic uremic syndrome (HUS) and infections caused by Shiga toxin-producing Escherichia coli (STEC).

Epidemiological, microbiological, and traceability investigations conducted since that date have confirmed a link between the occurrence of these clustered cases and the consumption of frozen pizzas from the Buitoni Fraîch’Up line contaminated with STEC bacteria. On March 18, 2022, the company initiated a recall of all pizzas in the Fraîch’Up line, which had been on the market since June 2021, and authorities asked anyone in possession of these pizzas not to consume them and to dispose of them.

The total number of HUS cases linked to the consumption of these pizzas has stabilized since the recall. Other reports of STEC infection are being investigated as part of routine surveillance. To date, these reports are not linked to clusters of cases or to the consumption of Fraîch’Up pizzas.

HUS Cases in France: Update as of 05/04/22

As of May 4, 2022, 56 confirmed cases have been identified, of which 54 are linked to STEC O26 strains and 2 to STEC O103 strains.

These 56 cases occurred in 55 children and 1 adult, who presented symptoms between January 18, 2022 (week 3) and April 5, 2022 (week 14) (Figure 1). The epidemic peak occurred in week 7 (February 14–20) and week 9 (February 28–March 6), with 10 cases in each of these weeks.

These 56 cases occurred in 12 regions of metropolitan France: Hauts-de-France (12 cases), Île-de-France (9 cases), Nouvelle-Aquitaine (8 cases), Pays de la Loire (7 cases), Brittany (6 cases), Grand Est (3 cases), Provence-Alpes-Côte d’Azur (3 cases), Auvergne-Rhône-Alpes (2 cases), Occitanie (2 cases), Centre-Val de Loire (2 cases), Bourgogne-Franche-Comté (1 case), and Normandy (1 case) (Figure 2).

The 55 affected children are aged 1 to 17 years, with a median age of 6 years; 25 (45%) are female; 48 (87%) developed HUS, and 7 (13%) had STEC gastroenteritis. Two children died. The adult did not develop HUS.