Highlights from the Midi-Pyrénées Regional Health Agency

Outbreak of Shiga toxin-producing Escherichia coli O157:H7 (STEC) infection linked to the consumption of ground beef

An outbreak of Shiga toxin-producing Escherichia coli infection occurred in France in June–July 2011. Eighteen cases were identified. These cases were children aged 6 months to 10 years who developed hemolytic uremic syndrome following prodromal diarrhea occurring between June 6 and July 15, 2011. Fourteen cases resided in the Nord-Pas-de-Calais region. Sixteen cases were caused by E. coli serogroup O157, 1 case by serogroups O157-O177, and 1 case by serogroups O157-O26. All O157 serogroup strains isolated from the cases’ stool samples were non-motile and fermented sorbitol, a characteristic very rare for O157 strains isolated in France.Epidemiological, microbiological, and traceability investigations showed that this outbreak was linked to the consumption of ground beef (ground beef patties and burgers). This outbreak, the second in France linked to the consumption of ground beef patties, underscores the importance of thoroughly cooking this product for young children.

Investigation of an unexplained mass illness outbreak at a secondary school

On October 6, 2011, emergency and medical services responded to a middle school in Saint-Sauveur-le-Vicomte (50) following a case of vasovagal syncope in a student at the school and the appearance of an increasing number of children presenting with nonspecific neurological and/or digestive symptoms during the morning. About thirty children were transported to the emergency departments of the Cherbourg and Saint-Lô hospitals. No medical diagnosis could be made, and no environmental abnormalities were identified to explain the event. At the request of the Basse-Normandie Regional Health Agency (ARS), an investigation was conducted by the Normandy Regional Health Agency (Cire Normandie).The results of the investigation led to a diagnosis of psychogenic mass psychosis. The investigation also identified the triggering factor: the onset of a vagal episode in one student, followed by a psychosomatic episode in a second student who witnessed the index case’s episode. The intervention of emergency and medical services likely played a significant role in amplifying the phenomenon. Unexplained mass psychogenic illness is a relatively unknown emerging phenomenon in France. Consequently, these events pose challenges in terms of care and management for the services likely to encounter them.