French authorities have confirmed a link between dozens of E. coli infections in children and frozen pizzas sold by Nestlé.

Officials did not say exactly how many people were sick but revealed that epidemiological, microbiological and traceability work had found a connection with Buitoni brand Fraîch’Up pizza and Shiga toxin-producing E. coli (STEC) infections.

Pizzas sold since June 2021 were withdrawn and recalled in mid-March after Nestlé was told about the presence of E. coli O26 in dough used to make them.

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 hemolytic uremic syndrome (HUS) reported in 2022. HUS is a type of kidney failure associated with E. coli infections that can result in lifelong, serious health problems and death.

Wider investigation
In total, 75 infections are being looked at including 41 cases of HUS that appear to be linked. In a previous update, health officials said 27 cases of HUS or serious infection had been identified with 31 others being investigated.

Sick children are aged from 1 to 18 with a median of 7 years old. Two have died. Most fell ill between early January and March this year. In France, STEC surveillance is based only on HUS in children younger than 15, so it only catches the most severe cases of E. coli infection. It is unknown how many adults might be infected.

Sixteen of the 75 cases live in Hauts-de-France, 11 in Nouvelle Aquitaine, 10 in Pays de la Loire, nine in Ile-de-France, seven in Bretagne, five in Grand Est, four each in Auvergne-Rhône-Alpes and Centre Val-de-Loire, three in Provence-Alpes-Côte d’Azur, two in Bourgogne Franche-Comté, Normandie and Occitanie.

Consumers who purchased Fraîch’Up frozen pizzas have been advised not to eat them and throw them away. All lots are affected and expiration dates range from June 1, 2022 to March 31, 2023. A recall has also been issued in Slovenia, Belgium and Luxembourg.

Halt to production
In a statement, Buitoni officials said the company will work with the authorities to understand what has happened with production suspended in the meantime.

“First of all, we would like to show our support to the families affected. This situation is all the more intolerable to us as children are concerned. The quality and safety of our products is and will remain our first priority. To date, the origin of the bacteria in the Fraîch’Up pizza remains undetermined,” according to the company’s statement.

Buitoni is doing its own research into the problem while the authorities are continuing to do tests and take the necessary samples for their investigation.

“We are surrounding ourselves with all the necessary experts, internal and external. Production will not restart until the cause of this contamination has been identified so that the necessary corrective measures can be taken,” the company statement said.

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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