Investigation into clusters of hemolytic uremic syndrome (HUS) and Shiga toxin-producing E. coli (STEC) infections linked to the consumption of Buitoni® brand Fraîch’Up pizzas. Update as of April 25, 2022.

Update as of April 25, 2022, on the cluster of cases of hemolytic uremic syndrome and infections caused by Shiga toxin-producing E. coli linked to the consumption of frozen pizzas from the Fraîch’Up line of the Buitoni® brand.

Pediatric hemolytic-uremic syndrome

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Hemolytic uremic syndrome is a primarily renal complication of infections caused by Shiga toxin-producing Escherichia coli. Although rare, it is a serious condition that primarily affects young...

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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 appears to have stabilized since the recall.

HUS Cases in France: Update as of April 25, 2022

As of April 25, 2022, 55 confirmed cases have been identified, 53 of which are linked to STEC O26 strains, and 2 to STEC O103 strains.

These 55 cases occurred in 54 children and 1 adult, who developed symptoms between January 18, 2022 (week 3) and March 25, 2022 (week 12) (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 55 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), Auvergne-Rhône-Alpes (2 cases), Occitanie (2 cases), Provence-Alpes-Côte d’Azur (2 cases), Centre-Val de Loire (2 cases), Bourgogne-Franche-Comté (1 case), and Normandy (1 case) (Figure 2).

The 54 affected children are aged 1 to 17 years, with a median age of 7 years; 24 (44%) are female; 47 (87%) developed HUS, and 7 (13%) had STEC gastroenteritis. Two children died. The adult did not develop HUS.

Figure 1 - Epidemic curve: number of confirmed cases of HUS and STEC infections, by week of symptom onset—mainland France, weeks 3–12, 2022 (N=53: week of symptom onset not specified for 2 cases)

Figure 1 - Courbe épidémique : nombre de cas confirmés de SHU et d’infections à STEC, par semaine de début des symptômes - France métropolitaine, semaines 3 à 12, 2022 (N=53 : semaine de début des symptômes non précisée pour 2 cas)

Figure 2 - Geographic distribution of confirmed cases of HUS and STEC infections (N=55) linked to the consumption of Buitoni®-brand Fraîch’Up pizzas, by region of residence in mainland France, weeks 3–12, 2022

Figure 2 - Distribution géographique des cas confirmés de SHU et d’infections à STEC (N=55) en lien avec la consommation de pizzas Fraîch’Up de marque Buitoni®, par région de résidence France métropolitaine, semaines 3 à 12, 2022

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