institut de ville sanitarie
http://www.invs.sante.fr/
Gripper
フランス保健相(INVS。SANTE。FR)の風邪インフルエンザの週間報告、現在 休止。
Siteation epidemiologique
Bulletin epidemiologique
http://www.invs.sante.fr/display/?doc=surveillance/grippe_dossier/index_hini.htm
フランス保健相(INVS.SANTE.FR)の病原性大腸菌(EHEC)と溶血性尿毒症症候群(HUS)の報告、2011年06月24日発表
Actualites
24/06/2011 cas groupes d'infections a Escherichia coli entero-hemorragique(EHEC) en Gironde
Point au 24 Juin 2011
http://www.invs.sante.fr/Dossiers-thematiques/Maladies-infectieuses/Risques-infectieux-d-origine-alimentaire/Syndrome-hemolytique-et-uremique/Actualites/Cas-groupes-d-infections-a-Escherichia-coli-entero-hemorragique-EHEC-en-Gironde-Point-au-24-juin-2011
News Published on 24/06/2011
Grouped cases of hemolytic uremic syndrome (HUS) North June 2011 - June 24, 2011 at Point June 22, two hospitals reported at Bordeaux Aquitaine Wax six cases of bloody diarrhea and 2 cases of hemolytic uremic syndrome (HUS). An epidemiological investigation was immediately implemented in connection with the LRA.
At June 24, a total of 10 cases of bloody diarrhea or HUS were identified. Eight of them are grouped geographically: 7 reside in one of the suburbs of Bordeaux, Bordeaux, and the last in a district of this town near Bordeaux, Nansouty. Among the eight cases combined, have a 5 and 3 SHU bloody diarrhea. These six women and two men aged 31 to 78 years. All were hospitalized.
Seven of the eight clusters of cases were interviewed. All seven have attended June 8 Recreation Center Early Bègles during an open house. Six of them reported having eaten sprouts during this visit, particularly used in decoration of a gazpacho. The sprouted seeds is not known for the seventh person who attended the recreation center. Epidemiological investigations are ongoing for the eighth case.
EHEC infection was confirmed for five patients. A strain O104: H4 resistant to many antibiotics has been isolated in 2 of these patients. The microbiological diagnosis of other cases is pending.
An investigation is under way traceability by the Provincial Directorate of the protection of populations to determine the origin of seeds consumed by patients during their visit to the recreation center.
The strain of E. coli isolated from a patient with HUS has the same characteristics as the strain responsible for a large epidemic EHEC infections due to consumption of sprouts occurred in Germany in May and June 2011.
Those who attended the Leisure Centre Early Childhood Bègles during the Open Day on 8 June with bloody diarrhea should consult their doctor or call the center 15 or SOS doctors.
24/06/2011 Cas groupes de syndrome hemolytique et uremique (SHU) Nord, Juin 2011
Point au 24 juin 2011
http://www.invs.sante.fr/Dossiers-thematiques/Maladies-infectieuses/Risques-infectieux-d-origine-alimentaire/Syndrome-hemolytique-et-uremique/Actualites/Cas-groupes-de-syndrome-hemolytique-et-uremique-SHU-Nord-juin-2011-Point-au-24-juin-2011
Published on 24/06/2011
Grouped cases of hemolytic uremic syndrome (HUS) North June 2011 - June 24, 2011 at Point On June 14, 2011, InVS was informed by a nephrologist pediatrician Regional Hospital of Lille, five cases of hemolytic uremic syndrome (HUS), which occurred mid-June in children residing in the Northern Department. HUS is a disease most often in children caused by bacteria belonging to the family of Escherichia coli (E. coli), some strains are more virulent and produce toxins, called "Shiga toxin". Infections with Shiga toxin-producing Escherichia coli (STEC) are manifested primarily by diarrhea often with blood, abdominal pain and sometimes vomiting. These symptoms may progress (in 5-8% of cases), after about a week to HUS.
The occurrence very close in time and geographically several cases of a rare disease (approximately 100 pediatric cases of HUS reported annually by the national surveillance of HUS) suggested a common source of contamination. An epidemiological investigation, coordinated by InVS in collaboration with the Regional Health Agency of Nord-Pas-de Calais (ARS) was implemented immediately.
At June 15, the results of the first epidemiological investigations suggested that this episode of clustered cases of HUS was linked to the consumption of a batch of burgers COUNTRY STEAKS brand with a use-by date (DLC) to 11 May 2012, sale in shops LIDL. In light of these initial results, control measures were implemented immediately by the manufacturer, at the request of health authorities. The further investigation of traceability and microbiological testing in children and steaks taken from the family of sick children have confirmed that this episode was related to the consumption of hamburgers COUNTRY STEAKS brand with a use-by date (DLC) on May 11, 2012 and a strain of E. coli producing Shiga serogroup O157.
Implemented: June 15: The authorities have asked the manufacturer to conduct a recall of frozen hamburger brand COUNTRY STEAKS. This product is sold in boxes of 1 kg (10 steaks 100g) with a (DLC) to 10, 11 and May 12, 2012. Press releases were issued on June 15 and June 16 The posters were put up in stores potentially affected. Health officials recommend that people who bought the steaks not to consume and report them to retail outlets. They invite people who consumed these products and presenting symptoms of STEC infections (often bloody diarrhea with abdominal pain and sometimes vomiting) should consult with their doctor and draws attention to the consumption and nature of the seed contaminant.
Investigations Point to 24/06/2011 Description of cases Ten cases of HUS occurred since June 1, residing in the area of distribution of batches of frozen hamburgers suspects have been reported in the June 24 InVS. These cases are children, 6 boys and 4 girls, ages 16 months to 8 years. Nine children reside in the Northern Department and in Picardy. The start date of the first symptoms (bloody diarrhea) are distributed in 10 children between 6 and 20 June
Survey of parents of cases The parents of 10 children were interviewed about risk exposures during the 7 days preceding the start of their child's diarrhea. These examinations have found no place frequented pool (bathing place, entertainment, events, etc.). And no common contact with animals (farm, zoo). The parents of seven children reported consumption of frozen hamburgers. For six of them, these steaks were frozen brand COUNTRY STEAKS. The burgers COUNTRY STEAKS brand were purchased in different stores in the chain Lidl in the department of Nord and Picardy during the period late May-early June 2011. Of frozen hamburgers in the same box as those consumed by children kept in the freezers of two families were made available to the Departmental population protection (DDPP) by 59 families for testing for microbiological research STEC.
Veterinary investigation / inquiry tracking The Directorate General of Food (DGAl) in connection with the DDPP concerned has implemented a tracking survey to identify the consignment and direct controls on these lots. The results of this survey show that LIDL stores that received the frozen burgers suspect lot (with a use-by date to May 11, 2012) are in the following departments: 59, 62, 76, 22, 29, 35, 56, 45, 58, 60, 72, 75, 77, 78, 25, 51, 52, 54, 55, 57, 70. The bulk of the suspect lot (83%) was distributed in the region Nord Pas de Calais.
Microbiological investigations The serological and microbiological testing E.. Shiga toxin-producing E. coli (STEC) on clinical specimens in children are performed at the National Reference Center for E. coli and Shigella (Institut Pasteur, Paris and microbiology laboratory of the Hospital Robert Debré, Paris). At June 24, the analysis carried out for 8 children showed that they were infected with STEC of the same serogroup, serogroup O 157.
The search for STEC in steaks found in the freezers of the families of cases performed at the National Reference Laboratory of E. coli (NRL) (Food Microbiology Laboratory of the National Veterinary School (ENV) of Lyon), revealed a strain of STEC O157 serogroup as the same strain isolated from sick children. The hemolytic uremic syndrome What is hemolytic uremic syndrome? The hemolytic uremic syndrome (HUS) is a rare disease in France, but serious as it is the leading cause of acute renal failure in children aged 1 month to 3 years. It is usually caused by bacteria belonging to the family of Escherichia coli (E. coli), some strains are more virulent and produce toxins, called "Shiga toxin".
The disease is first manifested by diarrhea often with blood, abdominal pain and sometimes vomiting. These symptoms may progress (in 5-8% of cases), after about a week to a hemolytic uremic syndrome. The child then presents signs of fatigue, pallor, decreased urine output, which become darker, and sometimes seizures.
The hospital treatment is carried through blood transfusions and / or dialysis.
One to two percent of the children dies more than a third keep kidney damage in the long term, requiring regular medical care.
What is the source of contamination? The bacteria responsible for hemolytic uremic syndrome are present in the intestines of many animals (cows, calves, goats, sheep, deer, etc..), And are eliminated through the stool, which can then contaminate the environment (water, manure, soil ) and the food. They tolerate the cold well (survival of several days in a refrigerator), but are destroyed by cooking.
Contamination occurs:
ingestion of contaminated food eaten raw or lightly cooked: beef (especially ground beef), milk or unpasteurized dairy products, apple juice, raw vegetables, or contaminated drinking water; wearing his soiled hands in their mouths after touching animals carry the bacteria or contaminated environment; contact with a sick person who excrete bacteria in their stool ("dirty hands").
How are monitored infections with E. Shiga toxin-producing E. coli and Hemolytic Uremic Syndrome (HUS)? Surveillance of STEC infections is carried out in France by a coordinated InVS through several monitoring systems:
mandatory reporting (OD) of foodborne disease (TIAC), which should identify any Tiac STEC; the National Reference Center for E. coli (Institut Pasteur, Paris and Service of Microbiology, Hôpital Robert Debré, Paris) that characterizes the E. Coli responsible for foodborne illness and HUS in France and alert the emergence of new bacteria; Surveillance of HUS in children under 15. Since 1996, a network of volunteers of Pediatric Nephrology 31 hospitals notify cases of HUS in care, the Institute for Public Health. About 100 pediatric cases of HUS are reported annually in France (file hemolytic uremic syndrome). As part of this network, specialized services (nephrology or pediatric intensive care unit) that support children with HUS inform the Institute of Health when a child is admitted and communicate a sheet collecting clinical information, Microbiological and epidemiological studies. For each child, the presence of E. Shiga toxin-producing E. coli (STEC) is sought by means of blood samples and stool, analyzed by the National Reference Center for E. coli and Shigella (Institut Pasteur, Paris and microbiology laboratory of the Hospital Robert Debré, Paris).
When more than two HUS occur simultaneously in the same geographical area, an investigation is carried out by InVS to determine if these infections have a common origin. This asked the parents of sick children on all possible causes of contamination by E. Shiga toxin-producing E. coli (food, drinking water, contact with animals, contact with sick people, etc..) during the week before the diarrhea. The information collected is used to suspect one or more origins which are then investigated and traceability veterinarian conducted by the Directorate General of Food (DGAl) and its decentralized services (Departmental Directorate of protection of the population). If it is a plant product, such surveys are conducted by the Directorate General for Competition, Consumption and Fraud. Action guided by these surveys are then implemented to prevent the emergence of new patients.
Monitoring results of hemolytic uremic syndrome in children in France Each year, between 70 and 100 children with HUS are notified to the Institute for Public Health; an increase in the number of HUS was observed in summer; HUS is most common in children under 3 years; 1%, on average, children with HUS die; infection with E. Shiga toxin-producing E. coli (STEC) is demonstrated in more than half of cases of hemolytic uremic syndrome, with a predominance of E. coli O157: H7; most cases of HUS occur in isolation; France, a 2001 study showed that the main risk factors for onset of HUS in children are the consumption of ground beef undercooked beef and contact with a person who had gastroenteritis; two small outbreaks of STEC infections occurred in France, both in 2005: one linked to the consumption of frozen hamburgers and other consumption of soft cheese made from raw milk. How to prevent transmission of infection with E. Shiga toxin-producing E. coli and hemolytic uremic syndrome? The transmission of the disease can be prevented by simple actions:
meat, and especially the ground beef should be cooked at heart; vegetables, fruits and herbs, especially those that will be eaten raw should be washed thoroughly; raw food should be stored separately from cooked or ready to eat; leftover food and dishes must be sufficiently heated and consumed quickly; kitchen utensils (especially when they have previously been in contact with raw meat) and the work plan should be thoroughly washed; hand washing should be routinely before preparing food and out of the toilet; in cases of gastroenteritis, it is necessary to avoid swimming in places of public bathing and preparing meals; Children should not drink untreated water (well water, streams, etc..), and avoid swallowing when swimming (lake, pond, etc.). Finally, avoid contact with very young children (under 5) with the cows, calves, sheep, goats, deer, etc.. and their environment. See the thematic Hemolytic Uremic Syndrome
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