Tag Archives: France

Hepatitis A surveillance in France, 2006-2015

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(Many thanks to our correspondent in France for sending this along).
Hepatitis A surveillance has been carried out by mandatory reporting (DO) since November 2005, with the objective of detecting clustered cases in order to quickly take control measures, and estimating reporting incidence rates. The results of the analysis of cases reported during the first ten years of surveillance (2006-2015) are presented.

Methods

One case (positive anti-HAV IgM) must be notified to the Regional Health Agency using an OD card. This sheet gathers sociodemographic and clinical information as well as risky exposures (in particular cases in the entourage, stay outside the metropolis, consumption of seafood).

Results

For the period 2006-2015, 11,158 cases of hepatitis A were notified, giving an average incidence rate of 1.7 / 100,000. A downward trend in this rate has been observed since 2010. The average incidence rate of reporting in men was 1.9 / 100,000 and, in women, 1.4 / 100,000, with a downward trend for both sexes. The main exposures at risk were the presence of cases in the entourage (46%) and a stay outside metropolitan France (38%). Thirty-two percent of cases belonged to an identified episode of clustered cases. Each year, the share of grouped cases was relatively stable, ranging between 28 and 37%.

Conclusion

The annual rate of notification incidence has gradually decreased since 2010, reaching in 2015 that of a country of low endemicity for hepatitis A (1.1 / 100,000). The highest incidence of reporting was found in the under-15 age group, which is the most affected by fecal-oral transmission of the virus, favored in families and communities of children. The data collected by the OD and by the investigations of grouped episodes made it possible, in 2009, to develop vaccine recommendations in the family circle of a patient with hepatitis A and in living communities in situation precarious hygiene.

First ten years of surveillance of hepatitis A through mandatory reporting, France, 2006-2015

BEH

Elisabeth Couturier 1, Lina Mouna 2 , Marie-José Letort 1 , Dieter Van Cauteren 1 , Anne-Marie Roque-Afonso 2 , Henriette De Valk 1 

http://invs.santepubliquefrance.fr/beh/2018/5/2018_5_1.html

Botulism in France, 2013-2016

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Human botulism is a rare but severe neurological disease which is submitted to the French Public Health. The biological diagnosis is performed by the National Reference Center of Anaerobic Bacteria and Botulism (CNR), Institut Pasteur, Paris.

This study carries the status of human botulism in France During the 2013-2016 period based on the epidemiological data of Public Health France and the biological investigation of CNR. episodes

Thirty-nine of confirmed botulism and 3 suspected episodes involving 68 and 4 persons, respectively were Identified: 6 Type A episodes (10 cases), 26 type B episodes (47 boxes), type 2 F episodes (5 cases), and 5 undetermined type episodes (6 boxes). The source of botulism was foodborne in 36 outbreaks (66 cases) and 6 cases were infant botulism. All type A and F botulism cases were severe forms

The incriminated food was identified in 15 of the 36 episodes of foodborne botulism. Homemade preparations of pork meat, especially raw ham, were responsible for 13 type B episodes, including 3 due to imported meat. Homemade pork meat was suspected in 12 other outbreaks. Other included pheasant pie and home canned asparagus. One of the two type F episodes was caused by industrial ground meat contaminated with Clostridium baratii F7 . No food has been identified in infant botulism and environmental contamination has been suspected in three cases. Penicillin and metronidazole resistant C. botulinum A2 strain was isolated from an infant botulism case with relapses.

Human botulism is rare in France. However, botulism surveillance is required for early identification of emerging novel botulinum toxin types, such as in the two C. baratii type F outbreaks in 2014 and 2015. Botulism surveillance also helps addressing recommendations to industrialists and consumers regarding hygiene and food preservation practices. Finally, this surveillance allows to quickly identify contaminated food in order to withdraw it from the market or from family’s homes.

Human botulism in France, 2013-2016

BEH

Christelle Mazuet 1 , Nathalie Jourdan-Da Silva 2 , Christine Legeay 1 , Jean Sautereau 1 , Michel R. Popoff 1

http://invs.santepubliquefrance.fr/beh/2018/3/2018_3_1.html

No hiding from DNA: Lactalis Salmonella contamination ‘may go back a decade’

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Expatica reports researchers raised fears Thursday that salmonella-tainted milk produced by French dairy giant Lactalis, which sickened dozens of babies, could have infected others over more than a decade.

Lactalis has been engulfed in scandal since December when authorities ordered a massive international recall of the baby milk which made at least 38 babies ill in France and Spain.

The Pasteur research institute said Thursday that the exact same strain of salmonella sickened at least 25 others between 2006 and 2016 — and that the same Lactalis factory in northwest France was the likely origin.

Lactalis has been the target of heavy criticism after it emerged that the company’s own tests found salmonella at the factory in Craon, but it did not sound the alarm because it had not detected the bacteria in the milk itself.

That raised fears that contaminations may have occurred well before last year’s discovery but gone undetected, with critics pointing to an outbreak at the same production site that sickened 146 children in 2005 — before it was bought by Lactalis a year later.

“First we confirmed that the same type of Salmonella agona was behind the two outbreaks, in 2005 and 2017,” Pasteur Institute director Francois-Xavier Weill told AFP.

“So we asked ourselves where the strain could have been during the 12 years in between” those two scares, he said.

“The only possible hypothesis is that it remained at the factory in question.”

Although the institute could not definitively determine whether the sickened babies drank Lactalis milk, “the DNA evidence is very clear, and it points to this factory,” Weill said.

Lactalis CEO Emmanuel Besnier confirmed Thursday that tests between the two outbreaks had found the same salmonella at the factory, though not in the milk.

“We can’t exclude the possibility that some babies drank contaminated milk during this period,” he admitted.

The bacteria was found in a dehydration tower used to reduce milk, which Lactalis now plans to shut down for good, Besnier told newspaper Les Echos.

The company is facing several lawsuits over the outbreak, and police raided the group’s headquarters in Laval, western France, earlier this month.

It recalled 12 million packages of the affected baby milk, under brands including Picot, Milumel and Celia, across 83 countries.

Several retailers later admitted that they had continued to sell the products even after the recall was announced.

Investigators have opened a preliminary inquiry for suspected fraud as well as endangering health by failing to properly execute the recall.

Modeling foodborne illness effects in France, 2008-2013

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Many thanks to our French correspondent who forwarded this abstract on the latest foodborne illness data from France.

To assess the impact of foodborne infections on human health and to set priorities for surveillance, prevention and control strategies, estimates of food-related morbidity and mortality are necessary. The objective of the present study was to produce the annual number of symptomatic cases, hospitalized cases and deceased cases for 21 foodborne pathogen agents (10 bacteria, 3 viruses, 8 parasites) in metropolitan France for the 2008-2013 period.

Our findings reveal that morbidity and mortality attributed to infectious foodborne diseases remain high in France, representing 1.28-2.23 million illnesses, 15,800-21,200 hospitalizations, and 232-358 deaths. Campylobacter spp., non-typhoidal Salmonella spp. and norovirus infections accounted for the majority of all food-related illnesses and hospitalizations in France. Non-typhoidal Salmonella spp. and Listeria monocytogenes accounted for half of the burden of food-related deaths.

The knowledge of the absolute and relative burden of food-borne infections is useful for all stakeholders (public authorities and operators) involved in the field of food safety.

Estimates of food-related morbidity and mortality in metropolitan France, 2008-2013

Bulletin epidemiologique hebdomadaire

Dieter Van Cauteren, Yann Le Strat, Cecile Sommen, Mathias Bruyand, Mathieu Tourdjman, Nathalie Jourdan-Da Silva, Elisaveth Couturier, Nelly Fournet, Henriette De Valk, Jean-Claude Desenclos

http://invs.santepubliquefrance.fr/beh/2018/1/2018_1_1.html

36 sick: Lactalis offers salmonella compensation, French government says probe continues

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We’re in New Caledonia for Amy to do some French professoring stuff, with the Calgary-Carolina hockey game on in the background on a sports channel from France.

I went for a walk along the ocean this morning, sans Ted, which is the extent of my French.

While I’m surrounded by the beauty of this Pacific island, the Lactalis mess in France continues a downslide into parody (except for the sick kids and their families).

According to Reuters, France welcomed dairy group Lactalis’ pledge to compensate victims of a Salmonella contamination in its baby milk on Sunday, but said a judicial investigation to determine who was responsible would continue.

Lactalis Chief Executive Emmanuel Besnier told the weekly Journal du Dimanche his family company, one of the world’s biggest dairies, would “pay damages to every family which has suffered a prejudice.”

Is prejudice French for barfing?

Salmonella infections can be life-threatening and the families of three dozen children who have fallen sick in France as a result of the contaminated baby milk have announced a raft of lawsuits.

Besnier’s promise came two days after Lactalis widened a product recall to cover all infant formula made at its Craon plan, regardless of the manufacture date, in a bid to contain the fallout from a health scare that risks damaging France’s strategic agribusiness in overseas markets.

“Paying compensation is good, but money cannot buy everything,” government spokesman Benjamin Griveaux said in an interview on BFM TV.

The health scare intensified last week after France’s biggest retailers including Carrefour, Auchan and Leclerc admitted products recalled in December had still found their way onto shelves.

“It is the job of the investigation to determine where failings occurred and who is to blame,” Griveaux said, adding that “responsibilities were shared.”

Implementing the global recall will be challenging. Privately owned Lactalis, one of the world’s biggest dairies, exports its baby food products to 83 countries across Europe, Africa and Asia.

The recall involves some 12 million tins of baby milk.

“It’s not easy to evaluate the number of items that need to be returned because we don’t know what’s been consumed already,” Besnier said in a rare newspaper interview published on Sunday.

Friday’s recall was the third in a month and Lactalis has come under fire for its clumsy response. Besnier also told the French weekly that the company had acted as quickly and efficiently as possible and denied slowing the process to curb losses.

Besnier has also been criticized for failing to speak out publicly during the salmonella scare.

While his family are France’s 11th wealthiest, according to a 2017 ranking by Challenges magazine, the dairy tycoon has long shunned the public limelight and schmoozing with politicians.

His workers nickname him the “invisible man.”

“We’re a discreet business. In this region there is a mentality of ‘work first, speak later,” he said. But he acknowledged lessons had been learned during the past few weeks.

Lactalis has become an industry giant, with annual sales of 17 billion euros ($20.73 billion) and 18,900 employees across some 40 countries.


 

Audits and inspections are never enough: French inspectors missed Salmonella at baby milk plant

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French food safety inspectors failed to detect salmonella contamination at a plant belonging to dairy giant Lactalis, three months before the company carried out a major recall of baby milk, a report said Wednesday.

Lactalis, one of the world’s largest producers of dairy products, discovered the bacteria at its factory in Craon, northwest France, during tests in August and November.

It did not however report the find to the authorities.

Officials from the food safety department carried out a routine inspection of the site in September and gave it a clean bill of health, the Canard Enchaine investigative weekly reported.

It was only three months later, after around 30 infants being fed Lactalis powdered milk fell sick, that the health ministry sounded the alarm.

Officials from the national anti-fraud bureau swooped on the site on December 2 and found the assembly line where liquid milk is transformed into formula to be contaminated.

Lactalis issued two major recalls covering all production from the site from February 15, blaming the contamination on renovation work.

The plant has been at a standstill since December 8.

Lactalis is under investigation over the affair.

It could face charges of causing involuntary injuries and endangering the lives of others.

Market food safety at retail so consumers can choose.

Audits and inspections are never enough: A critique to enhance food safety

30.aug.12

Food Control

D.A. Powell, S. Erdozain, C. Dodd, R. Costa, K. Morley, B.J. Chapman

http://www.sciencedirect.com/science/article/pii/S0956713512004409?v=s5

Internal and external food safety audits are conducted to assess the safety and quality of food including on-farm production, manufacturing practices, sanitation, and hygiene. Some auditors are direct stakeholders that are employed by food establishments to conduct internal audits, while other auditors may represent the interests of a second-party purchaser or a third-party auditing agency. Some buyers conduct their own audits or additional testing, while some buyers trust the results of third-party audits or inspections. Third-party auditors, however, use various food safety audit standards and most do not have a vested interest in the products being sold. Audits are conducted under a proprietary standard, while food safety inspections are generally conducted within a legal framework. There have been many foodborne illness outbreaks linked to food processors that have passed third-party audits and inspections, raising questions about the utility of both. Supporters argue third-party audits are a way to ensure food safety in an era of dwindling economic resources. Critics contend that while external audits and inspections can be a valuable tool to help ensure safe food, such activities represent only a snapshot in time. This paper identifies limitations of food safety inspections and audits and provides recommendations for strengthening the system, based on developing a strong food safety culture, including risk-based verification steps, throughout the food safety system.

35 infants sick with Salmonella: France to probe Lactalis

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Medical Xpress reports that French prosecutors have opened a probe into salmonella contamination and a major international recall of baby milk produced by dairy giant Lactalis, a legal source told AFP on Tuesday.

The investigation will focus on possible charges of causing involuntary injuries and endangering the lives of others but also possible cheating and failures in carrying out a product recall, the source said.

Reports of some 20 children falling sick after consuming Lactalis powdered milk—sold under several different brand names in France and abroad, including Picot and Milumel—first emerged in early December.

The company, one of the world’s largest producers of dairy products, ordered a first major recall on December 10 of nearly 7,000 tonnes of packets produced by a contaminated factory in Craon, northwest France.

At the time, it said it did not know how much of the potentially dangerous powder had been consumed or was in shops around the world and it announced a second, wider recall on December 21.

The group has now recalled all of its production from the Craon factory since February 15, blaming the contamination on renovation work carried out earlier this year.

The company believes the salmonella outbreak can be traced to an evaporation tower used to dry out the milk at the factory it acquired in 2006.

The plant had suffered salmonella contamination the previous year.

Outbreak of Salmonella Agona infections linked to internationally distributed infant formula – France

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Disease Outbreak News of the World Health Organization reports that on 2 December 2017, an increase of cases infected with the Salmonella Agona strain was identified by health authorities in France in young children aged under six months. Subsequent investigations identified an outbreak of Salmonella enterica serovar Agona associated with infant formula products manufactured by the Lactalis Nutrition Santé group in France.

As of 21 December, 35 confirmed cases of Salmonella Agona infections among infants aged less than six months have been identified in different regions of France. Sixteen infants have been hospitalized but all have fully recovered and no deaths have been reported.

The outbreak was associated with consumption of four different brands of infant formula, including products designed for infants with special medical needs. On 10 December, Lactalis Nutrition Santé withdrew and recalled over 600 batches (more than 7000 tonnes) of implicated products that were manufactured from 15 February 2017 to present. The implicated infant formula products have been distributed internationally to more than 50 countries and territories.

On 21 December 2017, Lactalis Group has conducted a new recall including all infant and nutritional products manufactured or packaged in the Craon plant since 15 February 2017. Efforts to trace the distribution of products included in this expanded recall are underway and will be communicated to affected countries through INFOSAN as they are identified.

French authorities ordered the suspension of marketing and exports and the recall of several infant formula products manufactured by the Lactalis Nutrition Santé group since 15 February 2017. On 9 December, health authorities issued three alerts to pharmacists and health facilities in France to stop delivering the products concerned. Recommendations for possible appropriate substitutions are published on the website of the Ministry of Solidarity and Health (see link below).

As of 15 December 2017, the recalled infant formula products have been exported to the following 48 countries (including France) and territories: Afghanistan, Algeria, Andorra, Bahrain, Bangladesh, Burkina Faso, Cambodia, Cameroon, China, Congo, Cyprus, Côte d’Ivoire, France, Gabon, Georgia, Greece, Guinea, Haiti, Hong Kong SAR (China), Iraq, Kosovo1, Kuwait, Lebanon, Madagascar, Mali, Monaco, Morocco, Netherlands, Pakistan, Paraguay, Peru, Qatar, Romania, Saudi Arabia, Serbia, Seychelles, Slovenia, Spain, Sudan, Switzerland, Taiwan (China), Togo, Turkey, Ukraine, United Arab Emirates, Vietnam, Yemen, The former Yugoslav Republic of Macedonia. The products have also been distributed in the French overseas territories and departments.

Working closely with the International Network of Food Safety Authorities (INFOSAN) Emergency Contact Point in France, the INFOSAN Secretariat has informed the INFOSAN Emergency Contact Points (and National IHR Focal Points) in the recipient countries outside of the European Union (EU) of the relevant distribution details to facilitate their investigations, recalls and risk management measures. Countries within the EU have been informed directly through the European Rapid Alert System for Food and Feed (RASFF).

Affected products present a risk for serious illness in infants (a susceptible at-risk group for serious disease and complications) that consume the product. Investigations are ongoing by French authorities to identify the outbreak’s source. Similar outbreaks have happened previously, despite stringent control measures being in place. Past outbreaks have been related to other manufacturers and multiple geographical locations.

Powdered infant formulas are not sterile products. Salmonella is prevalent in raw ingredients and can survive under harsh, dry conditions for lengthy periods of time. Preparing formula with tepid water can allow for rapid growth/multiplication of the initial low level Salmonella contamination, which may, in turn, cause serious illness and outbreaks among infants.

WHO advises against the application of any travel or trade restrictions on France based on the current information available on this event.

If children who have consumed these products exhibit symptoms, such as diarrhoea with or without fever, parents are recommended to contact a doctor as soon as possible. Detected cases of Salmonella Agona should then be reported to national health authorities.

Consumers are advised to follow the FAO/WHO guidelines for the safe preparation, storage and handling of powdered infant formula, available online (see link below).

In case substitution of some of the affected formula is not available, the French authorities have recommended to heat the prepared formula for two minutes at 70°C and let it cool down to 37°C before serving it to infants. This would also inactivate Salmonella bacteria. This could be used as an interim practical

26 infants sick with Salmonella from baby formula: French order recall

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Baby milk maker Lactalis and French authorities have ordered a global recall of millions of products over fears of Salmonella bacteria contamination.

Lactalis, one of the largest dairy groups in the world, said it has been warned by health authorities in France that 26 infants have become sick since Dec. 1.

The French company, one of the world’s largest dairy groups, said it was warned by health authorities in France that 26 infants have become sick since Dec. 1.

According to a list published on the French health ministry’s website, the recall affects customers in countries around the world, including: Britain and Greece in Europe, Morocco and Sudan in Africa, Peru and Colombia in South America and Pakistan, Bangladesh and China in Asia. The United States, a major market for Lactalis, is not affected.

Company spokesman Michel Nalet told The Associated Press on Monday that the “precautionary” recall involves “several million” products made since mid-February.

Lactalis said in a statement that the 26 cases of infection were linked to products branded Picot SL, Pepti Junior 1, Milumel Bio 1 and Picot Riz.

How is it precautionary when 26 babies are sick?

It said it is “sincerely sorry for the concern generated by the situation and expresses its compassion and support to the families whose children fell ill.”

The health scare started earlier this month when Lactalis was told that 20 infants under six months of age had been diagnosed with salmonella infection. The company ordered a first recall that has been extended to more products at the request of French authorities following new reports of infections.

Lactalis is a privately held company headquartered in Laval, western France. It has 75,000 employees in 85 countries and annual revenues of about 17 billion euros ($20 billion). Its other notable brands include President and Galbani cheeses and Parmalat milk.

166 schoolchildren suffer food poisoning in France

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166 of the 456 students at the public college of Julie-Victoire-Daubie Saint-Philbert-de-Grandlieu were missing after symptoms aroused suspicion around foodborne illness.

The students were reportedly intoxicated inside the school, according to the regional health agency (ARS) taken over by Ouest-France. Fortunately, no serious is to report according to the ARS.