Cheese link in Italian HUS case

hemolytic uremic syndrome HUS

Italian authorities have issued a warning after a young girl developed a serious condition after suffering an E. coli infection.

The Ministry of Health (Ministero della Salute) published a notice to consumers following a case of hemolytic uremic syndrome (HUS) which has affected a child in Trentino. HUS is a severe complication associated with E. coli infections that causes kidney failure.

Local health authorities have taken steps to try and verify the source of infection. They identified a probable link to the consumption of cheese produced in a malga, which is an alpine hut, in Coredo. In late July, local officials said the girl was hospitalized.

A related Rapid Alert System for Food and Feed (RASFF) report shows Shiga toxin-producing E. coli (STEC) O26 was detected in the cheese.

To protect public health, it was advised that anyone who had purchased dairy products from the implicated site, before July 14, should not consume them. Officials also added that raw milk products should not be given to children under 5 years of age or the elderly.

Overall picture
Between July 2022 and June 2023, 73 cases of HUS were recorded from 16 regions in Italy, including 70 in people younger than 15 years old.

Four people fell sick after returning from a trip abroad. The majority of domestic infections were recorded in Campania and Emilia-Romagna.

In the first half of 2023, the number of cases reported to the Italian HUS Registry was lower than expected. The decrease was particularly marked in April and May, when only one case was reported. However, in July and August 2022 cases were higher than the seasonal expectation.

The Italian Hemolytic Uremic Syndrome Registry is operated by the Italian Society of Pediatric Nephrology and the National Institute of Health (ISS). 

In 56 E. coli-positive cases it was possible to obtain information on the serogroup. The so-called Shiga toxin producing E. coli top-5 serogroups — O26, O157, O111, O145, and O103 — dominated with 51 cases. E. coli O26 was behind 27 cases while E. coli O157 was the second most common.

From January to December 2022, 91 cases were recorded. This was the most observed in a single year since the start of surveillance in 1988.

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