title: Cluster of cases of haemolytic uraemic syndrome due to unpasteurised cheese.
abstract: A cluster of four patients (1 girl, 3 boys) from a French village (2,000 inhabitants) had acute haemolytic uraemic syndrome (HUS) between March 1992 and May 1993. All had prodromes with fever and diarrhoea, then acute renal failure, anaemia, schistocytosis and thrombocytopenia. Peritoneal dialysis was carried out in three children (duration 3-12 days). The verotoxin VT2 gene was identified by polymerase chain reaction in the stools of two children. Some days prior to the diarrhoea, all children had eaten a cheese made with unpasteurised mixed cows' and goats' milk from the same farm. A case control study showed that the occurrence of HUS was linked to the consumption of this milk product (P = 0.006). The VT 2 gene was isolated from the cheese and from the stools of goats and cows from the farm, but not from the stools of farm employees.
authors.affiliation: Service de Néphrologie Pédiatrique, Hôpital d'Enfants Armand Trousseau, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Deschênes
authors.forename: C
authors.initials: C
authors.lastname: Casenave
authors.forename: F
authors.initials: F
authors.lastname: Grimont
authors.forename: J C
authors.initials: JC
authors.lastname: Desenclos
authors.forename: S
authors.initials: S
authors.lastname: Benoit
authors.forename: M
authors.initials: M
authors.lastname: Collin
authors.forename: S
authors.initials: S
authors.lastname: Baron
authors.forename: P
authors.initials: P
authors.lastname: Mariani
authors.forename: P A
authors.initials: PA
authors.lastname: Grimont
authors.forename: H
authors.initials: H
authors.lastname: Nivet
mesh_terms: D000208:Acute Disease; D000818:Animals; D001427:Bacterial Toxins / Q000235:genetics; D016022:Case-Control Studies; D002417:Cattle; D002418:Cattle Diseases / Q000382:microbiology / Q000635:transmission; D002611:Cheese / Q000009:adverse effects / Q000382:microbiology*; D016000:Cluster Analysis; D004269:DNA, Bacterial / Q000032:analysis; D004768:Enterotoxins / Q000235:genetics; D004926:Escherichia coli / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000382:microbiology / Q000635:transmission / Q000662:veterinary; D005243:Feces / Q000382:microbiology; D005260:Female; D005516:Food Microbiology; D005602:France / Q000453:epidemiology; D015511:Goat Diseases / Q000382:microbiology / Q000635:transmission; D006041:Goats; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D008892:Milk / Q000382:microbiology; D016133:Polymerase Chain Reaction; D022622:Shiga Toxin 1; D022641:Shiga Toxin 2
chemical_list: D001427:Bacterial Toxins; D004269:DNA, Bacterial; D004768:Enterotoxins; D022622:Shiga Toxin 1; D022641:Shiga Toxin 2