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Biological Health Hazard – Mass Food Poisoning (schoolchildren): Rouen, Haute-Normandie, France, France

2017/05/08

FOODBORNE ILLNESS – FRANCE (02): (NORMANDY) SCHOOLCHILDREN, CHEESE
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Published Date: 2017-05-08 15:53:21
Subject: PRO/EDR> Foodborne illness – France (02): (ND) schoolchildren, cheese
Archive Number: 20170508.5021628

Political Map of France

Political Map of France. Image: Nations Online Project

Date: Mon 8 May 2017
Source: The Independent [edited]

A dodgy batch of smelly French cheese has been blamed for a mass food poisoning outbreak at schools in Normandy. An investigation launched after 300 children fell ill in the town of Rouen named the culprit as gone-off cheese served up by school canteens.

One parent said her child would be avoiding school meals after the scandal, telling local media: “I’d prefer to take them to a fast food place”.

Local authorities inspected the producers of the cheese – a soft, mold-ripened local variety called neufchatel – but were unable to identify the origin of the contamination. The children began to suffer headaches, vomiting and stomach aches after eating the cheese at 54 different primary schools and nurseries on Thu 27 Apr 2017.

A survey of 1000 parents of children in the region, both those affected and not affected by the outbreak, found a “strong association between the consumption of the cheese and the appearance of digestive symptoms”, according to the local health board.

[Byline: Katie Forster]


Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[Neufchatel (http://www.cheese.com/neufchatel/) “is a traditional, soft-white, table cheese, originating from the village of Neufchâtel-en-Bray in northern Normandy. Made from cow’s milk, it is one of France’s oldest cheeses, dating back as far as 1035.

“The cheese is made in many forms, shapes and sizes – bonde (cylinders), coeur (heart shape), carre (square shape) and briquette (brick shape). Legend goes that French farm girls fell in love with English soldiers during the Hundred Years War and started making heart shaped cheeses to show their love.

“Granted AOC (Appellation d’Origine Contrôlée “controlled designation of origin”) status in 1969, Neufchatel can be industrial, farmstead or artisanal. Artisanal Neufchatel has a grainy, close textured and thick paste covered with a soft, downy, velvety bloomy rind. Matured for 8-10 weeks, the taste and texture is reminiscent of a Camembert; mushroomy, rich, nutty and slightly yeasty. It is made from pasteurized cow’s milk.”

According to the original report, the illness seems to begin within several hours after ingestion of the food. A short incubation period (1-6 hours) of a foodborne illness with nausea and vomiting without significant fever or diarrhea is usually due to staphylococcal enterotoxin. The following information regarding this entity is extracted from the US Food and Drug Administration’s Bad Bug Book available at http://tinyurl.com/mqf6hjm:

“In the diagnosis of staphylococcal foodborne illness, proper interviews with the victims and the gathering and analyzing of epidemiological data, are essential. Incriminated foods should be collected and examined for staphylococci. The presence of relatively large numbers of enterotoxigenic staphylococci is good circumstantial evidence that the food contains toxin. The most conclusive test is the linking of an illness with a specific food, or, in cases where multiple vehicles exist, the detection of the toxin in the food sample(s).

“In cases where the food may have been treated to kill the staphylococci, as in pasteurization or heating, direct microscopic observation of the food may be an aid in the diagnosis. A number of serological methods for determining the enterotoxigenicity of _S. aureus_ isolated from foods, as well as methods for the separation and detection of toxins in foods, have been developed, and used successfully, to aid in the diagnosis of the illness. Phage typing may also be useful when viable staphylococci can be isolated from the incriminated food, from victims, and from suspected carriers, such as food handlers.

“A toxin dose of less than 1.0 microgram in contaminated food will produce symptoms of staphylococcal intoxication. This toxin level is reached when _S. aureus_ populations exceed 100 000 per gram.

“Foods that are frequently incriminated in staphylococcal food poisoning include meat and meat products; poultry and egg products; salads such as egg, tuna, chicken, potato, and macaroni; bakery products such as cream-filled pastries, cream pies, and chocolate eclairs; sandwich fillings; and milk and dairy products. Foods that require considerable handling during preparation, and that are kept at slightly elevated temperatures after preparation, are frequently involved in staphylococcal food poisoning.”

A very short incubation of a vomiting-associated illness (less than 1 hour) also suggests that the etiology might have been heavy metal ingestion. A number of metals can cause this type of syndrome, which is usually caused by the ingestion of a liquid that had been kept in a metallic container. These metals include antimony, copper, tin, and zinc. The illnesses are usually self-limiting and require only symptomatic care. In addition to vomiting, other clues may include the liquid being described as having a metallic taste. Identifying the specific cause requires analysis of the food or liquid vehicle. Some potential differences in the illnesses exist between causes, including a longer incubation period (several hours) for zinc; vomiting and diarrhea for tin; and blue or green vomitus for copper.

Maps of France can be seen at https://www.gite.com/art/france-map/map-of-france-regions.jpg and http://healthmap.org/promed/p/7196.

Rouen (https://en.wikipedia.org/wiki/Rouen) is a city on the River Seine in the north of France. It is the capital of the region of Normandy. Formerly one of the largest and most prosperous cities of medieval Europe, Rouen was the seat of the Exchequer of Normandy during the Middle Ages. It was one of the capitals of the Anglo-Norman dynasties, which ruled both England and large parts of modern France from the 11th to the 15th centuries. Its location in France can be found on the above URL. – Mod.LL]

See Also

Foodborne illness – France: (ND) schoolchildren 20170428.5001309
Foodborne illness – India (02): (BR) RFI 20170417.4975686
Foodborne illness – Colombia: (BL) inmates, RFI 20170415.4959930
Foodborne illness – Cambodia: (BA) soy milk, RFI 20170407.4956397
Foodborne illness – India: (KL) police, fish curry, RFI 20170402.4942801
Foodborne illness – Lebanon: (BA) schoolchildren, RFI 20170402.4941722
Foodborne illness – Egypt (04): schoolchildren 20170324.4923928
Foodborne illness – Egypt (03): schoolchildren, RFI 20170323.4921318
Foodborne illness – Egypt (02): (SJ) schoolchildren 20170316.4905429
Foodborne illness – Egypt: (SJ) schoolchildren, RFI 20170315.4902833
Foodborne illness – South Africa: (EC) nursing home, fatal, RFI 20170314.4899809
Foodborne illness – Japan (02): (Tokyo area), nori, norovirus 20170302.4874642
Foodborne illness – Canada: (MB) healthcare lecture catering 20170227.4868222
Foodborne illness – Japan: (Tokyo area) RFI 20170223.4852615
Foodborne illness – USA: (FL) science olympiad, staphylococcal 20170210.4830795
Bacillus cereus foodborne illness – Taiwan: (TP) 20170115.4767696

2016
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Foodborne illness – France: (BF) prisoners 20161117.4628005
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Source:
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases


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