CLUSTER OF CASES OF HEMOLYTIC-UREMIC SYNDROME DUE TO UNPASTEURIZED CHEESE

A cluster of four patients (1 girl, 3 boys) from a French village (2,0 00 inhabitants) had acute haemolytic uraemic syndrome (HUS) between Ma rch 1992 and May 1993. All had prodromes with fever and diarrhoea, the n acute renal failure, anaemia, schistocytosis and thrombocytopenia. P eritoneal dialysis was carried out in three children (duration 3-12 da ys). The verotoxin VT2 gene was identified by polymerase chain reactio n in the stools of two children. Some days prior to the diarrhoea, all children had eaten a cheese made with unpasteurised mixed cows' and g oats' milk from the same farm. A case control study showed that the oc currence 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 stoo ls of goats and cows from the farm, but not from the stools of farm em ployees.