Contaminated infant formula: what is cereulide?

Babies suffering from  diarrhea  and  vomiting , worried parents, and manufacturers who, while stating that the link is not confirmed,  are recalling boxes of infant formula  in about ten European countries. The culprit is “cereulide,” a toxic substance produced by certain bacteria that can cause severe vomiting within hours of consumption.

Several major food companies—Switzerland’s Nestlé and France’s Danone and Lactalis—have announced recalls of infant formula in dozens of countries due to the suspected presence of cereulide. In Singapore, authorities also recalled milk produced by the French company Danone after detecting the same substance.

Cereulide is a toxic compound produced under certain conditions by a family of bacteria, Bacillus cereus . These bacteria are widespread in the environment—soil, water, plants—and therefore in many foods. They do not systematically cause infection, but some have a particular property: when heated to a temperature too low to kill them, and then cooled, they form spores and produce cereulide.

An emetic toxin

This substance is said to be “emetic”: in other words, it causes vomiting within hours of ingestion. “The symptoms of the emetic form of poisoning, namely nausea and vomiting, and sometimes diarrhea, appear between one and five hours after ingestion of the emetic form, and last less than 24 hours,” explains an article on Bacillus cereus poisoning , published in the journal Microbes and Infection . The presence of cereulide has often been observed in rice that has been reheated and then cooled, which has earned this infection the nickname “fried rice syndrome.”

In the case of the recalled milk, according to the French government website Rappel Conso regarding a recall of the Guigoz brand (Nestlé), “an ingredient from a supplier is the source of the potential presence of cereulide from an oil rich in arachidonic acid (ARA) .” This acid is a component added to infant formula to mimic breast milk, where it is naturally present. It is artificially produced by microbial fermentation and then incorporated into an oil.

In any case, Bacillus cereus infections are rare: approximately five cases per million inhabitants per year in France, according to the French Ministry of Agriculture. The Ministry describes them as “generally very benign ,” but vomiting can cause serious complications in vulnerable patients such as the elderly, pregnant women, and, in this case, infants.

French health authorities indicated on Tuesday that investigations were underway following the death of a baby who consumed infant milk produced by Nestlé, although it was not possible at this stage to establish a direct link.

Le Figaro