Several European countries have reported possible outbreaks of illness associated with recalls of contaminated infant formula.
A global recall of baby formula products from Nestlé, Lactalis, Danone and others is underway after detection of cereulide, a toxin produced by Bacillus cereus. The toxin can cause nausea, vomiting and abdominal pain between 30 minutes and 6 hours after ingestion. Cereulide was found in raw arachidonic acid (ARA) oil from a Chinese supplier.
Analysis of fecal samples for cereulide toxin is not part of routine diagnosis in clinical microbiology laboratories. Belgium is the only country to report positive fecal samples.
In Belgium, five infants tested positive based on clinical samples. All of them consumed the recalled infant formula. Of these milk powder samples, three out of five were positive.
moderate risk
In Spain, eight cases of vomiting and a history of consumption of affected products were reported. Five of them required hospitalization, but none of the suspected cases were laboratory confirmed.
In France, 5 of 11 hospitalized infants consumed recovered formula, but for 6 this information was not known. All infants recovered and were sent home.
Danish authorities have received reports of diarrhea in infants after consuming the recalled product, but it is not known whether there is a link between the illness and the product. Samples were not examined for the presence of toxins.
The Netherlands Food and Consumer Product Safety Authority (NVWA) has received 11 reports of children becoming ill after drinking infant formula. Swiss authorities said they had received reports of the illness and were trying to determine if there was a link to the recalled product.
The UK Health and Safety Executive (UKHSA) previously said it was investigating 36 reports of illness linked to the infant formula recall. This report is a clinical notification that a child who consumed the recalled batch developed symptoms consistent with cerulide toxin poisoning.
According to the European Center for Disease Prevention and Control (ECDC), the recalled products are widely distributed and if infants drink formula, their chances of being exposed to a contaminated batch are moderate to high. The effects of exposure to toxins and development of gastrointestinal symptoms are low to moderate depending on the child’s age.
ECDC and the European Food Safety Authority (EFSA) are preparing an outbreak assessment and will publish it later this month.
Specialized Nutrition Europe (SNE) has welcomed the activity reference values for celeulide in infant formula, follow-up formula and foods for special medical purposes for infants and young children developed by EFSA.
The group, which represents the professional nutrition sector, said it would support efforts to establish a uniform analytical methodology for cereulide detection across EU countries.
Official data and expert requests
In other news, the World Health Organization (WHO) and the Food and Agriculture Organization of the United Nations (FAO) have requested experts and data addressing microbiological risk assessment of infant formula.
The Joint FAO/WHO Expert Meeting on Microbiological Risk Assessment (JEMRA) was asked to conduct a risk assessment for spore-forming pathogens, including Clostridium botulinum and Bacillus cereus, in powdered infant formula. The meeting will also assess the burden of disease caused by pathogens and toxins resulting from such formula, as well as the extent and prevalence of contamination of infant formula with these pathogens from production to consumption.
FAO and WHO want scientists who can participate in this work. Selection of experts will begin on March 15th. This continues until sufficiently qualified candidates are identified.
The data will be used to develop scientific advice that will guide revisions to Codex documents. One request is a sampling plan and testing methods to monitor spore formation and environmental pathogens, including bacterial toxins. The deadline for submitting relevant information is May 15, 2026.
