Nestlé has been given permission to partially reopen a plant in France where pizzas behind a serious E. coli outbreak were made.

French officials from the Nord area of the country in the Hauts-de-France region gave the green light this past week for operations to restart at the Buitoni factory in Caudry.

Approval only applies to production of pizzas with cooked dough. The line making pizzas with no re-baking of dough, such as the Fraîch'Up range, will not restart yet.

Fraîch'Up frozen pizzas were the source of the largest E. coli-HUS outbreak ever documented in France. 

One element of the plan to restart has included the dismantling and cleaning of 19,000 parts on the production line.

Incident timeline

Overall, 56 confirmed and two probable cases with a median age of 6 were found nationwide with illness onset between mid-January and April. There were 50 cases of Hemolytic Uremic Syndrome (HUS), two children died and two others had severe aftereffects of infections. HUS is a type of kidney failure associated with E. coli infections that can result in lifelong, serious health problems.

Patients were positive for Shiga toxin-producing E. coli (STEC) O26:H11 or O103:H2. only two people were sick from E. coli O103, according to Santé publique France, the country's public health agency. 

STEC O26:H11 and O103:H2 outbreak strains were isolated from pizzas sampled in patients' homes and at the manufacturing plant. E. coli was also found in the flour used to make pizzas.

In March, Nestlé recalled and withdrew the incriminated pizzas, and production at the plant was suspended. A criminal inquiry into the incident was opened in May.

More than 2,000 samples have been taken at Caudry of the factory environment, raw materials, silos and finished products. Tests of flour samples and certain finished products revealed E. coli but results from production lines and the environment did not detect the pathogen, according to Nestlé.

This means the likely source of contamination was the flour used to make pizzas.

The company has also created a support fund, managed by the France Rein association, for patients diagnosed with HUS in France between January and August 2022.

A scientific review is planned to assess E. coli risk in flour in France and management in foods made from flour. Investigations also are ongoing to understand why typical baking temperatures and times for frozen pizzas didn't eliminate the risk of infection.