In one of the most severe and widespread incidents of its kind, an alarming E. coli outbreak linked to 11 daycare centers in the vicinity of Calgary, Alberta is feared to be the largest ever reported among children under the age of five. The Alberta Health Services (AHS) has confirmed 128 cases of the infection as of Thursday morning, with 25 children hospitalized and three discharged.
According to Dr. Stephen Freedman, a professor of paediatrics at Cumming School of Medicine, this could potentially be the most extensive outbreak of Shiga-toxin E. coli among children below five years of age ever recorded. The situation calls for crucial timing and prompt action as young children have a high risk of developing a grave condition called hemolytic uremic syndrome (HUS) within a timeframe of up to 10 days post symptom onset.
Freedman stated, with a note of urgency, that several organs, including the kidneys, brain, heart, liver, and pancreas, could be adversely affected. He added that concerns will persist until the last child exposed clears the risk window of 10 days post onset of symptoms.
Nine patients have confirmed cases of HUS. In a recent update, AHS announced that all patients are stable and receiving suitable hospital care. Some children, however, have to spend many hours each day in medical facilities undergoing blood tests to check for HUS.
The severity of declining health was highlighted with the case of a previously healthy three-year-old who exhibited symptoms of blood in stool and severe stomach cramps. Despite an early diagnosis, within 24 hours the child developed HUS, underwent surgery, and is currently on dialysis. The medical team continues to monitor the situation while the family fears the potential impacts on other organs.
In an alarming testament to the situation’s gravity, Bill Marler, a distinguished American food safety lawyer, stated, “Hemolytic uremic syndrome can potentially be a life-changing, deadly complication.” He predicts a class-action lawsuit may soon arise from affected families, arguing that such outbreaks indicate a high degree of negligence.
To mitigate the risk of infection, only two designated visitors are allowed to visit children admitted for E. coli related illnesses at the Alberta Children’s Hospital. Alternate means of communication like phone and FaceTime are encouraged.
Dr. Freedman mentions that 50 to 60 per cent of children who develop HUS will need temporary dialysis. Most of these children will recover kidney function and will not require chronic dialysis but may be prone to other complications in the future. “This group of children will be predisposed to having chronic kidney disease,” he noted.
The cause of the outbreak remains under investigation with some suspecting the source of contamination to be meatloaf served at a lunch meal. Public health inspectors are currently scrutinising the central kitchen, Fueling Minds, used by all the associated daycares.
Marler, the American lawyer known for representing families impacted by the fatal E. coli outbreak at U.S. Jack in the Box restaurants in 1993, opined that this might be the largest reported E. coli outbreak tied to a daycare.
Although not all daycare centers in the Calgary area report cases, six Fueling Brains Academy locations in Calgary and five other sites remain closed until the issue is resolved. Alberta Children’s Hospital has set up a dedicated clinic to monitor symptomatic patients after their first emergency room visit. A central website has been launched by AHS to keep parents updated.
Health inspection reports for the Fueling Minds kitchen dating back to 2021 show some violations but indicate that the kitchen met compliance standards in the most recent follow-up inspection done in April.
