California E. coli case prompts investigation

The Press-Enterprise reported yesterday that a San Bernardino child has been diagnosed with E. coli, and an investigation into his illness is ongoing.  Public health officials are working to determine the source of E. coli contamination, and are including the child's daycare in the investigation.

[Monique] Bivins said she twice took her son to the emergency room at St. Bernardine's Medical Center on Oct. 21 after he began vomiting earlier that week and suffered from bloody diarrhea. Ravon later was transferred to Loma Linda University Medical Center before doctors determined he had been infected by E. coli, Bivins said.

"I was freaking out because my son was bleeding," she recalled. "I just started breaking down and crying."

Bivins said health department investigators and social workers, who wore protective clothes and masks, questioned her last week at the hospital about her son's diet, whether the family had pets or if the toddler recently had been to a zoo, Bivins said.

Health department investigators commonly ask about animal and food exposures in the course of an E. coli investigation.  They also ask questions about contacts with other individuals, especially in daycare settings, since some cases are transmitted from person to person.  The Press-Enterprise story mentioned that California Department of Social Services spokesman Oscar Ramirez had stated the agency is investigating a complaint filed last week against the KinderCare facility that Ravon attended. 

In 2000, Marler Clark represented several children who became ill with E. coli infections while attending a KinderCare facility in Folsom, California.  More about that KinderCare E. coli outbreak can be read in the Marler Clark news archives.

Colorado E. coli outbreak investigation focuses on daycare, water sources

Health officials in Colorado are investigating an E. coli outbreak among children in Eagle County.  The Vail Daily News reported on the outbreak investigation on Friday:

Local and state health officials are working on a e.coli outbreak investigation in Eagle County, said Jill Hunsaker, the county’s public health manager.

Several cases have been confirmed in children under 5. The county is focusing on swimming pools and child-care centers in its investigation, Hunsaker said.

Past E. coli outbreaks have been traced to day care centers and recreational water sources, including the following:

  • White Water park E. coli Outbreak

    In the summer of 1998, 26 children became ill from E. coli O157:H7 contracted while playing in the kiddie pool at White Water Park, a commercial water park in suburban Atlanta. Seven of those children were hospitalized and a 2-year-old boy died from hemolytic uremic syndrome, a kidney disorder caused by E. coli O157:H7.

    Operators of the pool initially denied responsibility for the E. coli outbreak, but investigators determined that the chlorine level in the pool was well below the local health standard on the days when the water was contaminated, greatly increasing the risk of infection.
  • Kindercare E. coli Outbreak

    In August of 2000, the Kindercare facility located on Lexington Drive in Folsom, California, was traced as the source of an E. coli O157:H7 outbreak. Health department officials who investigated the outbreak determined that the probable “index case” – a child who unknowingly brought the bacteria into the facility – experienced “explosive diarrhea at the daycare on the afternoon of 8-3-00.”

    Shortly thereafter, four other children became infected with E. coli O157:H7 on successive days, the 6th, 7th, 8th and 9th of August, 2000. All of the children were in the same day care group. In addition to the illnesses of the children, the mother of one child, and another child’s sibling became ill and tested positive for E. coli. Another toddler also became ill.
  • CCC Alternative Learning Daycare E. coli Outbreak

    In June of 2002, the Tarrant County Public Health Department Disease Control Section was notified of the hospitalization of a 2-year old child with a diagnosis of hemolytic uremic syndrome or HUS, a complication of an E. coli O157:H7 infection. Over the following days, the Tarrant County Public Health Department (TCPHD) was notified of several additional cases of E. coli O157:H7 infections, which included five positive stool cultures. All of the identified cases were associated with the CCC Alternative Learning Program Daycare in Fort Worth, Texas.

    In the end, the TCPHD identified 15 cases of E. coli O157:H7 associated with the daycare, including 12 children, one daycare staff member and one parent of a daycare attendee. TCPDH conducted an investigation into the source of the infections. TCPDH reported that the investigation identified “several breaches in food preparation and procedures at the daycare facility.”

  • Kid's Korner Daycare E. coli Outbreak

    As many as 26 children were sickened, several of them critically, by an outbreak of E. coli O157:H7 at the Kid’s Korner Day Care Center in Joplin, in southwest Missouri in 2004. Marler Clark represents the family of a two-year-old who suffered kidney failure from hemolytic uremic syndrome, or “HUS.”

    Investigators traced the outbreak to the daycare center after several cases of E. coli poisoning were reported in the Joplin area.

    The two-year-old toddler was hospitalized for nearly three weeks, including a full week of kidney dialysis, seven blood transfusions and three surgeries.

Children die in Canada, Japan, after suffering E. coli infections

A two-year-old Canadian boy and three-year-old Japanese girl died recently after becoming ill with E. coli infections and hemolytic uremic syndrome.  The source of each child's illness is being investigated by public health officials.

The Canadian child became ill in June, and died just days after being hospitalized.  He was not part of an outbreak, and investigators are working to determine whether his illness can be associated with any other illnesses across Canada.  So far, they have not had luck in identifying the source of his infection.  The Winnepeg Sun ran a story recently on the boy's illness and death, and spoke with the lead investigators about his case:

"We go through the entire history, food exposure, water exposure, farms, animals, everything," said Dr. Tim Hilderman, acting director of communicable diseases for the province.

He said the first step was eliminating the most likely sources for the bacteria: local eateries and municipal water supplies.

"In this case when we looked at the most obvious sources we weren't able to find the source," explained Hilderman.

The Japanese child became ill at the end of July, and also died just days after her hospitalization.  Health officials have linked the girl's illness to a cluster of E. coli infections associated with the day care facility she attended, but have not yet announced whether the outbreak is foodborne or is from some other source.  Asahi.com published a story about the girl's illness and the ongoing investigation:

Officials said they suspect all five were fed the same food at the school, but they are also investigating whether the source of infection was from outside the school.

Two children are still being treated at a hospital in the city for diarrhea and sore tummies.

Thirty-one infants and pupils up to age 7 attend the Popora Osaka Tenrokuen nursery center.

Both of these stories remind us that E. coli is not just an American problem - it is a problem that public health officials around the world are working to prevent.

E. coli information available on Web

OMAHA, Neb. (July 13, 2006) -- An E. coli O157:H7 outbreak has been traced to a Sidney, Nebraska, day care center. The Associated Press reported that at least four children between the ages of nine and 18 months who were being cared for in the Blues Clues Room at Here Wee Grow day care center in Sidney have become ill with E. coli infections. Three children were hospitalized; two remain in the hospital, one has been released.

www.about-ecoli.com provides information related to the symptoms and risks associated with E. coli O157:H7 infection, how E. coli is detected, possible ways to prevent infection, and recent news associated with outbreaks. Nearly ten percent of children who become ill with E. coli O157:H7 infections develop hemolytic uremic syndrome (HUS), a complication that can cause kidney failure as well as damage to the pancreas, liver, brain, and heart. In fact, HUS is now recognized as the most common cause of childhood kidney failure. Children with HUS can develop medical conditions such as high blood pressure or diabetes, and often require medical monitoring and treatment throughout the rest of their lives.

"Most people have heard of E. coli, but until someone they know falls victim during an outbreak, they don't realize how devastating E. coli infection and HUS can be," said William Marler, a Seattle attorney who has represented hundreds of victims of E. coli outbreaks. "That's where the information on these sites comes in."

The Panhandle Public Health Department, Nebraska Department of Health, and Centers for Disease Control and Prevention are working together to investigate the source of the outbreak. "At this point, it's not clear how the bacterium was spread at the day care; however, any day care operator should have measures in place to prevent the spread of diarrheal illness at their facility," Marler continued. "A recent outbreak at a day care center in Tennessee was traced to a child who was allowed to remain in attendance at the day care even though they had diarrhea for four days."

Marler and the attorneys at Marler Clark have represented dozens of children who have become sick with E. coli O157:H7 and other pathogenic bacteria while attending day care. The firm recently settled the case of a Missouri child who suffered an E. coli infection and HUS after being exposed to the E. coli bacterium at a day care center in Joplin, Missouri. The firm has also represented children in Texas and California who became ill with E. coli and HUS after exposures at day care centers. For more information, contact Suzanne Schreck at (206) 346-1879 or sschreck@marlerclark.com.

Two still hospitalized, four treated after E-coli outbreak at daycare

Macon County Times
By Jerry Greenway

Six confirmed cases of a serious E. coli infection and four additional "suspected" cases are being looked into by the state Department of Health, according to Debbie Hoy of the agency's Cookeville office this Tuesday. All of the infected children, ages 5 and under, attended the same Key Road day care facility operated by Paulette Colter, west of Lafayette.

"Most of the six children with confirmed cases have been released from Sumner Regional Medical Center or treated by their family doctor and sent home with their parents," said Ms. Hoy. Two children, a girl age three-years and a sixteen month old boy, remain in Vanderbilt Children's Hospital where they are receiving treatment.

Ms. Hoy said she could not discuss the medical condition of the hospitalized children, but all of the children who have been treated and released are improving and doing well, she said.

An additional four young children have shown symptoms but have not become dangerously ill from the E. coli strain of infection, which can lead to serious complications including damage to the kidneys.

"The day care center voluntarily closed for the time being as a safety procedure and to make sure everything was thoroughly cleaned and sanitary before children return to avoid the possibility of further infections," said Ms. Hoy.

One child became ill nearly a week before other children at the facility began to show symptoms. Officials speculate that the first child may have infected toys, linens or other items from which the other children were infected. The bacterial infection is so aggressive that simple hand washing is not enough to prevent its spread, especially if hand to mouth activity immediately follows the initial exposure.

Because the virulent strain of E. coli is easily transmitted from person-to-person, day care center operator Paulette Colter voluntarily closed her facility last Friday when additional children showed symptoms of infection.

State officials are actively investigating the source of the infection, but Colter's facility has received good health and safety inspections in the past and has a history of adhering to high standards for the day care industry. The day care facility in Lafayette has been in continuous operation for nearly twenty years.

Macon County E. coli outbreak sends two children to hospital with kidney failure

LAFAYETTE, TN (June 28, 2006) -- An E. coli O157:H7 outbreak has been traced to a Macon County, Tennessee, day care center. The Tennessee Department of Health reported that nine children became ill with E. coli infections, after being exposed to an ill child at Paulette's Group Day Care Home. Two of the children were admitted to Children's Hospital after the E. coli bacteria caused their kidneys to shut down.

E. coli O157:H7 causes a diarrheal illness that results in painful abdominal cramping, nausea, and bloody diarrhea. Five to ten percent of children who become ill with E. coli O157:H7 infections develop hemolytic uremic syndrome (HUS), a complication that can cause kidney failure as well as damage to the pancreas, liver, brain, and heart. Children with HUS can develop medical conditions such as high blood pressure or diabetes, and often require medical monitoring and treatment throughout the rest of their lives.

A representative for the Tennessee Department of Health reported that the index case, or child who became ill and was the likely source of infection among the other nine children at the day care, attended the day care facility for three to four days while he was experiencing symptoms of E. coli infection.

"Any day care operator should have measures in place to prevent the spread of diarrheal illness at their facility, even if it means sending a kid home until they're feeling better and able to pass solid stool," said William Marler, an attorney who has represented hundreds of victims of E. coli outbreaks. "I understand that having an outbreak is a day care operator's worst nightmare, but this nightmare was largely preventable."

Marler and the attorneys at Marler Clark have represented dozens of children who have become sick with E. coli O157:H7 and other pathogenic bacteria while attending day care. The firm recently settled the case of a Missouri child who suffered an E. coli infection and HUS after being exposed to the E. coli bacterium at a day care center in Joplin, Missouri.

For more information, contact Suzanne Schreck at (206) 346-1879 or sschreck@marlerclark.com.