E Coli Lawyer & Attorney : Marler Clark Law Firm : E. coli Blog

Texas health officials are investigating an outbreak that has already resulted in one death, apparently caused by a Shiga toxin carried by bacteria.  KEYE TV reported today that in addition to four cases in Bastrop County, Lee and Fayette Counties have reported illnesses caused by a Shiga toxin-producing bacterium. 

E. coli O157:H7 and other bacteria contain Shiga toxins, and can cause severe illness, including hemolytic uremic syndrome.  The chain of events leading to HUS begins with ingestion of Shiga toxin producing E. coli (e.g., E. coli O157: H7) or another Shiga toxin producing bacteria in contaminated food, beverages or through person to person transmission. These E. coli rapidly multiply in the intestines causing colitis (diarrhea), and tightly bind to cells that line the large intestine. This snug attachment facilitates absorption of the toxin into the circulation where it becomes attached to weak receptors on white blood cells (WBC) thus allowing the toxin to “ride piggyback” to the kidneys where it is transferred to numerous avid (strong) Gb3 receptors that grasp and hold on to the toxin. Organ injury is primarily a function of Gb3 receptor location and density. Receptors are probably heterogeneously distributed in the major body organs, and this may explain why some patients develop injury in other organs (e.g., brain, pancreas).

Once Shiga toxin attaches to receptors, it moves into the cell’s cytoplasm where it shuts down the cells’ protein machinery resulting in cellular injury and/or death. This cellular injury activates blood platelets and the coagulation cascade which results in the formation of clots in the very small vessels of the kidney resulting in acute kidney injury and failure. The red blood cells are hemolyized (destroyed) by Shiga toxin and/or damaged as they attempt to pass through partially obstructed microvessels. Blood platelets (required for normal blood clotting), are trapped in the tiny blood clots or are damaged and destroyed by the spleen.

Read more about Shiga toxin-induced HUS here.

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This week's Food Safety Infosheet from the International Food Safety Network (iFSN) out of Kansas State University and the University of Guelph addresses concerns about E. coli O157:H7 - a potentially deadly foodborne pathogen.  From the infosheet:

E. coli O157:H7 can cause vomiting, diarrhea and can lead to kidney damage and is most dangerous for children and the elderly.

Foods that have been associated with E. coli O157:H7 include ground beef, fruits and vegetables, sprouts and unpasteurized juices.

When meat is ground, E. coli O157:H7 can be mixed from the surface into the middle of a patty or meatball. The only way to ensure that the dangerous
bacterium is killed is to use a digital tip-sensitive thermometer.

All three E. coli victims in the infosheet were hospitalized with Hemolytic Uremic Syndrome (HUS), a severe, life-threatening complication of an E. coli O157:H7 infection. Although most people recover from the symptoms of E. coli O157:H7 infection, about 5-10% of infected individuals develop (HUS).  The essence of the syndrome is described by its three central features: destruction of red blood cells (hemolytic anemia), destruction of platelets (those blood cells responsible for clotting, resulting in low platelet counts, or thrombocytopenia), and acute renal failure.

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A five-year-old from Hutchinson, Kansas, was released from Wesley Medical Center after being hospitalized for a month with hemolytic uremic syndrome.  Aubrey Anderson's kidneys failed after she became ill with an E. coli infection in October. 

According to the Hutchinson News, Aubrey was released from the hospital to recover at home because her mother is a registered nurse.  Public health officials have yet to identify the source of Aubrey's illness, and she will continue medical follow-up for months to years.  As the Hutchinson News reported:

It will be weeks, and perhaps months, before the family knows how much the illness damaged her kidneys, and whether she'll face a lifetime of treatment or be in the clear, said her father, Bill Anderson.

"We won't know until we get at least six or seven weeks out if there's any residual scarring as a result of the E. coli," Anderson said. "If there is scarring, it may mean anywhere from a range of a kidney transplant to her maybe having to take oral medication for the rest of her life to keep her body in balance."

Initial indications were that her kidneys were functioning, so the family is optimistic she'll make a full recovery.

All persons who have experienced HUS should be formally evaluated by a nephrologist—a kidney specialist—at a year following their acute illness. Kidneys injured by HUS may slowly recover function over at least a six month period following the acute episode and perhaps longer. Even persons with “mild” HUS who did not require dialysis should be formally evaluated. Such an evaluation should include a routine physical, blood pressure measurement, and blood and urine analyses from which kidney filtration rate can be calculated.

Physicians doing follow-up on HUS patients will carefully look for indications of kidney injury. These will include whether there is an abnormal amount of protein in the urine that may signal a significant injury to the kidneys or blood in the urine which also can reflect kidney injury. As assessment of the HUS patient’s glomerular filtration rate—“GFR”—is essential to determining whether the kidneys are functioning in the range of normal for that person age, sex, and size. It is also important to establish a baseline GFR so that future assessment of kidney function can reflect any potential loss of filtering capacity over time.

Studies done to date on HUS outcomes have largely confirmed a positive correlation between more severe kidney involvement acutely, particularly the need for extended dialysis, an increased incidence of future renal complications. However, it has been shown in multiple studies that even moderate kidney compromise in the acute phase of HUS can result in long-term complications due to damage to the filtering units in the kidneys.

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Sharon Smith, the mother of Stephanie Smith, a Minnesota resident who has been hospitalized for months after eating a hamburger and becoming ill with E. coli poisoning, spoke with Kirsti Marohn of the St. Cloud Times for an article that appeared in today's paper.  She shared the story of the few days before Stephanie became ill with symptoms of E. coli infection, and of her hospitalization. 

The 20-year-old dance instructor has undergone intensive medical treatment while doctors work to support her body.  Five days after becoming ill, Stephanie was hospitalized with hemolytic uremic syndrome and was placed in a coma when she began having seizures.  As Kristi Marohn wrote:

Two months later, she remains in critical condition at St. Marys Hospital in Rochester, fighting for her life against a severe case of E. coli poisoning.

Doctors have told Sharon that Stephanie remains extremely critical. She was diagnosed with hemolytic uremic syndrome, caused when E. coli toxins enter the bloodstream.

The severity of her case is very rare, similar to only a handful of others worldwide. Still, Sharon hasn’t given up hope that her only daughter, with her wide smile and warm personality, will pull through.

There are hopeful signs. Stephanie’s kidneys have started functioning again, and she no longer needs dialysis. But there are setbacks, too. Her tongue has swelled so doctors have had to prop her mouth open and put an oxygen mask on her. So far, attempts to lower the coma-inducing drugs have resulted in more seizures. She continues to breathe with the help of a respirator.

Stephanie's is one of the most severe E. coli cases reported on in recent years, but she is not alone.  Other E. coli victims from outbreaks this fall have also been hospitalized for lengthy periods - at least one other in a coma. 

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In September, an E. coli outbreak among students at Galena Elementary School perplexed health officials.  Several children became ill with E. coli and a source of the outbreak was elusive.  The sibling of two students at Galena Elementary battled an E. coli infection during the outbreak, and continues to recover after being on dialysis.  His mother has been hospitalized since she became ill with E. coli over 52 days ago. 

WAVE3 TV out of St. Louis, Missouri, reported the story of Amelia Seraiah's E. coli illness and hospitalization last night:

A Floyd County woman watched her son battle a deadly strain of E. coli back in September. Now she's hospitalized with the same illness. But her health isn't the only problem the single mother of five is facing.

It was 52 days ago -- on September 30th -- when Amelia Seraiah came down with the deadly bacteria. Her children are now staying with family members, who say they just pray she makes a full recovery.

Sharon Peltier has a lot to be thankful for this week. Her 3-year-old grandson, William, is off dialysis and doing better. He spent 17 days last month in Kosair Children's Hospital. Now Peltier's daughter (William's mother) is in Norton Hospital, fighting the same illness: E. coli.

Amelia isn't the only person battling an E. coli infection who will spend Thanksgiving in the hospital.  7-year-old Jayden Moss, of Willard, Utah, is expected to remain hospitalized until February.  He became ill with an E. coli infection earlier this fall and has suffered brain damage due to neurological involvement of HUS.  According to KSL.com:

Jayden is now at the learning level of an infant after developing Hemalitic Uremic Syndrome (HUS) from E. coli.

"He started throwing up and diarrhea," his mother, Rachael, said.

It eventually shut down his kidneys, and blood vessels in his body began bursting, causing severe brain damage. "Right now he doesn't walk, doesn't talk, he doesn't eat on his own, he's fed by a machine," Jayden's father, Jeremiah, explained.

According to the KSL story, Jayden's first-grade classmates have raised $6,500 to help his family pay their medical bills.

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A Mattoon High School senior from Mattoon, Illinois, who became ill with an E. coli infection last September shared his story with the Herald & Review. 

Matt Roberts became ill with an E. coli infection last September - just before an E. coli outbreak was traced to El Rancherito restaurant in Effingham.  His E. coli infection progressed to hemolytic uremic syndrome (HUS) and he was hospitalized for over a month.  While hospitalized, Matt was placed in a medically-induced coma for ten days, and underwent dialysis and blood and plasma transfusions.  Even after he was released from the hospital, Matt continued to receive plasma transfusions.

While Matt was ill, the Coles County Health Department worked to identify the source of his E. coli infection but has thus far been unable to determine the source of his illness.  According to the Herald & Review:

Coles County Health Department officials confirmed in early October they did not suspect any area restaurants as the source of Matt's infection or the E. coli contracted by another unidentified Coles County resident, who recovered from the illness relatively quickly.

Nor was Matt anywhere near the Effingham El Vaquero restaurant, to which seven E. coli cases were linked in late September.

And Matt was showing symptoms well before the Effingham outbreak.

A 20-year-old woman from Wisconsin was also hospitalized and in a drug-induced coma.  Stephanie Smith became ill this fall after eating ground beef contaminated with E. coli and developed HUS.

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The Hutchinson News from Hutchinson, Kansas, reported today that five-year-old Aubrey Anderson is undergoing dialysis treatments at a Wichita hospital to combat the effects of hemolytic uremic syndrome (HUS) secondary to E. coli infection.  The child has been hospitalized for 18 days. 

From About-HUS.com:

The essence of Hemolytic Uremic Syndrome is described by its three central features: destruction of red blood cells (hemolytic anemia), destruction of platelets (those blood cells responsible for clotting, resulting in low platelet counts, or thrombocytopenia), and acute renal failure. In HUS, renal failure is caused when the nephrons, or filtering units, become occluded (blocked) by micro-thrombi, which are tiny blood clots. In almost all cases, the filtering ability of the kidneys recovers as the body of the patient slowly dissolves the micro-thrombi within the microvessels.

A typical person is born with about one million filtering units, called nephrons, in each kidney. The core of the nephron is a bundle of tiny blood vessels, called a glomerulus, where osmotic exchange allows for the filtration of wastes that eventually collect in the urine and are excreted. During Hemolytic Uremic Syndrome, the lack of blood flow to the nephrons can cause them to die or be damaged, just as heart muscle can die as the result of coronary vessel occlusion during a heart attack. Dead nephrons do not regenerate.

In general, the longer a patient suffers kidney failure, the greater the loss of filtering units as a result. At some point, the damage to the kidneys’ filtering units can be so severe that the patient will, over a period of years, lose kidney function and suffer end-stage renal disease (ESRD), which requires chronic dialysis or transplantation.

HUS can also cause transient or permanent damage to other organs, which include the pancreas, liver, brain, and heart. The essential pathogenic process is the same regardless of the organ affected: microthrombi inhibit necessary blood flow and cause tissue death or damage. During the acute stage of Hemolytic Uremic Syndrome, patients must be carefully monitored for these extra-renal complications. It is very difficult to predict the severity and course of HUS once it initiates.

The active stage of Hemolytic Uremic Syndrome may be defined as that period of time during which there is evidence of hemolysis and the platelet count is less than 100,000. In HUS, the active stage usually lasts an average of six days (range, 2-16 days). It is during the active stage that the complications of HUS per se usually occur.

In the Hutchinson News article, Aubrey's father discussed her condition:

"Aubrey's hemoglobin was down a little today, which is not good," Anderson said in an e-mail. "Her platelets, however, have reached a 'normal' level and the doctor feels that they will not decrease again, and that is encouraging. Her toxicity level is down from yesterday, but they would like to see it come down farther."

Aubrey remains on a feeding tube, which goes down through her nose and bypasses her stomach into her intestines. She continues to frequently vomit, however, which displaces the feeding tube.

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Aubrey Anderson, a five-year-old from Sterling, Kansas, has been hospitalized with hemolytic uremic syndrome (HUS) secondary to E. coli infection, according to several media reports.  She is currently being treated at Wesley Medical Center in Wichita, and doctors believe she could remain hospitalized for 3-6 weeks. 

KSN TV's website featured a story on the child's illness, and interviewed her parents.  From the story:

Aubrey's kidneys have shut down, but the Anderson's are confident she will recover.

"I think there is more than a 95 percent chance that she will come out of this without any residual affects," Bill said.

Aubrey does have a long road ahead.

Public health officials have not yet been able to determine the source of Aubrey's illness, unlike in the case of Courtney Hansen, an eight-year-old from Ellsworth, Wisconsin, who was recently released from the hospital after a five-week stay while she was treated for HUS.  In Courtney's case, the Pierce County Herald reported that she and her younger twin sisters all became ill with E. coli infections after eating wind-fall apples. 

Two benefits are planned to raise money for medical expenses.  Details of the benefits were provided in the Herald:

The family and Our Savior’s Lutheran Church invite the public to attend the two benefits in Courtney’s honor.

The first is a luncheon 11 a.m. to 2 p.m. Saturday, Nov. 10, at Our Savior’s Lutheran Church, N6450 530th St., Beldenville.

Lunch will consist of soup, sandwichs and salads. Homemade pies will be available for sale.

There will be silent auction as well. To donate an item for the auction, contact Audrey Severson at 273-5019 or mail items directly to: Auction Item, c/o Severson, N6059 530th St., Ellsworth, WI 54011.

The second benefit will be a Hunters’ and Shoppers’ Breakfast 4 a.m. to 9 a.m. Saturday, Nov. 17, also at Our Savior’s Lutheran Church.

The breakfast menu will include egg bakes and rolls.

Free will donations will be accepted at both events.

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WAVE TV reported Saturday that Sidney Jacobi, a 6-year-old child who is part of the E. coli outbreak among Galena Elementary School students, is home from the hospital.  Sidney sustained the most serious injures of any child hospitalized during the outbreak, suffering hemolytic uremic syndrome, which caused kidney failure.  WAVE interviewed Sidney's mother about her illness and return home:

"She was so fluid and puffy that she didn't look like herself," Marcia said.

During the time she was in the hospital, Sidney received cards from hundreds of people. Some that knew her and many that didn't.

Sidney is still recovering. High blood pressure is still a concern.

"We still have to watch her kidneys and our numbers still need to come down," said Marcia.

Follow-up treatment for victims of E. coli and hemolytic uremic syndrome is very important, and all persons who have experienced HUS should be formally evaluated by a nephrologist—a kidney specialist—at a year following their acute illness. Kidneys injured by HUS may slowly recover function over at least a six month period following the acute episode and perhaps longer. Even persons with “mild” HUS who did not require dialysis should be formally evaluated. Such an evaluation should include a routine physical, blood pressure measurement, and blood and urine analyses from which kidney filtration rate can be calculated.

Physicians doing follow-up on HUS patients will carefully look for indications of kidney injury. These will include whether there is an abnormal amount of protein in the urine that may signal a significant injury to the kidneys or blood in the urine which also can reflect kidney injury. As assessment of the HUS patient’s glomerular filtration rate—“GFR”—is essential to determining whether the kidneys are functioning in the range of normal for that person age, sex, and size. It is also important to establish a baseline GFR so that future assessment of kidney function can reflect any potential loss of filtering capacity over time.

Studies done to date on HUS outcomes have largely confirmed a positive correlation between more severe kidney involvement acutely, particularly the need for extended dialysis, an increased incidence of future renal complications. However, it has been shown in multiple studies that even moderate kidney compromise in the acute phase of HUS can result in long-term complications due to damage to the filtering units in the kidneys.

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WATE.com reported yesterday that a Cocke County, Tennessee child died after fighting an E. coli infection.  According to the story, the girl, who was 20-months-old and was diagnosed with E. coli on October 9, was determined to be brain-dead on Monday and her heart stopped functioning late Tuesday night.  As to the source of her illness, WATE reported:

Officials with the East Tennessee Regional Health Department said Wednesday the source of Jaycee's infection has not been confirmed.

However, her family says Jaycee had a little bit of hamburger meat the Saturday before she got sick but they don't know if that was the cause of her infection.

Since no other E. coli infections have been reported recently in Cocke County, health officials say they think the cases will be limited to Burgin's.

Young children who become infected with E. coli O157:H7 and other strains of E. coli are susceptible to a complication of E. coli infection called hemolytic uremic syndrome (HUS).  HUS develops when the toxin from E. coli bacteria, known as Shiga-like toxin (SLT), enters the circulation by binding to special receptors. These Shiga-toxin receptors, known as Gb3 receptors, are probably heterogeneously distributed in the major body organs allowing disparate thrombotic (blood clotting) impacts in different HUS victims, although the greatest receptor concentration appears to be in the kidneys, especially in children. As the inflammatory reaction process accelerates, red blood cells are destroyed and cellular debris aggregates within the microvasculature while the body’s inherent clot breaking mechanisms are disrupted. The result is formation of microthrombi within particularly susceptible organs such as the kidneys and brain. Because there exists no way to halt the progression of HUS, doctors are left to support the HUS victim while the acute process runs its course.

Some organs appear more susceptible than others to the damage caused by these toxins, possibly due to the presence of increased numbers of toxin-receptors. These organs include the kidney, pancreas, and brain.

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A six-year-old first grade student at Galena Elemenary School in Indiana has been hospitalized with kidney failure after she developed hemolytic uremic syndrome following an E. coli infection, according to WLKY news.  The child is one of six students at the school who have been confirmed as suffering E. coli infections, with five cases unconfirmed but possibly linked to the outbreak.  WLKY reported that the state health department has joined the outbreak investigation, and is sending three additional investigators to help determine the source of the outbreak.  According to the news report:

The school has been thoroughly cleaned, officials said, but parents are still concerned about the safety of their kids.

State Health Officials said they are sending three more specialists to Floyd County to help track down the source of an E. Coli infection.

Two food specialists and a second epidemiologist are scheduled to inspect the school Tuesday.

In 1998, a seemingly similar E. coli outbreak-situation occurred in Washington state. 

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The Troy Messenger published a follow-up story on Mallory Chandler, a Troy, Alabama, toddler who became ill with an E. coli infection and HUS while she was on vacation with her family in late June.  Mallory was recently released from the hospital, and The Messenger spoke with her grandmother, Linda Chandler, about her illness and hospitalization.

Where Mallory contracted E.coli, Chandler said probably no one will ever know.

“They thought it might have been from the pool, but I don't really think that,” she said. “It could have come from anywhere. She could have touched something and then put her hand in her mouth. We just don't know.”

Exposure to E. coli can occur in any of a number of different ways.  The following is a list of ways to avoid exposure to E. coli O157:H7:

1. Cook all ground beef thoroughly.

Eating undercooked ground beef is the most important risk factor for acquiring E. coli O157:H7.[1] Because ground beef can turn brown before disease causing bacteria are killed, use a digital instant read meat thermometer to ensure thorough cooking. Ground beef should be cooked until a thermometer inserted into several parts of the patty, including the thickest part, reads at least 160º F. Persons who cook ground beef without using a thermometer can decrease their risk of illness by not eating ground beef patties that are still pink in the middle. If you are served an undercooked hamburger or other ground beef product in a restaurant, send it back for further cooking.[2]

Avoid spreading harmful bacteria in your kitchen. Keep raw meat separate from ready-to-eat foods. Wash hands, counters, and utensils with hot soapy water after they touch raw meat. Never place cooked hamburgers or ground beef on the unwashed plate that held raw patties.

Wash meat thermometers in between tests of patties that require further cooking.

2. Drink only pasteurized milk, juice, or cider.

Commercial juice with an extended shelf life that is sold at room temperature (e.g. juice in cardboard boxes, vacuum-sealed juice in glass containers) has been pasteurized, although this is generally not indicated on the label. Most juice concentrates are also heated sufficiently to kill pathogens.

3. Wash fruits and vegetables thoroughly, especially those that will not be cooked.

Children younger than 5 years of age, immunocompromised persons, and the elderly should avoid eating alfalfa sprouts until their safety can be assured.[3] Methods to decontaminate alfalfa seeds and sprouts are being investigated.

4. Drink municipal water that has been treated with chlorine or other effective disinfectants, or bottled water that has be sterilized with ozone or reverse osmosis (almost all major brands use one or the other method).

5. Avoid swallowing lake or pool water while swimming, especially pool water in public swimming facilities.

6. Avoid Petting Zoos and other animal exhibits.

7. Make sure that persons with diarrhea, especially children, wash their hands carefully with soap after bowel movements to reduce the risk of spreading infection, and that persons wash hands after changing soiled diapers.

Anyone with a diarrheal illness should avoid swimming in public pools or lakes, sharing baths with others, and preparing food for others.

[1.] Slutsker L, Ries AA, Maloney K, Wells JG, Greene KD, Griffin PM. A nationwide case-control study of Escherichia coli O157:H7 infection in the United States. Journal of Infectious Diseases 1998;177:962-926.
[2.] http://vm.cfsan.fda.gov and http://www.cfsan.fda.gov/~dms/fc01-toc.html give the Food and Drug Administration advice and Food Code, respectively, about food cooking temperatures and other prevention techniques.
[3.] Breuer T, Benkel DH, et al. A Multistate outbreak of Escherichia coli O157:H7 infections linked to alfalfa sprouts grown from contaminated seeds. Emerg Infect Dis, 2001; 7:977-82.

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The Huntsville Times reported today on an outlying case of E. coli that was investigated as potentially linked to the E. coli outbreak linked to lettuce consumed at Little Rosie's restaurant in Huntsville.  While that case was ultimately determined to be unrelated to the Little Rosie's E. coli outbreak, the Times updated its report on three victims of the outbreak who were hospitalized.  The three remain hospitalized with hemolytic uremic syndrome (HUS).  A recap on the outbreak from today's article:

Health officials say the Huntsville outbreak most likely was caused by contaminated lettuce served at Little Rosie's between June 27 and June 30. Eighteen of the 19 known victims ate at the popular Mexican restaurant on Whitesburg Drive on those dates; the other infected person did not eat at Little Rosie's and caught the bacteria another way.

Three Little Rosie's customers have been in the hospital since about July 4 undergoing dialysis for kidney damage.

Treatment for HUS is minimal, with doctors providing mostly supportive care for individuals who develop the syndrome.  Dialysis and plasmapheresis are two treatments physicians can use to help victims battle HUS.  From the About-HUS website:

There is no known therapy to halt the progression of Hemolytic Uremic Syndrome. The active stage of the disease usually lasts one to two weeks, during which a variety of complications are possible. HUS is a frightening illness that even in the best American medical facilities has a mortality rate of about 5%. By comparison, the mortality rate in the developing world is much higher. About 50% of patients require dialysis due to kidney failure, 25% develop pancreatitis, 25% experience seizures, and 5% suffer from diabetes mellitus. The majority of Hemolytic Uremic Syndrome patients requires transfusion of blood products and develops complications common to the critically ill. The illness is a living nightmare for the patients and families, and leaves a painful memory that lingers long after the acute illness had passed.

Among survivors of HUS, about five percent will eventually develop end stage kidney disease, with the resultant need for dialysis or transplantation, and another five to ten percent experience neurological or pancreatic problems which significantly impair quality of life. Since the longest available follow-up studies of HUS are about twenty (20) years, an accurate lifetime prognosis is not available, and as such, medical follow-up is indicated for even the mildest affected cases.

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The Bracken County, Kentucky, health department is investigating how three children became ill with E. coli infections.  According to an article posted at wlwt.com, two siblings and another child fell ill with E. coli nearly a month ago.  Two of the children were hospitalized for several weeks with hemolytic uremic syndrome. 

WLWT interviewed Nicole Logan, the mother of two of the children who were ill - one, her son, Zachary, has been receiving treatment for HUS for over 3 weeks.

"Sometimes the children are not very sick and just have abnormalities in their blood tests. Other times they become very ill and require dialysis or even [have] permanent kidney failure," said Dr. Mitchell Cohen of Children's Hospital.

The Health Department is investigating what could have caused the three cases.

"They're for some reason leaning toward hamburger or spaghetti sauce," said Logan. "I just hope they can find it. I hope it's not still out there. I don't want more people to get sick."

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The Troy Messenger reported that a 22-month-old child has been hospitalized with hemolytic uremic syndrome in the Birmingham, Alabama, Children's Hospital.  Her grandfather, Dr. Malone Chandler, was interviewed for the story, and discussed her illness and possible exposures she could have had to E. coli, the most common cause of HUS.

“The concern for Mallory is that her kidney function began to decline in the past 24 hours. She is on dialysis, temporarily, and she has had a blood transfusion. She is not in great shape, but the news that we got today is encouraging.”

Chandler said the source of Mallory's illness is not known and may never be.

“At the beach, Mallory played in the pool,” he said. “She had not eaten anything much since last Wednesday or Thursday, so we really don't know of any food that she might have eaten that could have made her sick. We are wondering if it could have been something in the pool water.”

Chandler said in the past week four children have been admitted to Children's Hospital suffering from the same symptoms as Mallory.

Past outbreaks have been traced to contaminated water sources, such as pools, water parks, and spray parks.  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 after suffering HUS.

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.

Marler Clark represented most of the victims and their families, eventually obtaining millions of dollars in settlements. The incident also increased national awareness of the hazards of water contamination, prompting the industry to pay closer attention to pool cleaning and chlorine.

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According to an article posted on the Times Argus Web site, two Vermont children have been hospitalized in Boston with hemolytic uremic syndrome secondary to E. coli infection.  The health officials investigating the two cases at this point do not believe that the cases are related, but are continuing to look into the source of both children's E. coli infections.

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CHRISTY LATTIN, clattin@lahontanvalleynews.com
July 1, 2006

While many are grilling burgers and having fun this holiday weekend, one Fallon family is maintaining a vigil by their little girl's hospital bed in Oakland, hoping and praying she'll overcome an E. coli infection.

Four-year old Lanie Hope Smith of Fallon, daughter of Ken Smith of Reno and Melanie Smith of Fallon, fell ill last weekend and was admitted into Banner Churchill Community Hospital on Sunday, said her great-aunt Marie Nygren. Test were run but the cause of her stomach cramps were unknown.

Nygren said Lanie's kidneys began failing and she was transferred to Washoe Medical Center, where it was determined she had the E. coli infection. According to the WebMD Web site, E. coli is a bacterium with hundreds of strains that can live harmlessly in the digestive tracts. Some strains produce a toxin that can lead to kidney failure.

While at Washoe Med, Lanie's kidneys began shutting down and her blood cell counts became dangerously abnormal, said her grandfather, Jack McKay.

The Children's Hospital and Research Center in Oakland, Calif., was alerted and sent a plane to Reno for Lanie. Lanie flew to Oakland where she was admitted on Wednesday. Nygren said Lanie had surgery to insert two shunts for kidney dialysis.

Kathy Smith of Reno, Lanie's grandmother, said she was in stable condition around noon on Friday and that her son hasn't moved from her side.

"They're bonded, Daddy and daughter," she said. "He's very involved, they're very close. There's a heavy duty bond there."

Smith said because Lanie's kidneys are compromised, excess fluid is building in her system and she now has fluid in her lungs. The little girl is hooked up to continuous dialysis and oxygen.

Smith said the first sign of happiness was when Lanie woke briefly and asked her dad why she was in the hospital and were they up in the air together.

"This has really affected all of us. We're used to her being active and excited about life. She hasn't said much since she got sick," said Smith.

McKay said Lanie was sedated at Banner Hospital and Washoe Med because of the stomach pains.

Smith said Lanie performed in her first ballet recital earlier this month and was very excited.

"She put her hands around her mouth and told her mom to 'Find my Daddy.' He was there filming but she just couldn't see him," she said.

McKay said his step-daughter Melanie has been tough through the ordeal but had a few breakdowns as the bad news continued.

Smith said Lanie could be hospitalized in Oakland from three weeks to two months. She's sent prayers to the Wailing Wall in Jerusalem and to a global radio prayer ministry.

McKay said Lanie's been going downhill for the past few days, but Washoe Med told them her health would deteriorate before improving.

"She's very, very sick," he said.

Nygren has established a fund at Colonial Bank to help pay for family expenses related to Lanie's illness and McKay said he will collect funds at his business, Jack's Place on Center Street.

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