The Fueling Brains Academy McKnight location in Calgary on Sept. 13. Eleven child-care sites in Calgary and the surrounding area were ordered to close last week.Todd Korol/The Globe and Mail
Daycares at the centre of a significant outbreak of E. coli in Alberta have been given permission to reopen, even as authorities continue to search for the source of the illness, and as confirmed cases, most of them in children, surpass 300.
Eleven child-care sites in Calgary and the surrounding area were ordered to close last week. The last of those orders were rescinded Wednesday morning after Alberta Health Services inspectors determined the facilities to be “safe environments,” Francesco Rizzuti, medical officer of health with the service’s Calgary Zone, said in an update later in the day. A centralized kitchen that serves the daycares and is believed to be at the root of the outbreak remained closed.
Dr. Rizzuti said the inspections at each daycare were “thorough and highly detailed,” and took several hours.
“These daycares have addressed any immediate risks found and have met all requirements under the Public Health Act related to sanitation and safe operations,” Dr. Rizzuti said, adding that decisions to reopen will ultimately be made by the daycare operators.
“Our investigation into the source of the illness continues,” he said. “We have not identified a food source at this point.”
A total of 310 confirmed cases of illness were connected to the outbreak as of Wednesday, and 21 children were in hospital, according to Tania Principi, section chief of pediatric emergency medicine at the Alberta Children’s Hospital, who joined Dr. Rizzuti at the briefing. This is one of the largest outbreaks of pediatric E. coli known to have occurred in Canada. (There are many varieties of E. coli bacteria, some of which cause severe illness by producing toxins in the human body.)
Dr. Principi said 20 patients had hemolytic uremic syndrome, which can damage organs, including seven who were receiving dialysis, up from six on Tuesday. Two other patients had recovered from the syndrome since Tuesday. The majority of the children with E. coli are presumably under the age of 5, Dr. Principi said, based on the daycares’ demographics.
Another 18 people had been infected with E. coli because of secondary transmission within households, she said. “This is heartening and shows that our quick response and communication with families have helped to limit that spread,” she added.
Alberta Health Services declared the outbreak on Sept. 4 at six Fueling Brains Academy daycare locations in Calgary, and five other child-care sites. All of the facilities were served by a central kitchen operated by Fueling Minds Inc., which has the same directors as Fueling Brains.
Fueling Minds describes itself on its website as a “full service catering company and school lunch delivery service provider.” It says Red Seal certified chefs are responsible for its menus.
Kent Hehr, a former Liberal MP for central Calgary who now serves as vice-president of strategic partnerships and growth at Fueling Brains, said in a statement that Fueling Brains and Fueling Minds share similar ownership but are separate entities. He said the Fueling Brains daycares are sourcing food from a “mix of alternative external providers” and parents while the catering kitchen remains closed.
“We remain focused on supporting our kids, families and staff during this very difficult time and are committed to working with AHS in determining the exact source of the infections and will implement any changes in our operations and processes that are required,” Mr. Hehr said.
Fueling Brains came under intense scrutiny after the outbreak. Parents and guardians of children who attend the daycares have previously told The Globe and Mail that they are frustrated with what they have characterized as the company’s lack of communication, refusal to offer refunds and prioritization of profit over child safety. A class-action lawsuit has been filed against all of the affected daycares, alleging negligence.
The kitchen has been cited by public-health inspectors for a number of violations since July, 2021. An inspection conducted on Sept. 5, one day after it was ordered closed, found cockroaches, a sewer gas smell in the food preparation area and a lack of appropriate equipment for keeping food cold during transportation.
Food samples from the kitchen and affected daycares are being tested to identify the cause of the outbreak, but health investigators and scientists say definitive answers may be hard to come by.
Michael Gaenzle, professor and Canada Research Chair in the University of Alberta’s department of agricultural, life and environmental sciences, said investigators will need to isolate the outbreak strain from the foods that were served at the daycares to identify the actual source.
Most types of E. coli are unpleasant but ultimately harmless. But the bacteria related to this outbreak produces a type of toxin known as Shiga. Dr. Gaenzle said fewer than 10 cells of this variety of E. coli can make a person sick. This, he said, will make the investigation more complicated, because there are one trillion bacterial cells in a gram of food.
“You are looking for the needle in the haystack,” he said.
The size and scale of the outbreak has led him to believe that neither cross-contamination nor cockroaches in the kitchen were the main cause. This, he said, leaves food as the likely source.
Dr. Gaenzle said he has spoken to AHS workers who said the province’s labs are swamped, meaning a definitive answer may never be found.
Timothy Sly, an epidemiologist and professor emeritus at Toronto Metropolitan University, said cattle are often the source of such widespread outbreaks. He said he suspects undercooked beef as the culprit.
With a report from The Canadian Press