A pediatric E coli outbreak was declared on Sept 4 in this Calgary building, pictured Sept. 12. There are currently 264 cases connected to the outbreak.Jude Brocke/The Globe and Mail
An investigation into one of Canada’s largest outbreaks of pediatric E. coli continues after a newly released report revealed that cockroaches, improper food storage equipment and a “sewer gas smell” were identified by public-health inspectors in a kitchen serving Calgary daycares that is believed to be ground zero for the crisis.
Health officials said Tuesday that six patients at Alberta Children’s Hospital sickened in the outbreak are undergoing dialysis for kidney failure but are in stable condition. Twenty-two of the 25 people who remain hospitalized are confirmed to have hemolytic uremic syndrome, a severe illness caused by E. coli that can damage organs.
Some have been given intravenous fluids to cope with vomiting and diarrhea while others have needed transfusions because of anemia and a drop in hemoglobin, Dr. Tania Principi, section chief of pediatric emergency medicine at Alberta Children’s Hospital, said during a press conference.
Alberta Health Services declared the outbreak on Sept. 4 for six locations of the Fueling Brains daycare in Calgary and five additional child-care sites connected by a central kitchen. Confirmed cases have grown to 264, as of Tuesday.
The outbreak has sparked concerns from parents and guardians that Fueling Brains is putting profit ahead of child safety, highlighted by the operator’s lack of communication and unwillingness to refund child-care fees. A class-action lawsuit was filed on Friday against all of the affected daycares alleging negligence.
The Globe explains: What to know about E. coli infection symptoms and how to handle an outbreak
Fueling Brains has not responded to multiple requests for comment.
The press conference on Tuesday was the first time since the outbreak was declared that government officials – Alberta Chief Medical Officer of Health Mark Joffe, Health Minister Adriana LaGrange and Children and Family Services Minister Searle Turton – publicly addressed the health emergency.
“This has been an extraordinary outbreak, both in terms of the numbers and the severity. It is certainly the largest E. coli outbreak in Alberta that I’m aware of,” Dr. Joffe said. “We will continue to do all that we can do to investigate what happened here … and most importantly, what needs to be done differently.”
The cause of the outbreak is still under investigation even as about half of the affected facilities had their orders to close lifted on Tuesday. However, the decision to reopen is made by independent operators, at least one of whom notified parents late Monday night that it was delayed.
The centralized kitchen remains closed and “will only reopen once we are absolutely satisfied that it is safe,” Dr. Joffe said. But he offered reassurance to parents that it is “safe to send your children back” to sites that reopen.
A health inspection of the catering kitchen was conducted Sept. 5, the day after it was ordered closed, and found several violations. “Food was not being handled in a manner that makes it safe to eat,” health inspectors concluded.
“Operator indicated that cold foods were being transported to other locations in excess of 90 minutes without temperature control,” the report said. It also noted that two live adult cockroaches were seen around the dishwashing area and traps by sinks had “at least 20 cockroaches on the sticky pads each.”
Alberta Minister of Health Adriana LaGrange, left, listens as chief medical officer of health Dr. Mark Joffe speaks to the media about an E. coli outbreak linked to multiple Calgary daycares on Sept. 12.Jeff McIntosh/The Canadian Press
Other violations included a large pool of water beneath an upright cooler in the dishwashing area that led inspectors to conclude that “food equipment is not in good repair or is not in proper working order.” As well, they found that sanitizer solutions and equipment were not appropriate or not maintained.
Dr. Joffe said it is not unusual for violations to be found during an inspection and that inspectors consider the operator’s willingness to address violations and responsiveness, along with specifics of the infractions when conducting an overall risk assessment. The kitchen has been investigated by public-health officers six times this year, but Alberta Health Services inspection reports dating back to 2021 note numerous violations – some repeated.
Public-health inspectors have collected samples of 11 food types found in the centralized kitchen, including eight leftovers from daycares, which are being tested. Dr. Joffe said. Food histories are being collected from people who attended or worked at the sites, both from those who fell ill and those who did not.
Comparing the ways food was prepared, delivered and provided to sites with higher rates of infection and daycares with relatively few or no cases will help establish the sources of the outbreak, he added.
Dr. Joffe, when asked about the government’s absence over the past week, said officials did not “feel there was urgency” to address the public until now. He later clarified, in a statement, that the issue “has been addressed with urgency from the very start.”
He said health professionals have kept in regular contact with parents and caregivers. “The priority was first and foremost getting people looked after and then to provide the public with a fulsome update,” he said. Ms. LaGrange said the situation will be high priority “until every single one of those children are home.”
Meanwhile, the owners of Fueling Brains are so far declining to refund parents’ fees, instead saying they will receive a credit for the days child-care centres are closed. The operator said, in a document on Monday, that credit will be extended for any time the students need to be absent because of E. coli.
Parents are angry at the operator. “They have illustrated over and over throughout this process that they’re putting profits before our children,” said Katie McLean, whose two-year-old daughter attends the McKnight location and spent six days in hospital last week.
The co-founders of Fueling Brains Academy, Faisal Alimohd and Anil Karim, are listed as the directors of Fueling Minds Inc., which operates the shared kitchen, provincial documents show. The company has a moral obligation to offer refunds given the link between Fueling Brains and Fueling Minds, Ms. McLean said.
Credits for days missed won’t ease the financial hardship on parents who have had to stay home to care for their children or help parents who choose not to send their children back to Fueling Brains, she said.
Ms. McLean said she can’t picture dropping off her daughter at the daycare when she tests negative.
“It feels like that would feel cruel,” she said. “I think of her eating that meal and it just makes me sick.”