The entrance to the emergency department at Peter Lougheed hospital in Calgary on Aug. 22.Jeff McIntosh/The Canadian Press
A Calgary E. coli outbreak that likely originated in a daycare kitchen has now infected more than 140 people, some of them children who became so ill they required dialysis.
Alberta Health Services said on Friday that 142 lab-confirmed cases of E. Coli have been linked to the outbreak, which led to the closing of 11 daycares whose meals were prepared in a central kitchen.
Twenty-five of the infected patients were being treated at Alberta Children’s Hospital and one at the Peter Lougheed Centre, another Calgary hospital, on Friday, said Franco Rizzuti, the Medical Officer of Health for AHS’s Calgary zone. Eleven children had what Dr. Rizzuti described as more serious cases, and a small number of those were on dialysis.
A run-of-the-mill E. coli infection is unpleasant but usually resolves itself with no long-term consequences after a few days of diarrhea. The Calgary outbreak is different: It involves a subtype of E. coli that produces the more dangerous of two types of shiga toxins, which can enter the bloodstream, cause inflammation of the blood cells and lead to an uncommon but serious complication called hemolytic uremic syndrome, or HUS.
Patients with HUS have a combination of anemia, low platelet counts and acute kidney injury, which may need to be treated with a blood transfusion or dialysis.
“This is probably the largest single point – meaning single source – outbreak of this type of E. coli in children under five years of age ever,” said Stephen Freedman, a professor of pediatrics at the University of Calgary’s Cumming School of Medicine and a pediatric emergency-medicine physician at Alberta Children’s Hospital.
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Dr. Freedman said Alberta typically sees 30 to 40 cases of this subtype of E. coli infection in children over the course of a year. Now, they’ve confirmed 142 cases in about a week, most in children. “The numbers are astronomical,” he said.
Children caught up in the Calgary daycare outbreak who haven’t been admitted to hospital are being asked to come in for daily bloodwork to monitor for HUS. Alberta Children’s Hospital has set up a makeshift clinic in a conference room to handle some of the testing, but the volume is so high that AHS, the organization that oversees health care delivery in the province, has also set up clinics around the Calgary region to meet the need.
“At this time, all children on inpatient units are stable,” Dr. Rizzuti told a news conference on Friday. “Dialysis machines have been brought in from other Alberta Health Services sites, as well as rented, to ensure we have adequate capacity to care for patients now and in the coming days.”
Most of the daycare sites and the central kitchen are run by a chain called Fueling Brains Academy. However, Dr. Rizzuti said four of the 11 shuttered locations had seen no cases; those sites are due to reopen on Monday. The other sites can begin reopening on Tuesday, he added, but staff and children can’t return until they’ve tested negative for E. coli.
Kyla Herman, whose 4½-year-old daughter, Cameron, attends the Braeside location of Fueling Brains Academy, was sent home from the daycare last Thursday because her fever spiked at 102 F. The little girl was lethargic and had no appetite for two days before vicious stomach cramps and diarrhea began on Saturday night.
By 3 a.m. on Sunday, there was blood in Cameron’s stool. When Ms. Herman took her daughter to the emergency room of Alberta Children’s Hospital on Monday morning, the pair were whisked out of the waiting room and into the department, where Ms. Herman found an “absolutely heartbreaking” scene.
“There were kids in every corner, in every chair, on every bench, just wrapped around their parents, just crying and screaming,” Ms. Herman said through tears. “It was just the most terrible thing to see.”
Ms. Herman spoke to The Globe and Mail by phone from outside Alberta Children’s, where Cameron remained on Friday. She was on IV fluids, and health staff were testing her blood and monitoring her kidney function for signs of HUS.
Also on Friday, Julia Cossolin’s daughters, ages four and nearly two, were waiting in the emergency room of a hospital in High River, a town south of Calgary, for bloodwork and stool tests to see if they were still testing positive for E. coli. The girls were infected at Vik Academy in Okotoks, another of the daycares whose meals were supplied by the central kitchen.
Both girls fell ill with severe diarrhea on the weekend. They wound up spending four days at the Peter Lougheed Centre with their mother at their side. Ms. Cossolin said she was distressed at the prospect of sending her children back to Vik Academy when it reopens.
“I have to work to provide for our family. So I’ll have to send them back,” she said. “And that just breaks my heart because I honestly want them to just stay with me. It’s hard to trust again.”