Calgary doctor to study long-term implications of E. coli infections amid daycare outbreak

A University of Calgary doctor is looking to shed some light on the long-term implications of shiga toxin-producing E. coli, focusing on those with milder infections.

Dr. Stephen Freedman has been studying foodborne illness for approximately a decade.

"It’s one of those neglected illnesses that occurs often enough that it's important, but not frequent enough that anyone really has expertise in it," said Dr Freedman.

Sarah MacDonald's four-year-old son was one of hundreds of lab-confirmed cases of E. coli connected to an outbreak among Calgary daycares.

She says he came home from daycare in September with a fever. The next day, his symptoms intensified.

"When he initially he got it, I didn’t know how serious it was," said MacDonald.

She fears for his long-term health.

"The concern is over time, these kids that have had injuries to their kidney have a higher chance of developing kidney disease," said MacDonald.

Sarah MacDonald's four-year-old son came home from daycare with a fever. The next day, his symptoms intensified. At the hospital, E. coli was confirmed.Freedman is looking to study a total of 500 children from the recent Calgary outbreak with an approximate breakdown of 250 children who were E.coli positive and 250 who were negative. 

By studying children with a variety of illness severity and including children who tested negative for E. coli, he says he will be able to identify long-term outcomes even in children with mild infections.

"We don't know what impacts this infection will have on children with milder infections, as many of the children during the outbreak were asymptomatic or had only mild diarrhea and no complications. Understanding the potential for long-term complications in this population is extremely important," he said.

Possible complications that might go unnoticed, which are known to occur in children with more severe infections include chronic kidney disease, high blood pressure or the development of diabetes.

"We want to be sure that we're not overlooking potentially important complications in a large group of children. We need long-term follow-up to clarify these risks," said Dr. Freedman.

Freedman says he will evaluate the participants for a variety of complications from kidney and intestinal problems to early diabetes and high blood pressure, checking in after six months, 12 months and two years. For the long-term study, his team of researchers was granted over $1 million US dollars by the National Institute of Health.

CTV News has asked AHS for updated case numbers connected to the Calgary E. coli outbreak, including the total number of patients currently receiving care in hospital and how many remain on dialysis, but hasn't been sent the information requested.

Two weeks ago, AHS said that as of Oct. 16, there was 357 lab-confirmed cases connected to the outbreak, but didn't relay the number of patients in hospital or how many remain on dialysis, despite requests for that information.

The last update posted to AHS' website was in regards to the outbreak was on Sept. 22.

Freedman says he will begin reaching out to parents over the next two months to patriciate, hoping to have it wrapped up by the fall of 2025.

UPDATE

Following the publishing of this article on Oct. 30, Alberta Health Services sent a statement to CTV News on Oct. 31 that linked to updated outbreak numbers online.

The update, posted on Oct. 31, says that the entire Calgary E. coli outbreak is "now closed."

Though final data validation is underway, AHS says there are a total of 446 cases linked to this outbreak, including 356 that have been laboratory confirmed and 90 probable cases (probable cases include people with gastrointestinal symptoms who were epidemiologically linked to the outbreak but who did not have an STEC positive stool test).

The post indicates a total of 32 lab-confirmed secondary cases linked to this outbreak.

"Thirty-eight children and one adult were hospitalized, with 23 of these patients diagnosed with the severe outcome of hemolytic uremic syndrome, and eight requiring peritoneal dialysis," reads the statement. "No patients remain in hospital, and there have been no deaths."

"A total of 1,581 children connected with this outbreak have been cleared to return to a daycare facility."