Families fear for kids as number of E.coli cases connected to Calgary daycares jumps to 128

A food poisoning spate connected to 11 Calgary-area daycares is believed by some to be the largest serious E. coli outbreak of children under the age of five ever reported.

Alberta Health Services (AHS) says 128 cases have been confirmed as of Thursday morning, with 25 in hospital and three who've been discharged from hospital.

"This may be the largest outbreak of this specific type of Shiga-toxin E. coli in children under five years of age reported," said Dr. Stephen Freedman, a Cumming School of Medicine professor of pediatrics who studies E. coli.

Timing is critical. Young children are considered high-risk of developing a serious condition known as hemolytic uremic syndrome (HUS) up to 10 days after symptoms begin.

"The kidney is the most commonly affected organ but it can affect almost any organ in the body, including the brain, the heart, the liver, the pancreas," Freedman said.

"So until the last child exposed is out of the at-risk window, which is about 10 days after the onset of their symptoms, then we will continue to worry that we will see children who have seen significant disease."

Nine patients have confirmed cases of HUS.

AHS said Thursday all of the patients are stable and receiving care in hospital.

Some children are spending several hours a day at the hospital, getting blood tests to monitor for HUS.

"Children can really deteriorate acutely. They can go from looking quite well and having a really quite normal biochemical bloodwork profile to, you know, requiring dialysis within 24 hours," Freedman said.

A family member of a three-year-old E. coli patient says the severity of the situation is not being communicated.

He says while parents have been complaining about not having a daycare, he has watched a previously perfectly healthy three-year-old suffering in hospital.

It started Saturday, when they noticed blood in the child's stool, and he was suffering from severe stomach cramps.

They took him to the Alberta Children's Hospital, where he was admitted and they were told it was good to catch it early.

Over 24 hours, things went from bad to worse.

They were told the child had the worst form of E. coli but hadn't developed HUS.

Six hours later, they were told he in fact does have it.

He underwent surgery on Wednesday and was then put on dialysis.

Doctors say they are monitoring his situation.

The scariest part for the family is they were told it's not clear how this might impact his other organs.

The child has labour-level stomach cramps every three to five minutes, as well as bruises from all the blood they've taken from him.

"It's just hell," the family member said.

"Hemolytic uremic syndrome can potentially be a life-altering, deadly complication," said Bill Marler, a renowned American food safety lawyer.

Marler has been contacted by Calgary families with children infected by the daycare E. coli outbreak, and a Canadian lawyer.

Though he cannot practice in Canada, he can provide consultation.

"I would not be surprised that you saw a class-action lawsuit filed immediately," he said.

"These kinds of outbreaks, where you have literally hundreds of people sick from consuming food, you know, don't happen without some high degree of negligence."

Of the 25 patients in hospital, 20 are at the Alberta Children's Hospital and five are at the Peter Lougheed Centre.

Thursday evening, AHS released the following statement to CTV Calgary:

"To ensure the safety of our patients, families and care teams, a limit of two designated visitors are permitted to visit inpatients receiving care for E. coli at Alberta Children’s Hospital at this time. One caregiver is permitted to attend an appointment with a child receiving outpatient care.

"This visitor restriction is in place to reduce any potential risk of spread of infection to our patients, families and staff.

"Other means of communication with inpatients other than in-person visits include phone, or FaceTime.

"We appreciate everyone’s understanding and patience as we work to care for the patients and families that need our care."

Freedman says approximately 50 to 60 per cent of children who develop the hemolytic uremic syndrome will need dialysis for a short period of time.

Freedman says most of those children will recover kidney function and will not require chronic dialysis but could be at risk of complications as they get older.

"This group of children will be predisposed to having chronic kidney disease," he said.

AHS says most people who get sick from E. coli improve on their own within 10 days.

"Antibiotics are not recommended and in fact have a risk of increasing the risk of children developing the hemolytic uremic syndrome," Freedman said.

"We have no other specific treatment for this disease at the moment aside from really preventing dehydration."

The source of the outbreak is still under investigation.

Many parents wonder if the contamination may have been in meatloaf served for lunch on Tuesday of last week.

Public health inspectors have collected and are testing food samples from Fueling Minds, the central kitchen used by all the daycares.

A main focus now is preventing secondary cases, which can be spread when bacteria is shed in stool.

"Obviously, meticulous attention to hand hygiene is of paramount importance to reduce the risk of transmission, which is estimated to occur in about 10 per cent of households," Freedman said.

Secondary cases can be just as serious.

Marler represented families affected by a deadly E. coli outbreak at U.S. Jack in the Box restaurants in 1993, including one of the children who died.

"That child was a secondary case," Marler said.

The American lawyer, who was in Banff in June 2023 speaking at the 11th VTEC Symposium on Shiga Toxin Producing Escherichia coli Infections, says this may be the largest reported E. coli outbreak connected with a daycare.

"I'm not aware of any daycare case that I've ever heard of, where you have over 100 people sick," he said.

Not all the 11 Calgary-area daycares have confirmed cases, but six Fueling Brains Academy locations in Calgary and five other sites will remain closed until the issue is resolved.

AHS has launched a central website with information for parents of kids at these daycares.

Alberta Children's Hospital has set up a dedicated clinic to monitor symptomatic patients after their initial emergency room visit.

AHS advises families not to take children to hospital if they are not symptomatic.

AHS health inspection reports for Fueling Minds dating back to 2021 show some violations, including dirty food contact surfaces and food not being stored at safe temperatures, but follow-up inspections, most recently in April, show the kitchen in compliance.