Yesterday, health officials announced an E. coli O157:H7 outbreak amongst children who attended a daycare in Clark County.  Daycares are a recognized setting for the transmission of disease, and frequently the transmission has nothing to do with food.  Often, the spread of disease is linked to the daycare’s sanitation practices. 

A short list of other daycare E. coli outbreaks over the last few years:

San Bernardino, California (2007):  at least one child ill with E. coli O157:H7; California Department of Social Services spokesman Oscar Ramirez stated the agency investigated a complaint filed against the KinderCare facility that the sick child attended.

Colorado, 2007: Health officials in Colorado investigated an E. coli outbreak among children in Eagle County. Several cases have been confirmed in children under 5. The county focused on swimming pools and child-care centers in its investigation.

Folsom California (2000):  In August of 2000, the Kindercare facility located on Lexington Drive in Folsom, California, was traced as the source of an E. coli O157:H7 outbreak. Health department officials who investigated the outbreak determined that the probable “index case” – a child who unknowingly brought the bacteria into the facility – experienced “explosive diarrhea at the daycare on the afternoon of 8-3-00.”

Canada, Japan (2007):  A two-year-old Canadian boy and three-year-old Japanese girl died recently after becoming ill with E. coli infections and hemolytic uremic syndrome. The source of each child’s illness is being investigated by public health officials. The Canadian child became ill in June, and died just days after being hospitalized. He was not part of an outbreak, and investigators are working to determine whether his illness can be associated with any other illnesses across Canada. The Japanese child became ill at the end of July, and also died just days after her hospitalization. Health officials have linked the girl’s illness to a cluster of E. coli infections associated with the day care facility she attended, but have not yet announced whether the outbreak is foodborne or is from some other source.

Sidney, Nebraska (2006):  An E. coli O157:H7 outbreak has been traced to a Sidney, Nebraska, day care center. The Associated Press reported that at least four children between the ages of nine and 18 months who were being cared for in the Blues Clues Room at Here Wee Grow day care center in Sidney have become ill with E. coli infections. Three children were hospitalized; two remain in the hospital, one has been released.

Macon County, Tennessee (2006):  A representative for the Tennessee Department of Health has reported that an outbreak of E. coli at a local day care was probably started with one infected child who then transmitted the bacteria to other children.  The infected child probably attended the day care facility for three to four days while he was experiencing symptoms of E. coli infection. Nine children have become ill as a result, with two children developing hemolytic uremic syndrome, a potentially fatal disease that causes kidneys to shut down.

Jasper County, Missouri (2004):  On May 10, 2004, the Jasper County Health Department (JCHD) received a report from St. Johns Regional Medical Center that two 2-year-old children had been hospitalized with hemolytic uremic syndrome (HUS) at Children’s Mercy Hospital in Kansas City, Missouri. The children, one boy and one girl, were residents of Carthage Missouri. Five of the girl’s family members soon developed symptoms of E. coli infection, and one later tested positive for E. coli O157:H7.

JCHD began investigating the apparent E. coli outbreak, and learned that the hospitalized girl and one of her siblings attended daycare at Kid’s Korner daycare in Joplin, Missouri. JCHD investigators visited the daycare facility on May 11. They did not note any major hand washing or diapering violations, and discussed the importance of excluding children with diarrheal illness from the daycare with daycare operators and employees.

On May 24, JCHD was notified that a 4-year-old girl who attended daycare at Kid’s Korner had become ill with symptoms of E. coli infection on May 14 and was being transferred from a Joplin hospital to Children’s Mercy in Kansas City with HUS.

JCHD inspectors returned to Kid’s Korner on May 25, and instructed the daycare to distribute a letter explaining the incidence of E. coli at the daycare and the signs and symptoms of illness to parents. During this inspection, JCHD investigators noted deficiencies conducive to the spread of disease and instructed Kid’s Korner employees on methods of hygiene and sanitation effective to prevent the further spread of E. coli.

By May 26, JCHD had received two additional reports of illness in children who attended Kid’s Korner. One of the children had had bloody diarrhea on May 11; the child’s sibling fell ill on May 26 and was later hospitalized with HUS. Despite their earlier assurances that no children at the daycare had been symptomatic during the month of May, Kid’s Korner then produced a list of nine children who had exhibited symptoms of E. coli infection to JCHD investigators.

On May 27, JCHD inspectors returned to the daycare center and noted handwashing lapses. They also learned that Kid’s Korner had failed to distribute the May 25 letter regarding possible E. coli exposure and symptoms to 32 percent of the families with children in attendance at Kid’s Korner.

Marler Clark represented the family of a two-year-old boy and his eight-month-old sister who both attended Kids’ Korner and became ill with E. coli infections. The two-year-old boy developed HUS and was hospitalized for nearly three weeks. He endured a full week of dialysis, seven transfusions, three surgeries, and a severe case of pancreatitis. The family’s claim was resolved in 2006.