Calgary E. coli cases continue to rise as some daycare centres reopen
21 children have severe illness hemolytic uremic syndrome (HUS)
The number of E. coli cases linked to an outbreak at a number of Calgary daycare centres continues to rise, with 231 people now infected, an increase from 190 people on Sunday.
In a statement, Alberta Health Services (AHS) said that, as of Monday afternoon, 25 children and one adult are hospitalized. Eleven patients have been discharged since the onset of the outbreak.
Twenty-one patients, all of whom are children, have the severe illness hemolytic uremic syndrome (HUS), said AHS.
Fewer than 10 of these patients are on dialysis, the health agency added.
The rise in case numbers comes amid news that daycare centres that were initially under closure orders from AHS are now allowed to reopen at their own discretion, as long as no staff or attendees from those sites test positive for E. coli before doing so.
Of the 11 total closed sites, AHS cleared four daycares to reopen on Monday, which were not linked to any positive E. coli cases. Little Oak Early Education, Almond Branch and Braineer Academy resumed operations Monday. The fourth, Fueling Brains Bridgeland, told CBC News it plans to reopen Tuesday.
AHS cleared the remaining seven sites to reopen beginning on Tuesday. In an email sent to parents obtained by CBC News, Fueling Brains said it was working on a "staggered reopening plan" for its five other affected sites (Braeside, Centennial, McKnight, New Brighton and West 85th). None of these sites will be opening Tuesday.
Determining the cause
As a result of its investigation into the outbreak, AHS has said that it is "highly likely" that a central kitchen the daycare sites share is where the contaminated food came from, although the agency has yet to provide more details.
Brett Finlay, a professor at the University of British Columbia in the department of microbiology and biochemistry, said that finding the source of an outbreak of E. coli is a complex process.
While it takes about 10 million microorganisms of salmonella to get someone sick, becoming infected with E. coli requires a much smaller number of microorganisms, only about 10, said Finlay.
"If you take a pound or a kilogram of ground beef and then there's only 10 microbes in there, I mean that's needle in a haystack type hunting."
WATCH: How will the source of Calgary E. coli outbreak be found?
While he's certain the source will eventually be found, Finlay said it may take time to detect it, especially if it was only present in such small amounts.
"Kitchens are complex and there's a lot of things that go into food preparation," said Finlay. "They have to check each [ingredient] and where it's coming from and they have to be confident enough that they have enough of it [to make people sick]".
Once the source is identified, Finlay said there could be mass recalls of the contaminated product.
E. coli is carried by cattle so it can often be caught through eating beef. Fresh uncooked produce can also become contaminated if it comes in contact with a water source carrying the bacteria.
Public health response
The Alberta Children's Hospital (ACH) has established a dedicated clinic to monitor symptomatic patients after their initial emergency department visit and for patients who have been discharged from hospital.
Dr. Stephen Freedman, a professor of pediatrics and emergency medicine at the University of Calgary, said the Alberta Children's Hospital is seeing roughly 50 kids a day for follow up appointments and ongoing monitoring, while the South Health Campus is seeing between 15 and 20 kids daily.
Freedman said that the opening of the dedicated E. coli clinic within ACH is unprecedented.
"I think of this truthfully as the COVID pandemic right now that we're going through of the pediatric population," said Freedman.
"At a hospital health-care system level, [during COVID] we weren't opening up new clinics suddenly to manage children at three hospitals across the city. So this is a large response and I think actually that was one of the outstanding pieces that has happened throughout this.
"People are all working overtime, extra time, chipping in, and it's not just physicians. Obviously this is a multidisciplinary, across-the-team approach because you need to have everyone on board to do this."
Freedman added that the outbreak — which he said is the largest single point exposure of E. coli in children under the age of five ever recorded — should raise attention to the importance of food handling and monitoring when it's being distributed to such a large number of people.
With files from Jennifer Lee and Colleen Underwood
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