E coli outbreak threatens infants in crèches

INFANTS attending crèches were among those most at risk of E coli infection, public health specialists investigating Ireland’s largest recorded E coli 0157 outbreak have found.

A report on the outbreak in West Limerick between October 15 and November 30 last also identified drinking water from private group water schemes (GWSs) as a hazard.

A total of 18 cases of E coli 0157 infection were recorded in the Kilfinny area of West Limerick at the time. As a result of the outbreak, two children were hospitalised with haemolytic uraemic syndrome, a type of acute renal failure associated with anaemia. The syndrome has a fatality rate of about 10%. One child required dialysis.

The report, published in Eurosurveillance Weekly and reported in Medicine Weekly, found nine of the 18 cases were in preschool children attending two local crèches, which closed voluntarily. There were five family clusters, including three sets of siblings.

“Preliminary results from the investigation support the hypothesis that crèche attendance and drinking water from a local GWS were risk exposures,” the report said. “Transmission appeared to be confined to childcare and household settings, and there was significant person-to-person transmission.”

The report warned of the importance of maintaining water quality standards in private GWSs, and the need for parents to be aware of how childcare facilities are regulated.

Registered crèches are subject to basic minimum hygiene requirements, and regularly inspected by local authorities, but unregistered ones are not.

The two associated with the E coli 0157 outbreak were unregistered.

Yesterday, a statement from the Health Service Executive Mid-Western Area said no new cases of E coli O157 have occurred in the West Limerick area since the end of November.

“However, the boil water notice remains in force for Kilfinny GWS pending the completion of upgrading of disinfection equipment and recording of satisfactory chlorination levels.”

The HSE also said there was “a propensity for spread of E coli O157 in family or crèche situations.