KC
Moderator
Fears of more virulent E coli strain as fourth nursery child taken to hospital
IAN JOHNSTON
The Scottsman 11/05/2006
http://news.scotsman.com/scotland.cfm?id=703132006
A FOURTH child was seriously ill in hospital last night after the outbreak of the deadly E coli bug in Fife.
The 22-month-old girl was rushed to Glasgow's Yorkhill Hospital, where the three other children, all aged two, were being treated for kidney failure.
Two other boys, aged 21 months and five years, who, like the others, attend the Careshare nursery at Lauder College in Dunfermline, were also being monitored after showing signs of illness.
The apparent lack of less serious infections prompted one expert to warn that the bug may have mutated into a more virulent form.
One of the children in Yorkhill was said to be "improving" on Tuesday, but yesterday the conditions of all four were described as "serious". The two boys being kept at home had not developed the serious complication known as HUS that can cause kidney failure. Dr Charles Saunders, a consultant in public health medicine at NHS Fife, said: "There are now four children confirmed as having kidney failure in the suspected E coli 0157 outbreak in children attending Careshare nursery.
"We are also aware of a further two possible cases in young children which are being investigated."
The nursery, in the Halbeath area of the town, has been closed voluntarily by its owners while health chiefs investigate.
The children have been diagnosed clinically as having the 0157 E coli strain, but this is still to be confirmed using microbiological tests. That strain of the disease killed 21 people in Lanarkshire in 1996.
However, Dr Anthony Hilton, the general secretary of the Society for Applied Microbiology, said doctors would normally expect only about 25 per cent of cases to develop the HUS complication that leads to kidney failure.
He said: "One possibility is that we have a particularly virulent strain which is causing HUS in a higher percentage than you might expect.
"I wouldn't be surprised if it hadn't suddenly acquired some new genes, causing it to become more virulent. If you had a particularly virulent strain of E coli producing a lot of toxin, it may be more children would suffer from kidney failure."
Dr Hilton said the other possibilities were that the children were, by chance, more susceptible than average to the disease, or that, more worryingly, there were still unidentified cases.
A spokeswoman for NHS Fife said stool samples were being taken from all children and staff at the nursery and these would be sent for analysis to see if there were more cases. She added that government scientists would look into the virulence of this strain of E coli.
NHS Fife confirmed all six children attended the nursery. Four were in the "tweenies" group, one in the toddlers group and the five-year-old was a member of the pre-school class.
Asked whether high standards of hygiene would stop E coli spreading in a nursery if an infected child arrived, the spokeswoman said: "Effective, supervised hand-washing after using the toilet and before and after handling food and eating is extremely effective in preventing the spread of E coli."
Professor Hugh Pennington (pictured), a microbiologist who wrote a report on the Wishaw outbreak, said it would be difficult to stop children passing E coli to each other. "It is hard to stop it spreading because the infectious dose is very low and the kids are very susceptible," he said.
"If a child is ill with diarrhoea, it shouldn't be there; it shouldn't be mixing with other kids. That's something the outbreak control team will be looking at."
Yesterday, The Scotsman reported that the nursery had been criticised by government inspectors in January over infection-control procedures. Staff were found not to change aprons often enough or use two gloves when changing nappies.
A spokesman for the Careshare nursery group insisted yesterday: "As far as we are concerned, there still isn't any proven link between the nursery and the E coli outbreak."
Asked if the company would pay compensation to the affected families if it was found to have been at fault, the spokesman said: "That's not something I can get into myself ... as far as the situation goes, we are not going to say anything more at the moment."
IAN JOHNSTON
The Scottsman 11/05/2006
http://news.scotsman.com/scotland.cfm?id=703132006
A FOURTH child was seriously ill in hospital last night after the outbreak of the deadly E coli bug in Fife.
The 22-month-old girl was rushed to Glasgow's Yorkhill Hospital, where the three other children, all aged two, were being treated for kidney failure.
Two other boys, aged 21 months and five years, who, like the others, attend the Careshare nursery at Lauder College in Dunfermline, were also being monitored after showing signs of illness.
The apparent lack of less serious infections prompted one expert to warn that the bug may have mutated into a more virulent form.
One of the children in Yorkhill was said to be "improving" on Tuesday, but yesterday the conditions of all four were described as "serious". The two boys being kept at home had not developed the serious complication known as HUS that can cause kidney failure. Dr Charles Saunders, a consultant in public health medicine at NHS Fife, said: "There are now four children confirmed as having kidney failure in the suspected E coli 0157 outbreak in children attending Careshare nursery.
"We are also aware of a further two possible cases in young children which are being investigated."
The nursery, in the Halbeath area of the town, has been closed voluntarily by its owners while health chiefs investigate.
The children have been diagnosed clinically as having the 0157 E coli strain, but this is still to be confirmed using microbiological tests. That strain of the disease killed 21 people in Lanarkshire in 1996.
However, Dr Anthony Hilton, the general secretary of the Society for Applied Microbiology, said doctors would normally expect only about 25 per cent of cases to develop the HUS complication that leads to kidney failure.
He said: "One possibility is that we have a particularly virulent strain which is causing HUS in a higher percentage than you might expect.
"I wouldn't be surprised if it hadn't suddenly acquired some new genes, causing it to become more virulent. If you had a particularly virulent strain of E coli producing a lot of toxin, it may be more children would suffer from kidney failure."
Dr Hilton said the other possibilities were that the children were, by chance, more susceptible than average to the disease, or that, more worryingly, there were still unidentified cases.
A spokeswoman for NHS Fife said stool samples were being taken from all children and staff at the nursery and these would be sent for analysis to see if there were more cases. She added that government scientists would look into the virulence of this strain of E coli.
NHS Fife confirmed all six children attended the nursery. Four were in the "tweenies" group, one in the toddlers group and the five-year-old was a member of the pre-school class.
Asked whether high standards of hygiene would stop E coli spreading in a nursery if an infected child arrived, the spokeswoman said: "Effective, supervised hand-washing after using the toilet and before and after handling food and eating is extremely effective in preventing the spread of E coli."
Professor Hugh Pennington (pictured), a microbiologist who wrote a report on the Wishaw outbreak, said it would be difficult to stop children passing E coli to each other. "It is hard to stop it spreading because the infectious dose is very low and the kids are very susceptible," he said.
"If a child is ill with diarrhoea, it shouldn't be there; it shouldn't be mixing with other kids. That's something the outbreak control team will be looking at."
Yesterday, The Scotsman reported that the nursery had been criticised by government inspectors in January over infection-control procedures. Staff were found not to change aprons often enough or use two gloves when changing nappies.
A spokesman for the Careshare nursery group insisted yesterday: "As far as we are concerned, there still isn't any proven link between the nursery and the E coli outbreak."
Asked if the company would pay compensation to the affected families if it was found to have been at fault, the spokesman said: "That's not something I can get into myself ... as far as the situation goes, we are not going to say anything more at the moment."