Suspected case of dangerous E coli in Laois infant: HSE confirm investigation was started

Lynda Kiernan

Reporter:

Lynda Kiernan

The HSE began investigation of suspected case of VTEC E coli in Laois infant

The Health Service Executive has confirmed to the Leinster Express that an investigation was started late last week after a potentially serious strain of E coli was suspected in a Laois baby.

The baby attends a busy community childcare facility in Mountmellick which was contacted by the Department of Public Health as part of its investigation.

It is understood that the child has since been diagnosed with the less dangerous E coli bacteria, which can cause vomiting and diahorrea.

The serious strain is called VTEC or verotoxigenic E coli and comes from contact with faeces of healthy farm animals. It can cause a serious form of gastroenteritis in humans and in rarer cases, kidney failure. It can be easily spread through children's shared toys or in nappy changing or lack of thorough hand washing.

Because it is so serious, even suspected cases require a mandatory investigation to be started by the Department of Public Health, with preventative measures in case it is diagnosed, to stop the spread of infection. 

The investigation included contacting the creche where the baby attended, Sonas Community Childcare Centre in Mountmellick last Friday June 8, to raise awareness among staff and parents and to ascertain if other children had exhibited similar symptoms.

"This process begins prior to the diagnosis being confirmed, as the safety of young children is of paramount importance," the HSE told the leinster Express.

A HSE letter was given to the creche, who then issued it to parents last Saturday and Monday (see below).

The letter gave guidance for parents on what to do if their child had diarrhoea since May 11, over the incubation period of the bacteria, or if they became ill in the coming week.

It tells parents to contact their doctor and keep their child home from crèche if they have concerns.
It also gave advice on what to do if symptoms of a more dangerous illness called HUS developed, which can cause kidney failure. 

While the HSE says its policy is not to comment on individual cases, it has not taken further action at the facility, indicating that the E coli is not in fact the dangerous strain called VTEC.

The HSE explained their reasons for starting the investigation.

"As this infection can potentially be serious, particularly for young children, it is standard practice for the Department of Public Health to commence an investigation on the notification of a “presumptive case” of VTEC.  A presumptive case means that early tests on the stool sample suggest that VTEC is a possible diagnosis.  A full investigation will continue if the diagnosis of VTEC is confirmed by the Public Health Laboratory in Dublin."

It explains why it is important to contact the childcare facility attended by an infected child. 

"If a case of presumptive VTEC is notified to the Department of Public Health in a young child who attends a childcare facility, it is normal for the department to make contact with the facility as VTEC can spread easily within groups of small children.  The main reason for this contact is to raise awareness among the management and staff of the facility as well as the parents of other young children who attend the facility.  Another reason for this contact is to commence a risk assessment, and to evaluate whether other children have been exhibiting symptoms of VTEC. 

The early date on the letter of May 11 is due to the long incubation period before illness.

"The dates included in our communication are based both on the risk assessment and also on the incubation period of VTEC.  Verbal and written information and advice will normally be issued to the staff of the childcare facility and to the parents.  

When the diagnosis is not VTEC, the HSE says the process still raises important awareness. 

"Should the diagnosis be confirmed, further action is taken.  Measures to prevent the spread of infection, such as exclusion and screening of all staff and children attending a childcare facility, are necessary if a case of VTEC is confirmed and there is evidence of spread of the infection within the facility.  Occasionally the confirmatory lab will discover that the actual diagnosis is not, in fact, VTEC.  If this is the case, no further action in needed.  However the process of raising awareness among parents and staff of the importance of hand hygiene and enforcing strict exclusion policies is always a beneficial process in terms of protecting the health of young children," the HSE state.

See full letter given to parents below in two pages:

Page 2: