Tracking sickness through social networks – practical use during an E. coli O157 outbreak in a primary school in London

This paper describes the practical use of social network diagrams in the management of an outbreak of Escherichia coli O157 (VTEC) in a primary school in London. The diagrams were created during the outbreak to establish the extent nurseryand nature of person-to-person transmission in the cases and their contacts. The diagrams supported a tailored public health action, and hence aided in the control of the outbreak. We conclude that for selected infectious diseases, social network diagrams can provide a valuable tool in the management of an outbreak.

Epidemiology and Infection / FirstView Article, pp 1-9

D. Devakumar, A. Kitching, D. Zenner, A. Tostmann and M. Meltzer

7 sick; report says E coli outbreak at nursery in Scotland linked to dirty nappies

One child remains in hospital almost five months after seven people were struck down with E. coli O157 at the Rose Lodge Nursery in Aberdeenshire in May.

The mother of the 22-month-old boy still hospitalized who has lost his sight, has severe hearing loss, complete kidney failure and partial brain damage, said through her solicitor “the report does not answer anything for her.

“The mother has been permanently residing in the hospital complex to care and attend to the child and is at the hospital from about morning until late evening seven days a week.

“She specifically wants the public reminded about how aggressive E. coli 0157 can be.

“She believes that she and the child have been forgotten about and that she is very angry about that.”

The report by NHS Grampian on the outbreak yesterday revealed that one of the possible reasons for the spread of the infection was staff failing to wash their hands properly after handling nappies.

However, the report said that the bug could have been passed on through private drinking water contaminated with animal feces from nearby fields, or due to issues with hand hygiene at a relative’s home.

The bug originated in the baby unit of the Aboyne nursery, which cares for 35 children. Four infants, one relative and two members of staff were all struck down with E coli O157.

The report advised the nursery to stop the use of a communal bowl for handwashing in the baby room and said the water at a sink in the nappy-changing area might have been too hot for effective handwashing. It also warned staff of the potential for contamination of the nursery floor from parents’ shoes.

An NHS Grampian spokesman said: “If the parents require any further clarificiation, they should contact the health protection team. We will be happy to meet them to discuss their concerns.”

A communal handwashing bowl when surrounded by poop – baby poop? If I was a parent taking my kid to that daycare, I would have said something. I know the parents and staff hate me at Sorenne’s school for being such a microbiological stickler, but this is why people have to speak up – before there’s an outbreak.

 

Seven now confirmed with E. coli O157 linked to Aberdeenshire nursery

The number of confirmed cases of E. coli in an outbreak connected to an Aberdeenshire nursery has risen to seven, including three adults and four children; a further four children are suspected cases.

The outbreak centres on the Rose Lodge Nursery School in Aboyne, Aberdeenshire, where the first suspected case emerged last Sunday.

NHS Grampian’s health protection team is investigating the source of the outbreak.

E. coli O157 outbreak at Scottish nursery grows

An additional six cases of E. coli O157 are now suspected in children at a nursery in Scotland, as one of the three hospitalized children has been released.

The Scottish Sun reports infection experts are trying to track down the source of the sickness and diarrhoa outbreak which hit the under-twos section at Rose Lodge Nursery in Aboyne, Aberdeenshire.

NHS Grampian said health protection teams found “reasonable” food hygiene and infection control at the unit.

Owner Julie Grant said: “We have taken the advice to close our Baby Room until further notice.

“The nursery remains open to unaffected families of children over two years old.

“We have a high standard of hygiene and rigorous infection control procedures. Our thoughts are with the children and families affected.”

3 infants stricken with E. coli O157 at Scottish nursery

It’s an unfortunate, but familiar story for UK childcares.

The Scotsman reports three infants were being treated in hospital following a suspected E coli O157 outbreak linked to the baby unit at a nursery school.

NHS Grampian confirmed that infection control specialists at the health authority are investigating two confirmed cases and four suspected cases of potentially deadly E coli O157 infection in children who attend Rose Lodge Nursery School in Aboyne, Royal Deeside.

The baby unit at the nursery school has been closed while investigations continue to identify the source of the bug. The garden in the grounds of the nursery in the heart of the village has also been declared out of bounds to the children but the nursery remains open.

The three children who have been admitted to hospital were all being cared for in the baby unit. There are a total of 40 children at the nursery, which takes children from six weeks up to the age of five.

NHS Grampian stressed yesterday the investigation to pinpoint a possible source for the bug was not focused solely on the nursery and that other potential sources of infection in the predominantly rural area were also being looked at.

A spokeswoman for NHS Grampian said no orders had been issued to close the Aboyne nursery. “The investigation is not centring on the nursery. We are also investigating other potential sources of exposure. E coli O157 are bacteria that are commonly carried in the gut of a variety of farm animals and their feces.”

NHS Grampian was informed about the first possible case of infection on Sunday night and of two other cases on Tuesday.

3 confirmed with E. coli O157 at Welsh nursery

Three cases of E. coli O157 have been confirmed in an outbreak at a children’s nursery on Anglesey.

Tri Ceffyl Bach Nursery in Amlwch was closed as a precaution last Thursday.

Dr Chris Whiteside, consultant in communicable disease control for Public Health Wales, said: "Given the nature of this infection it is not unusual for more cases to be identified amongst children attending the nursery. This is why the nursery was closed and the children and staff were asked to be tested.”

Irish nursery to close after E coli O26 outbreak

A creche in Limerick has been asked to close by the public health department of the Health Service Executive as a result of an outbreak of E coli O26.

Fewer than ten children have been infected; a number of linked cases have been identified.

The closure is to enable all staff and children attending the creche to be screened.

The HSE said it was satisfied that the creche was fully compliant with pre-school standards.

However, children from this creche will not be able to attend other child care facilities until they have been cleared of infection.

28 sick, E. coli cases on rise at Playdays nursery

More cases of E. coli O157 are being confirmed at James Cook University Hospital in Middlesbrough, U.K., with 27 children and one adult now affected.

Three of the children were admitted to hospital with the potentially lethal bug, which can lead to kidney failure. One child is still being treated at the Royal Victoria Infirmary in Newcastle.

Four children sick with salmonella at UK nursery

Another salmonella outbreak at another nursery, this time in the U.K.

Dunfermline Press reports four children who attend a West Fife nursery have been confirmed as suffering from Salmonella group B infection.

NHS Fife said that the cases were identified in early October and none of the children are seriously ill.

NHS Fife said that washing hands is an important way to avoid spreading the infection.
 

Lessons learned from E. coli outbreak in UK nursery

In Feb. 2010, the Feltham Hill Nursery and Infant School was closed for three weeks when E. coli O157 was contracted by pupils, affecting 18 people in all.

A report to the Hounslow Council contained 28 recommendations to improve future responses to emergency situations, including:

• the situation should have been declared ‘an emergency’ sooner than it was;
• there were delays in stopping the spread of the outbreak because the school had no emergency plan;
• information sharing between the school and the health authorities was poor;
• confusion over information given to parents resulted in many being worried that the outbreak was not being controlled.

Two children were treated in hospital for the bug, one of which was for a prolonged period of time. The report reveals that the source of the outbreak was never discovered.

The complete report is available at:
http://democraticservices.hounslow.gov.uk/mgConvert2PDF.aspx?ID=53762