Dialysis machines brought in to treat children in Calgary daycare E. coli outbreak

Click to play video: 'Calgary E. coli outbreak: Some patients developing kidney complications'
Calgary E. coli outbreak: Some patients developing kidney complications
WATCH: Alberta's pediatric health system is being pushed to the brink, as hospitals deal with one of the biggest e.coli outbreaks involving young children in Canadian history. As Heather Yourex-West reports, some patients are now developing a related kidney and blood disease – Sep 8, 2023

More cases continue to be linked to the Calgary daycare E. coli outbreak.

And while some parents are having to watch as their kids are being hospitalized, other parents are taking action to seek restitution.

On Friday, Alberta Health Services said there were 142 lab-confirmed cases linked to the outbreak and 26 kids were stable in hospital – one at the Peter Lougheed Centre and the rest at the Alberta Children’s Hospital – and five patients had been discharged from hospital. On Thursday, the outbreak included 128 lab-confirmed cases and hospitals had 25 patients.

Calgary Zone medical officer of health Dr. Franco Rizzuti said 11 of those hospitalized patients have more serious illness than the bloody diarrhea that is part of a Shiga toxin-producing E. coli infection, which includes hemolytic uremic syndrome (HUS) and other complications.

“We continue to work to find the source of this outbreak, but have not yet pinpointed it,” Rizzuti said, noting the rate of cases is consistent with the working theory that a central kitchen is the source of the outbreak.

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“We do anticipate that our case numbers will stabilize as we move into the weekend and next week.”

Rizzuti said a “small number” of kids were requiring dialysis, “however, this number is too small to provide for privacy reasons” and dialysis machines were brought in from other AHS sites in case they are needed in the coming days.

Click to play video: 'Calgary E. coli outbreak: Boy ‘spent nights on the toilet’ amid fears of long-term consequences'
Calgary E. coli outbreak: Boy ‘spent nights on the toilet’ amid fears of long-term consequences

One of those children on dialysis is two-year-old Amelia Leonard.

Amelia’s father Ryan said it wasn’t until the second day of bloodwork that doctors caught any kidney dysfunction in Amelia.

“(Her kidneys are) not doing as much as they’re supposed to be doing,” Ryan told Global News.

He said his daughter was in good spirits the day before she was admitted to hospital for monitoring. Her dialysis started on Friday, and a family member set up a GoFundMe to help with costs associated with Amelia’s hospitalization.

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Amelia Leonard, one of more than 100 children impacted by a daycare E. coli outbreak, sleeps in a bed at the Alberta Children’s Hospital. Courtesy: Ryan Leonard

“It’s definitely scary to think that at that age, kids shouldn’t be having to go through this. They should be having fun and stuff, especially with her birthday next week, on the Wednesday,” Ryan said.

Doctors said she could face a month-long stay in hospital, but didn’t have any predictions on how she’ll fare through the treatments.

“They say that she’s in a good spot, but they can’t really confidently say if tomorrow she’s going to be better or she’s going to start getting worse and worse, because it’s kind of hard to tell – is what they have been saying to me,” Ryan said.

“All my thoughts have just been on my kid.”

Click to play video: 'E. coli outbreak: How to protect yourself from infections, bacteria?'
E. coli outbreak: How to protect yourself from infections, bacteria?

Historic outbreak

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A professor of pediatrics and emergency medicine said this outbreak is “very unusual.”

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“This is probably the largest outbreak in children less than five years of age associated with a single point source,” Dr. Stephen Freedman said Friday. “And the real concerning piece about it all is that the children involved under five years of age are the highest risk group when they are infected with Shiga toxin-producing E. coli.

“Alberta has a high endemic rate of Shiga toxin-producing E. coli infection, meaning every year there’s a background rate of about 30 to 40 children who are infected across southern Alberta and another 20 to 30 probably in northern Alberta who are infected with Shiga toxin-producing E.coli strains.

“In this past week, we’ve seen numbers that we typically would see in four years.”

Freedman said antibiotics can make an E. coli infection worse and can increase the risk of developing HUS, a type of kidney failure.

Click to play video: '96 cases confirmed in Calgary daycare E. coli outbreak'
96 cases confirmed in Calgary daycare E. coli outbreak

And HUS can sometimes come up after symptoms, like bloody diarrhea, start improving.

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“That’s when the toxin really starts to manifest. And so the children might seem to be getting better for a day or two, but biochemically there’s a cascade going on in their body whereby the hemolytic uremic syndrome is starting to manifest, which is why we actually monitor children very studiously, doing bloodwork every 24 hours,” Freedman said.

“Because it seems like it gets better before it gets worse again, we can be lulled into a false sense of security that doing one set of blood work or that if a child is well, at one point in time, that they’re not going to get worse. And unfortunately, that is not the natural history of this disease.”

He said the length of time a child requires dialysis can be an indication of whether there will be longer-lasting effects of the E. coli infection.

“The shorter that period of dialysis, the better.”

Class action filed: lawyer

As more cases are linked to the outbreak, which was declared earlier this week, parents are seeking redress of some sort.

Kate Maxwell, who runs a cleaning business, has a son who attended Fueling Brains Academy in its Centennial location. She said she learned about the outbreak while working in Canmore, Alta., listening to Global News Radio.

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“Just thinking about the parents, obviously, and just thinking, like, ‘Am I going to find something with Farley? Like, is he getting sick? Is he going to get sick? And just how did this happen when you’re responsible for children?’” she said.

She said her son hasn’t yet had any symptoms of an E. coli infection. Maxwell credits her son’s food preferences for him likely avoiding an infection.

But she’s been in contact with other parents about the outbreak.

Click to play video: 'E. Coli outbreak at Calgary daycares: Confirmed cases nearly double to 96'
E. Coli outbreak at Calgary daycares: Confirmed cases nearly double to 96

“People are livid,” Maxwell said. “I just think that they feel like they don’t know where to turn and what to do, because especially when there is no real presence of the company and not a lot of answers. And I think everybody’s kind of waiting to see how this unfolds.

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“I was talking to another parent yesterday and (their child) just got admitted (to hospital). So it’s not over. It’s not there are still people being admitted getting sick.”

A statement of claim for a potential class action was filed in court Friday morning.

“Katie, our representative plaintiff, she just wants to do the best she can for all of these families because she’s not only experienced, but witnessed first-hand in the hospital room next door, what these children and parents are going through,” Maia Tomljanovic, partner at Cumming & Gillespie Lawyers, told Global News.

“We’re all used to the illnesses that we expect with daycare or school-aged children. But this is not what you expect as a parent,” Tomljanovic, who is also a mother, said. “And yeah, I can’t imagine what they’re going through, especially those who are in the hospital and are having to have blood drawn on a daily basis. That’s really tough with little kids.”

Tomljanovic said a number of families have reached out to the law firm and the statement of claim names all of the daycares, central kitchen and other facilities.

The statement of claim says “negligent, unsanitary and unsafe food storage, preparation and handling practices” resulted in the E. coli infections, resulting in a variety of illness, emotional upset, and caused a loss of income and loss of “housekeeping capacity.”

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They seek $150,000 per class member among other damages.

None of the claims have been tested in court.

Daycares to reopen

Not all 11 of the Calgary-area daycares that were closed as part of outbreak control have had any lab-confirmed cases linked to them and can reopen on Sept. 11, including:

  • Fueling Brains Bridgeland
  • Little Oak Early Education
  • Almond Branch
  • Braineer Academy

Those facilities will be allowed to reopen on Monday if there are no cases, kids or staff reporting symptoms.

The other seven facilities are under an exclusion order, prohibiting any of those children and staff from visiting other child care facilities.

These facilities will be allowed to reopen on Sept. 12, but children and staff will require AHS clearance to return to them:

  • Fueling Brains Braeside
  • Fueling Brains West 85th
  • Fueling Brains New Brighton
  • Fueling Brains Centennial
  • Kidz Space
  • Vik Academy in Okotoks

“No facility is allowed to reopen without our strict regulations being adhered to. And I really do want to reiterate that we only reopen the facility if we are confident that health and safety will not be affected,” the Calgary Zone medical officer of health said.

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In a statement, Fueling Brains Academy co-founders Faisal Alimohd and Anil Karim said the health and safety of the children, parents and staff continue to be their priority.

“Right now, we are focused on continuing to work with Alberta Health Services in their investigation, deep cleaning our facilities and supporting families. The exact source of the outbreak has still not been identified and we are continuing to review our policies, procedures, and sourcing related to food services for our facilities,” the statement reads.

“We understand a lawsuit may have been filed, however, as it is a legal matter, we cannot provide further comment.”

E. coli clinics have been set up to help children affected by the outbreak. Rizzuti urged any parent who is seeing symptoms of diarrhea and especially bloody diarrhea to call Health Link 811 or visit a nearby emergency department.

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Parents with asymptomatic children are urged to call Health Link for further advice.

Freedman said the outbreak contributed to an “extreme amount of pressure” on the hospital and health-care system.

“From the pediatric perspective, I think this is as much or more pressure than we ever felt during COVID,” he said. “Calgary, thankfully, was in a good position because we have a lot of expertise in this illness and that really has allowed us to be on top of it.”

Rizzuti said AHS has been able to reallocate healthcare workers with pediatric training in the Calgary region to support the children affected by this outbreak.

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