Four Calgary daycares shuttered amid a large-scale E. coli outbreak that infected dozens of children are scheduled to reopen on Monday, with health officials noting the facilities didn't see a single case of the bacterial infection.

As of Sunday, AHS has linked 190 cases to the outbreak, which prompted the closure of 11 local child-care facilities. Twenty-seven people are in hospital, and 20 have been confirmed to have hemolytic uremic syndrome (HUS), a severe disease that affects the kidneys and blood clotting systems.

Seven patients have been discharged from hospital.

AHS said each of the 11 affected locations will be able to open this week, starting Monday with four facilities that had no cases identified.

Fueling Brains Bridgeland, Little Oak Early Education, Almond Branch, and Braineer Academy will resume operations Monday morning "as long as no one from the site tests positive for (E. coli) before this time," AHS said.

"Public health inspectors have assessed the readiness of these four facilities to reopen and ensured that they have taken appropriate measures such as cleaning and disinfection," said the health authority.

Closure orders for the seven locations where cases were identified - Vik Academy in Okotoks, Kidz Space and Fueling Brains campuses Braeside, West 85th, New Brighton, Centennial and McKnight - will be lifted Tuesday. But health officials say children and staffattending those locations, even if they've had no gastrointestinal symptoms, must test negative for E. coli and be cleared by health officials before returning.

AHS said the outbreak is very likely rooted in the kitchen shared between the 11 locations.

"Based on the epidemiology of the cases we've seen to date, it is highly likely the source of this outbreak is food that was distributed from the central kitchen," said AHS in a Sunday statement. "At this point, AHS has not been able to identify a food item that was the source."

The kitchen remains closed as AHS continues to investigate.

A statement of claim for a potential class action lawsuit was filed Friday, naming the daycares and their shared kitchen.

The claim alleges "negligent, unsanitary and unsafe food storage, preparation and handling practices" led to the infections.

GOVERNMENT OFFICIALS SPEAK ON OUTBREAK Premier Danielle Smith and other government officials publicly addressed the situation Sunday for the first time since the outbreak was declared on Sept. 4. In separate posts on X, formerly known as Twitter, she and Health Minister Adriana LaGrange offered "thoughts and prayers" to the young patients and others dealing with the infection.

"My heart also goes out to the families of these little ones. Thank you to all the front line workers who've been working tirelessly to treat and care for these children," said Smith.

"I've asked the Minister of Health, Adriana LaGrange and the Minister of Children and Family Services, Searle Turton to do a full assessment of this outbreak to ensure steps are taken to prevent this from happening in the future."

For further information, affected families can go to ahs.ca/ecoli.

- With files from Bill Kaufmann mrodriguez@postmedia.com X: @MichaelRdrguez

Alberta Health Services says there are 142 lab-confirmed cases of E. coli linked to an outbreak at Calgary daycares — and a small number of children are now receiving dialysis.

Alberta Health Services says there are 142 lab-confirmed cases of E. coli linked to an outbreak at Calgary daycares — and a small number of children are now receiving dialysis. 

Dr. Francesco Rizzuti, the medical officer of health for Alberta Health Services Calgary Zone, said Friday that a small number of patients are receiving peritoneal dialysis, but he said the number of patients is too small to give figures for privacy reasons. 

There are 26 hospitalizations linked to the outbreak.

There are also 11 children with serious illness. Rizzuti said some of those have been confirmed as having hemolytic uremic syndrome. 

Hemolytic uremic syndrome is a disease which affects the kidneys.

Rizzuti added that some of the daycares that were previously issued a closure order will be permitted to re-open next week. 

More to come...

Alberta Health Services will give an update on the E. coli outbreak at Calgary daycares on Friday.

Alberta Health Services is set to give an update on the E. coli outbreak at Calgary daycares on Friday. 

Dr. Francesco Rizzuti, the medical officer of health for Alberta Health Services Calgary Zone, will give an update on the E. coli outbreak which has been declared at six locations of a Calgary daycare service, and five additional sites that share a central kitchen.

That update is scheduled to begin at 3 p.m.

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Previous story: 

The number of lab-confirmed cases of E.coli connected to an outbreak at Calgary daycares has ballooned to 128, Alberta Health Services said in an update Thursday. 

There are 11 Calgary daycares which have been issued a closure order until further notice following an outbreak of the shiga toxin-producing E. coli, which can cause health serious issues. 

Additionally there are nine patients who have been confirmed as having hemolytic uremic syndrome. They are stable and receiving the appropriate care in hospital, Kerry Williamson, executive director, issues management with AHS, said in an emailed statement. 

Hemolytic uremic syndrome is a disease which affects the kidneys.

There are currently 25 children receiving care in hospital, Williamson said. Twenty of those are at Alberta Children's Hospital and five are at Peter Lougheed Centre. Another three patients have been discharged from hospital.

AHS said it is also aware of three patients linked to the daycares that are receiving care outside of Alberta.

"Alberta Children's Hospital is well-equipped to handle this situation, and AHS is supporting the site with resources from elsewhere in the zone. As needed, additional inpatient beds are available at the Peter Lougheed Hospital and some patients are being looked after at that site," Williamson said. 

Williamson said AHS staff have been working with the operators of the 11 daycares which have been issued closure orders. 

On Wednesday, Dr. Francesco Rizzuti, medical officer of health with AHS Calgary zone, said the shared kitchen used by the 11 daycare sites "was in compliance with AHS health regulations" prior to the outbreak. 

Rizzuti added that not all of the closed sites have been positively linked to the outbreak. 

Williamson said Alberta Children's Hospital has established a dedicated clinic to monitor symptomatic patients after their initial emergency department visit, and for those who have been discharged from hospital. 

The following daycare centres remained closed until further notice:  

• Fueling Brains Braeside.
• Fueling Brains West 85th.
• Fueling Brains New Brighton.
• Fueling Brains Centennial.
• Fueling Brains Bridgeland.
• Fueling Brains McKnight.
• Braineer Academy.
• Kidz Space.
• Little Oak Early Education (formerly Mangrove).
• Almond Branch School.
• VIK Academy in Okotoks, Alta.

A ballooning E. coli outbreak connected to Calgary-area daycares is sending dozens of children to hospital, some with serious illness, and sparking concern among parents and doctors alike.

A ballooning E.coli outbreak connected to Calgary-area daycares is sending dozens of children to hospital, some with serious complications, and sparking concern among parents and doctors alike.

According to Alberta Health Services (AHS), 128 cases of an E. coli strain that can be particularly dangerous for young kids have been identified so far and 25 children are in hospital.

In addition, three patients have already been released and three more are being treated in other provinces.

What is most worrisome, doctors say, is that nine children have been diagnosed with a severe complication that can force kids into dialysis treatment.

"This is not the typical type of E. coli that causes maybe a day or two of watery diarrhea, or 'traveller's diarrhea,' that some people talk about," said Dr. Stephen Freedman, an ER physician at Alberta Children's Hospital and professor in the Cumming School of Medicine at the University of Calgary.

This particular strain is a type of E. coli 0157. It is known as shiga toxin-producing E. coli (STEC) because it secretes a toxin that can lead to serious organ damage, often targeting the kidneys.

"This is one of the most distressing illnesses that we see," Freedman said in an interview on The Calgary Eyeopener.

Complications include kidney failure

This strain is often carried by cattle and can contaminate food, including meat (through the slaughtering process) and fresh produce (through water tainted by infected animal feces).

Eleven child-care centres have been shut down by health officials as they search for the source of this outbreak. Public health investigators suspect the culprit is likely a common food served from a central kitchen.

What is so problematic about this outbreak, according to doctors, is that it has taken root among children under the age of five — one of the most vulnerable groups.

"What's scary about this one is that it seems to have a large number of kids involved," said Dr. Cora Constantinescu, an infectious diseases specialist at Alberta Children's Hospital.

Early in the infection, symptoms can include diarrhea (sometimes bloody), vomiting and fever.

But the toxin can eventually lead to a condition known as hemolytic uremic syndrome (HUS), where the toxin enters the blood stream and attacks the kidneys, potentially leading to kidney failure.

According to Constantinescu, while most children who are infected will recover, approximately 10 to 20 per cent will go on to develop HUS.

Half of those children will end up on dialysis for kidney failure.

"Because this is a serious condition, this is why we're being so hyper-vigilant about it," she said.

On Thursday, AHS confirmed nine children had been diagnosed with HUS. But the health authority didn't say how many patients are on dialysis.

'Insidious' illness

Treatment for this type of E. coli includes intravenous fluids to manage dehydration.

And because HUS can be quietly damaging the organs as initial symptoms appear to resolve, infected children, including those who don't require hospitalization, need close monitoring, including blood tests every 24 hours.

"It is quite insidious. So it kind of starts to manifest when the children seem to be getting better. But it's at that point in time that the complications start to emerge," Freedman said.

"You're taking a previously healthy toddler to dialysis in about six days."

Key symptoms

Doctors are urging parents to watch their children closely.

"If your child has symptoms, they should be seen. Don't manage that at home because it could start off pretty mild but then end up pretty bad," said Constantinescu.

AHS has set up a webpage for Albertans looking for information on this E. coli outbreak.

"We have a lot of worried parents and families," said Dr. Tania Principi, a pediatric ER physician and clinical associate professor at the University of Calgary.

According to Principi, children connected to the outbreak who show any of the following symptoms should be taken to the emergency room:

• diarrhea (may or may not be bloody)
• inability to drink fluids
• infrequent urination (less than once every 12 hours)
• tea-coloured urine
• unexplained bleeding, bruising or a purple rash
• severe abdominal pain, severe headaches         

"Our aim is to really catch people early on in the illness and ensure that they have adequate hydration to try and prevent that cascade or that deterioration to worse outcomes," said Principi.

Deaths are extremely rare, she noted. No children have died as a result of this outbreak, according to AHS.

University of Alberta infectious disease specialist, Dr. Lynora Saxinger, said there could also be longer term health problems.

"Most kids, even those with more severe organ damage, do recover to have functional kidneys again," she said.

"But even some of those can later on show that they actually have lost some kidney function and might need special monitoring in the future as well."

Community transmission

There are also concerns about secondary infections, if children spread the illness to family members or other close contacts.

The bacteria can pass from one person to another through fecal-oral transmission. That can happen if someone doesn't wash their hands properly after going to the bathroom or changing a diaper, for example.

"Within-household transmission is a major concern," said Freedman, noting seniors are another very high risk group.

"For those grandparents who are involved in care, I would really, really try to minimize or eliminate exposure if at all possible."

Meanwhile, he estimates the onslaught of cases will hit its peak this weekend.

According to Freedman, children usually start having symptoms within 10 days of exposure, often earlier. And if there are complications, the need for dialysis usually occurs about seven days after symptoms begin.

Alberta Health Services says it is "highly likely" that the source of an E. coli outbreak that has led to more than 150 cases in Calgary children is food that was distributed from a central kitchen shared between dozens of daycare sites in the city.

Alberta Health Services says it is "highly likely" that the source of an E. coli outbreak that has led to more than 150 cases in Calgary children is food that was distributed from a central kitchen shared between dozens of daycare sites in the city.

In a statement on Saturday afternoon, the health care agency said that there are now 164 lab-confirmed cases connected to this outbreak — up from 142 the day before.

"Based on the epidemiology of the cases we've seen to date, it is highly likely the source of this outbreak is food that was distributed from the central kitchen," AHS said in a statement. 

"At this point, AHS has collected food samples for testing and awaiting results. At this time AHS has not been able to identify with certainty the exact food item that was the source. We continue to investigate."

There are currently 27 patients receiving care in hospital, with 19 confirmed as having severe illness or hemolytic uremic syndrome (HUS), a serious complication of shiga-toxin producing E. coli which affects the kidneys. 

AHS says those patients are stable and being treated.

More to come... 

None of the four facilities that are allowed to open at their discretion Monday were linked to any positive E. coli cases, despite sharing a kitchen where the outbreak started, Alberta Health Services.

Closure orders for four daycare sites in Calgary that received food from central kitchen where an E.coli outbreak occurred will be lifted on Monday.

On Sunday afternoon, Alberta Health Services (AHS) confirmed that Fueling Brains Bridgeland, Little Oak Early Education, Almond Branch and Braineer Academy, will be allowed to re-open at their discretion on Monday, as long as no staff or attendees from those sites test positive for E.coli before then.

None of the four facilities were linked to any positive E.coli cases, the health agency said. In a previous release, AHS said the closure orders were a precautionary measure.

CBC News has reached out to all four facilities since the AHS update. 

Little Oak Early Education and Braineer Academy confirmed that they plan to reopen tomorrow. Almond Branch and Fueling Brains Bridgeland have not yet responded.

"Staff and children from these four facilities do not need stool testing to return if they have had no gastrointestinal symptoms and have not been told otherwise by AHS," the health agency said. 

"Public health inspectors have assessed the readiness of these four facilities to reopen and ensured that they have taken appropriate measures such as cleaning and disinfection."

The central kitchen that provides food services for these daycares is still closed.

Numbers still rising

As of Sunday morning AHS confirmed that 20 patients, all of which are children, have severe illness or hemolytic uremic syndrome (HUS) — an increase of one from the previous day.

The number of lab-confirmed cases has also increased to 190. There were 164 cases on Saturday.

27 patients are currently receiving care in hospital and seven have been discharged since the beginning of this outbreak.

Other facilities can open on Tuesday

In its update, AHS said that the remaining seven daycare sites where some children were infected in connection to the outbreak, will have their closure order lifted on Tuesday.

They include:

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

AHS said that children who will be five years of age or older by Dec. 31, 2023 and staff from those seven facilities who have had no gastrointestinal symptoms, must test negative for E. coli before they can attend any childcare facility.

A few of a growing number of patients from a daycare E. coli outbreak are receiving dialysis treatments, Alberta Health Services said Friday.

That news came hours after a class-action lawsuit was filed against the operators of several daycares that were served by a single kitchen being investigated as the possible source for the infections, which on Friday numbered 142.

Of those, 26 are currently hospitalized, with 11 of those in more serious condition, some with hemolytic uremic syndrome (HUS), a condition that affects the kidneys and causes blood clots.

“Dialysis machines have been brought in from other Alberta Health Services sites as well as rented to ensure we have adequate capacity now and in the coming days,” said Dr. Franco Rizzuti, AHS medical officer of health for the Calgary zone.

“All children on in-patient units are stable.”

Hospital units treating the mostly child patients have also increased their supply of vital-signs monitors and IV pumps, said the physician.

“This is all out of an abundance of caution, that should we see any more serious illnesses that we have everything needed,” said Rizzuti, adding he expects the case numbers to stabilize going into the weekend and next week.

One parent representing the class action; lawyer anticipates number of plaintiffs will grow

On Thursday, AHS said 128 people had tested positive for E. coli with 25 in hospital, nine of them suffering from HUS.

AHS says they were first made aware of bloody diarrhea symptoms from children at the daycares last Saturday and moved to close 11 daycare locations that  had been served food from the same kitchen, Fueling Minds, that’s affiliated with Food For Brains daycare.

Other locations shuttered were Braineer Academy, Kidz Space, Little Oak Early Education (formerly Mangrove), Almond Branch School and Vik Academy in Okotoks, which all also received food from the same kitchen.

Rizzuti said the source of the illnesses still hasn’t been determined, though an investigation continues.

Meanwhile, a class-action lawsuit was filed Friday at Court of King’s Bench, naming all of the daycares involved in the episode.

Currently, one parent is representing the class action “and we anticipate that number (of plaintiffs) will grow,” said Maia Tomljanovic, a partner with Cuming and Gillespie Lawyers.

“As a result of negligence, unsanitary and unsafe food storage, preparation and handling practises, it resulted in these students suffering.”

Source of outbreak hasn’t been identified, academy says

In a statement, the founders of Fueling Brains Academy said they were aware of the legal action but were focused on the unfolding situation facing their clients and staff.

“ The health and safety of our children, parents and staff continues to be our priority as we work through this challenging time,” said Faisal Alimohd and Anil Karim.

“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.”

Four of the locations that were closed as a precaution have had no instances of infection — Fueling Brains Bridgeland, Almond Branch, Little Oak Early Education and Braineer Academy — and can open Monday if no symptoms from their children arise.

The remaining daycares will be allowed to open Tuesday, but their students and staff will require medical clearance to attend and cannot be present at any other child-care facility, said Rizzuti.

“We only reopen a facility if we are confident that health and safety will not be affected,” said Rizzuti.

All the daycare operators involved have been fully co-operating with AHS, he said.

For updated information, affected families can go to ahs.ca/ecoli .

BKaufmann@postmedia.com

X: @BillKaufmannjrn

This summer has been one of the worst summers on record for overdoses or drug poisoning-related fatalities in Alberta.

Recent modelling from Health Canada suggests that these numbers are only going to continue to rise and no matter the scenario, we will likely not reduce drug poisonings to levels seen before the pandemic. While experts across the country have taken a variety of approaches to tackling this crisis, there has been no silver bullet and the death toll continues to rise.

Efforts are made in every sector to combat the crisis, from health care to police and justice, to social services, policymakers, and the government, yet the death toll continues to rise. While we rely on these sectors to manage the crisis, we the general public, can do our part, as well.

One key intervention that everyday citizens can be versed in is overdose reversal. As we walk our streets or visit parks, we should always be on alert and vigilant about someone potentially overdosing. If we see someone passed out in a corner, simply and gently checking up on them to ensure they're rousable and breathing can be a life-saving measure.

Additionally, much like how mandatory first-aid training has been implemented in numerous work environments, we can learn how to use a naloxone kit and carry one at all times. Naloxone is a key antidote in reversing opioid-related overdose. Learning how to use one can save a life. It is incredibly easy to use, and it does not need to be a rushed process. If one forgets or feels nervous about administering it, reading the instructions within the kit or playing an instructional video on YouTube and taking your time to save a life while you call 911 can be key.

More recently, there has been a push to increase supervised consumption services in our communities, especially in areas where there are a high number of overdose deaths. At this time, we see more overdoses near the Calgary Drop-In Centre than our Beltline supervised consumption site, yet community opposition by the community members and businesses at the East Village halted its implementation.

They voiced concerns about crime, needle debris, and fear of violence. Yet evidence from other jurisdictions shows the exact opposite occurs in areas already ridden with these concerns. Overdose prevention sites reduce criminality, public injection, and substance use, as well as needle debris.

Walking around the Drop-In Centre, people continuously use outside as they are not allowed to use inside. Having a supervised consumption site within the facility would effectively bring the substance-using population back indoors. The very things that are already happening in Calgary's East Village would be reduced and reversed by this simple measure. This means less needle debris, visible drug use and less visible homelessness in Calgary's East Village. The Calgary Drop-In Centre also contains access to detox beds and addiction treatment services on top of housing and social support.

All of this is a recipe for success for the community, not something to be feared or obstructed. Despite popular belief, these services are not based on a "buildit-and-they-will-come" model but rather provide support to community members who are already there and struggling.

Edmonton is no different. With the announcement of the new supervised consumption site being implemented in Edmonton Strathcona, there has been equal opposition and fearmongering. As residents of Strathcona who have seen an increase in homelessness and substance use, we fully support implementing these services.

We would see increased access for our neighbourhood's most vulnerable to wellness supports including housing and food security, substance-based treatment options, wound care and mental-health support. It would improve the health and vibrancy of our community.

Lastly, and most importantly, we as everyday citizens can change our language and perceptions around substance users. Substance use is a biological process, not a moral choice or failure. Treating substance use as a health issue, and not a criminal concern, is an attitude we must adopt as a society.

It's an attitude that is hard to shift given that many of us grew up in an era where the war on drugs was a key concept taught to us in schools and through public messaging.

Yet simply changing our perceptions and attitudes toward substance users can mean the difference between them hiding their substance use for a sense of shame and stigma; being fearful of losing their jobs or children or being abandoned by their loved ones, to being open about it and being willing to seek help.

One doesn't have to look far to know someone whose friend or family member is affected by this disease and it is important that we do not alienate or isolate people who use drugs which, in many cases, only serves to worsen their addiction.

Say hi, make eye contact and converse with this population. Show them they matter. After all, the well-being of our community would only be as good as the well-being of its most vulnerable. Will Rioux is a medical student at the University of Alberta and a resident of Edmonton Strathcona. S. Monty Ghosh is an addiction physician and assistant professor at the University of Alberta and University of Calgary, as well as a resident of Edmonton Strathcona and Calgary City Centre.