Photo from encyclopediaofarkansas.net

By: Candess Zona-Mendola

A community in Sharp County, Arkansas is grappling with a possible outbreak of E. coli from a mystery source after one child has died and another battles for his life at a local children’s Hospital.

The Spring River Chronicle reports that the child has undergone surgery and dialysis and appears to be recovering as of April 18. The child’s aunt informed the media that the child was released from the Intensive Care Unit on April 15.

The Sharp County, AR toddler who recently died reportedly had the same type of infection. Local health departments have not yet confirmed whether the two cases are linked and have not issued any statements regarding a potential source, the type of E. coli involved, or the parameters of an investigation.

The local media reported on its Facebook page, that there are reports of another child, a teenager, with an E. coli diagnosis. That would make three children in the community severely sick without any answers about what caused their illnesses.

What Kind of E. Coli Could Cause This?

The media reported that the child fell ill last week and was rushed to the Arkansas Children’s Hospital in Little Rock, Arkansas. Arkansas Department of Health and the Sharp County Health Unit have not yet issued statements concerning the potential outbreak. The exact strain of E. coli involved in these cases can only be speculated at this time.

Although the media have not reported the child’s symptoms, it appears from the treatment reported that the child developed a rare, but very severe complication of E. coli infections – hemolytic uremic syndrome. Hemolytic syndrome is a severe complication of the most dangerous forms of E. coli – Shiga toxin-producing E. coli (STEC). The Centers for Disease Control and Prevention report on their website that:

“The most commonly identified STEC infections in North America are E. coli O157:H7 (often shortened to E. coli O157 or even just O157). When you hear news reports about outbreaks of E. coli infections, they are usually talking about E. coli O157.”

However, there are other non-O157 STEC forms of E. coli as well, including E. coli O26, E. coli O111, E. coli O121, E. coli O45, and E. coli O145. In the past, these strains were difficult to find, as there was little research done on them. According to a recent study by L. H. Gould, this is shifting because “Non-O157 STEC infections are being recognized with greater frequency because of changing laboratory practices.”

The Concerns of Children with E. coli Infections

It is widely known that E. coli can infect anyone, regardless of age, health status, or location. However, children are one of the most susceptible groups to E. coli infection with severe symptoms and complications. In instances such as this potential outbreak, where an STEC E. coli pathogen is the likely culprit and children are involved, the prevalence for severe complications is a real concern: According to the CDC, “Around 5–10% of those who are diagnosed with E. coli O157 infection develop a potentially life-threatening complication known as hemolytic uremic syndrome (HUS).”

An E. coli infection in a child can start relatively mildly, usually with some nausea, vomiting, and abdominal pain. In most E. coli infections, the victim will also suffer from severe watery diarrhea, which may progress to become bloody. Some children may also exhibit a low-grade fever. As symptoms become worse, the early onset of HUS is usually seen through its own group of additional symptoms. These can include: decreased urination, pallor (an unhealthy pale appearance to the skin), fatigue and irritability, confusion, seizures, high blood pressure, unexplained bruising, bleeding from the nose and/or mouth, and edema (swelling of the hands, feet, face, or entire body). The Mayo Clinic recommends that families seek emergency medical care at any sign of some of these symptoms.

HUS is not the only concerning complication of a STEC E. coli infection. E. coli can also potentially cause central nervous systems issues (including brain swelling and/or stroke), intestinal issues (like colitis), and hypertension (high blood pressure).

Could My Children Become Infected?

The scary answer is, yes. There has not yet been an identified source, and E. coli can be in a variety of placed. E. coli, which is typically found in the intestinal tract of animals, has been traced to swimming pools, beaches, petting zoos, and various food products. Some of the food products involved in recent E. coli outbreaks include: soy nut butter, beef, raw milk, and flour, to name a few.

What Caused The E. Coli Outbreak?

E. coli infections typically come from eating food that has been contaminated with E. coli bacteria. Undercooked meat, especially hamburger, is one of the major sources of E. coli infections. Raw milk and raw milk produce, like soft cheeses, are also concerning vehicles of this illness. Thorough cooking of food and drinking pasteurized milk are recommended methods to reduce the likelihood of E. coli infection.

Petting zoos, beaches, and swimming pools have also been the source of E. coli infections. In fact, in 2015, Arkansas Department of Health closed several beaches in Arkansas due to E. coli contamination, including:

  • Swim Beach in Jacksonport
  • Devil’s Fork at Greers Ferry Lake
  • Blanchard Springs in Stone County
  • Spring River Beach in Sharp County
  • Kia Kima in Sharp County
  • Mirmichee in Sharp County
  • Current River in Randolph County

The good news is that E. coli infections are preventable. Good hygiene practices, like hand washing, and cooking food to their optimum cooking temperatures are only a few ways you can help reduce the likelihood of E. coli infection. For more information about parents’ concerns about E. coli during an outbreak, you can visit our post here. If you believe your child may have E. coli, we also have another resource for you here.

If you have a child and you reside in or around Sharp County, Arkansas, and your child is exhibiting symptoms of E. coli infection, urgent medical care is highly recommended. You child’s pediatrician or local emergency room can diagnose an E. coli infection through a routine stool test. It is important that you request a stool test, and inform your doctor of your concerns that your child may have an E. coli infection. Urgent medical care is crucial to reduce the risk of the development of HUS and other potentially severe long term complications.

UnsafeFoods will continue to monitor this potential outbreak and make reports.

 

Sources:

http://www.springriverchronicle.com/news/e-coli-outbreak-leaves-more-questions-than-answers/article_83bf7c2e-247d-11e7-a355-df05f8d983cc.html

https://www.ncbi.nlm.nih.gov/pubmed/23560425

http://www.mayoclinic.org/diseases-conditions/hemolytic-uremic-syndrome/symptoms-causes/dxc-20204144

https://www.cdc.gov/ecoli/general/index.html