By: Candess Zona-Mendola

Two young children have died in a recently announced outbreak of E. coli in southwestern Utah. Both children were from the small city of Hildale, Utah, a community close to the Utah-Arizona border just south of Zion National Park. The Southwest Utah Health Department is investigating a possible source of the outbreak and if others have become ill with the same strain of E. coli that infected the two children. Little is known at this time about the outbreak, but more information is anticipated in the following week.

What We Do Know

The local health authorities have confirmed that both children were close friends who lived in the same housing complex in Hildale, Utah. Both children were just six years old. The families of these children are working closely with the Southwest Utah Health Department to help figure out how their children became infected with the Shiga-toxin (STEC) species of E. coli. Both children appear to have died from hemolytic uremic syndrome and kidney failure – a rare, but sometimes fatal complication of E. coli infections.

As of this weekend, the Southwest Utah Health Department confirmed that they are hopeful that the outbreak has a limited contagion area. An agent commented to the local media that they believe the outbreak has “little or no risk to the larger community.” The agency has already commenced investigation. They have tested the community water source, and have not found the related E. coli strain. According to the health department’s spokesperson, David Heaton, “We’re pretty sure it’s not from the water. The tests that we’ve done there have been clean every time. We’re looking at either exposure to an infected animal or to contaminated food, like food poisoning.” Mr. Heaton went on to state that is has been quite some time since an outbreak of E. coli has occurred in southern Utah, although there have been sporadic cases. Mr. Heaton further noted that the number of cases linked to this outbreak is currently unavailable.

The Southwest Utah Public Health Department has taken to social media to keep the community informed about the outbreak:

“The Southwest Utah Public Health Department is investigating an E.coli bacteria outbreak in Hildale, Utah. Currently, this outbreak appears to be confined to a limited area with little or no risk to the larger community. We will post updates to this page. Please visit this link for more information: http://swuhealth.org/e-coli/

What Kind of E. Coli Could Cause This?

The exact strain of E. coli involved in these cases can only be speculated at this time. But, it is known that the children developed a rare, but very severe complication of E. coli infections – HUS. HUS is a rare complication of the most dangerous forms of E. coli – Shiga toxin-producing E. coli (STEC). The Centers for Disease Control and Prevention say the following about STEC E. coli strains:

“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 and Other High Risk Individuals with E. coli Infections

It is a fact that E. coli infections can affect anyone, regardless of age, health status, or geographic location. Those who are high risk though, usually have more severe infections. Children are among those who are most at risk to develop E. coli infections with severe symptoms and complications. In outbreaks such as this one, where likely an STEC E. coli is the culprit, the threat 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 high risk person can start relatively mildly, usually with some nausea, vomiting, and abdominal pain. In most E. coli infections, the infected person will also suffer from severe watery diarrhea. This may progress to become bloody. Some individuals may also develop a low-grade fever. The early onset of HUS is usually apparent with 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 those showing these symptoms obtain emergency medical care.

It is important to note that HUS is not the only complication of a STEC E. coli infections. These strains of 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). Early treatment and medical care may be able to reduce the risk of development of these severe complications and mortality.

Preventing E. coli Infections During an Outbreak

An outbreak of infectious diseases can cause stress to any community, especially for those households with older adults, young children, and individuals with compromised immune systems. E. coli is indeed a scary pathogen, but it is preventable. There are several easy practices anyone can do to help prevent E. coli infections.

Our contributing writer, Alice Vo Edwards, has given us great tips on cleaning your home to prevent E. coli infection here.

Unsafefoods will continue to follow the details of this outbreak as they unfold. We will continue to report updates on our blog and social medial platforms. For more information about children and E. coli infections, you can visit our posts here and here.

 

Sources:

http://swuhealth.org/e-coli/

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