The South Carolina Department of Health and Environmental Control (DHEC) announced Sunday that lab tests have confirmed seven cases of Shiga toxin-producing E. coli (STEC) associated with a daycare in Greenwood, SC. On Monday, the department updated the number of confirmed E. coli cases to eight. Four of these individuals have infections with the same bacteria strain, DHEC noted, and two of them are in the hospital. DHEC issued a public health consent agreement with The Learning Vine in Greenwood to close and the facility has, officials stated, adding that no current information suggests a risk to the broader community.

“At this time, there is no evidence of ongoing transmission of the infection within the facility,” said State Epidemiologist Dr. Linda Bell. “However, due to the possibility of bacterial shedding from individuals who do not have symptoms and out of an abundance of caution, DHEC and The Learning Vine have agreed to close the facility to reduce the risk of potential infection until all daycare staff and attendees are tested.” A 2-year-old Greenwood boy who attended the daycare recently died of STEC-related complications. Myles Mayfield developed hemolytic uremic syndrome (HUS) and passed away on May 31, 2015. His funeral was held Saturday in Greenwood.

His older sibling attended Springfield Elementary School in Greenwood, which has now been cleaned and sanitized. DHEC had been investigating the school as a potential source of the infections, but on Monday, officials said, “At this time no other facility is included as part of this ongoing investigation.” DHEC officials held a meeting Friday with parents whose children attended The Learning Vine to discuss their concerns. They noted that the facility had been thoroughly cleaned twice. However, parents at the meeting reportedly were worried there could be additional STEC cases before the outbreak was over. The department’s Monday update stated that the following criteria must be met before students and staff may return to The Learning Vine:

• All students and staff must be tested for Shiga toxin-producing E. coli (STEC) and have at least one negative stool sample before returning to the facility. Some individuals may be required to have two negative stool samples before returning to the facility based on their history of illness or contact with cases.
• The facility must continue to follow all recommendations issued by DHEC.

The department stated that the following steps have been taken to identify the E. coli source and stop the spread of infection:

• Completed an initial onsite inspection of the daycare facility and provided cleaning guidance.
• Conducted more than 50 interviews to identify and notify individuals at possible risk for exposure.
• Collected and tested samples for laboratory analysis.
• Established a hotline and held a forum to provide assistance to those affected.
• Confirmed that the daycare facility had completed the required cleaning by conducting a follow-up inspection with the South Carolina Department of Social Services.
• Issued a public health consent agreement with the daycare facility in order to limit the possibility of further spread of the infection.

Symptoms of STEC infections typically include severe stomach cramps, diarrhea (often bloody), and vomiting. Most people get better within five to seven days. However, children younger than 5, seniors, pregnant women, and people with a chronic health condition or a weak immune system are more prone to serious complications from E. coli infections. The best way to avoid STEC and other E. coli infections is to wash your hands often using soap and warm water after using the bathroom, before eating and when changing diapers. Also, do not send children to daycare or school if they are sick, and keep them at home until diarrhea has ended and the child has been cleared by a medical professional. For more information about STEC and how to prevent it, go here.