Officials in Latvia are investigating 40 Salmonella and Shiga toxin-producing E. coli illnesses with mostly children affected.
A total of 36 children and four employees of educational institutions are ill, according to the Latvian Centre for Disease Prevention and Control (SPKC).
Salmonellosis has been laboratory confirmed in nine children with symptoms of acute intestinal infection thought to have occurred from Sept. 9 to 11. Patients have been recorded at Levina and Tornisi kindergartens.
Four children develop HUS
Shiga toxin-producing E. coli (STEC) infections have been linked to schools identified as Levina, Saulite and Piladzitis in Sigulda, a town in the country.
At least four children aged three to six years old have developed hemolytic uremic syndrome (HUS) after STEC infection from early September in Sigulda. HUS is a type of kidney failure associated with E. coli infection. It can occur in people of any age but is most common in children under 5-years old because of their immature immune systems.
The SPKC has surveyed parents of sick children, visited preschools to obtain information on absent children and staff and the cause, analyzed food menus and possible risk factors.
Nineteen infections at three other pre-school facilities in Ikskile, Garkalne and Ogre are not thought to be related to those ill in Sigulda.
The Latvian Food and Veterinary Service (PVD) has been investigating catering units at the three sites linked to E. coli infection where catering comes from one company. Initial suspicions pointed to contaminated watermelons.
Inspections at the catering units did not reveal violations of hygiene requirements that could contribute to the spread of infection. The sites also underwent cleaning and disinfection.
PVD suspended operations of a vegetable processing firm called “Jelgavas Augļi” due to violations of hygiene requirements, product traceability and inadequate storage temperature for pre-packed vegetables that were stored at 13 degrees C instead of the required 6 degrees C. The company, through Baltic Restaurants Latvia, supplies fresh fruits and vegetables to Sigulda educational institutions but a connection to the outbreak has not been established.
Testing at the firm so far has not found E. coli. Other results are pending but the company will be allowed to resume operations if they are negative and when it corrects the deficiencies identified by authorities.
Authorities have also found issues with transportation of food by the company “Point to Point” Ltd between educational institutions.
Most people infected with Salmonella develop signs 12 to 72 hours after being exposed to the bacteria. Symptoms can include diarrhea, fever, abdominal cramps and vomiting that lasts for several days.
Otherwise healthy adults are usually sick for four to seven days. Older adults, children, pregnant women and people with weakened immune systems, such as cancer patients, are more likely to develop a severe illness and serious, sometimes life-threatening conditions.
Symptoms of E. coli infection include abdominal cramps and diarrhea that can become bloody. Fever and vomiting may also occur. The incubation period can range from three to eight days and most patients recover within 10 days.
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