Public health officials in Ireland are searching for the source of an E. coli O26 outbreak in part of the country.

The Department of Public Health Mid-West of the Health Service Executive (HSE) is investigating the outbreak of Shiga toxin-producing E. coli (STEC) that has affected one setting in a region that includes Clare, Limerick and North Tipperary.

STEC, also known as Verotoxigenic E. coli (VTEC), caused the outbreak among young children in recent weeks.

It is the first outbreak of its kind reported this year in the area. To date in 2021, there have been 14 recorded cases of STEC in the region.

Incidence of STEC tends to be higher in warmer weather, particularly over the summer, according to health officials, though the annual number is likely to be lower in 2021 because of the COVID-19 pandemic. In the Mid-West area, there were 128 cases in 2018; 130 in 2019; and 117 in 2020.

Public Health Mid-West would not share any details on the age and gender of patients or whether any of them had developed hemolytic uremic syndrome (HUS), citing patient confidentiality.

The agency continues to consider a range of risk factors for the outbreak that it described as under control. When a child becomes infected with STEC, there is an increased risk of person-to-person contact in day care centers or households where there are children younger than five years of age.

Dr. Rose Fitzgerald, specialist in Public Health Medicine at Public Health Mid-West, said: “Ireland has one of the highest incidence rates of STEC in Europe, and the Mid-West has one of highest incidence rates in Ireland.

“Anyone who is infected, or is a close contact of a case requires clearance from a public health doctor to attend healthcare, childcare or work that involves food-handling. It’s a serious disease that can cause serious life-changing illness in young children and the elderly. It underpins the importance of hand hygiene before and after preparing food, after contact with farm animals and their environment, and effective treatment and rehabilitation of private wells.”

About E. coli infections
Anyone who has developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible exposure to the bacteria. Specific tests are required to diagnose the infections, which can mimic other illnesses.

The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications, according to the Centers for Disease Control and Prevention (CDC).

About 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication, known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor.

Many people with HUS recover within a few weeks, but some suffer permanent injuries or death. This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients.

People who experience HUS symptoms should immediately seek emergency medical care. People with HUS will likely be hospitalized because the condition can cause other serious and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.

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