Health officials in Ireland are investigating an E. coli O26 outbreak at a childcare facility.

Officials with the Department of Public Health Mid-West of the Health Service Executive (HSE) said the agency is managing the outbreak of Shiga toxin-producing E. coli (STEC) and highlighted the importance of effective hand hygiene and well water treatment.

The agency added that there are fewer than five patients at the childcare facility in Limerick and the incident is under control.

STEC, also known as Verotoxigenic E. coli (VTEC), can cause serious illness in children under 5 and the elderly. The serious outcomes of illness shows the importance of hand hygiene before and after preparing food and after contact with farm animals and their environment, said officials.

Seasonal E. coli rise
Ireland has one of the highest rates of STEC in Europe, and the Midwest region has one of the top rates in the country. In the Midwest, there were 128 cases in 2018; 130 in 2019; 117 in 2020; and 79 so far in 2021.

Earlier this year, another E. coli O26 outbreak among young children affected one setting in a region that includes Limerick.

The most common ways to be infected are through contact with farm animals, swimming in streams and lakes, drinking untreated water from private wells, person-to-person contact in child care centers or households with children under 5 years old, and through food and drinks contaminated with microscopic amounts of fecal matter.

Rose Fitzgerald, specialist in public health medicine, said infections and outbreaks are more common during summer.

“We are asking the public to be conscious of their activities throughout the summer period, particularly in relation to hand hygiene, drinking treated water, swimming in potentially contaminated fresh waters, and being on farms,” she said.

“It is a serious disease that can cause life-changing illness, and while it can last in the system for as short as a week, it can sometimes take several months to clear the infection. 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.”

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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