Nearly 50 people are part of an outbreak of E. coli infections in Scotland, which has closed five nurseries.

E. coli has been confirmed in three nurseries, while another two are shut as investigations and testing are carried out.

A total of 47 cases have been confirmed. Officials previously said E. coli O157 had sickened a number of young people in the East Lothian area. Some patients were hospitalized but most people had mild symptoms and did not require hospital treatment.

Cases are linked to Pear Tree Nursery on Church Street and Meadowpark Pear Tree Nursery, both in Haddington and Musselburgh Private Nursery, Bridge Street.

Church Street nursery was reopened on Aug. 29. Pear Tree Nursery on West Road is shut but no cases of E. coli have been confirmed.

Musselburgh Private Nursery was closed as a precaution after sicknesses, but now E. coli has been confirmed. Musselburgh Nursery in Stoneybank has also been closed after reports of symptoms and a connection with its sister nursery were identified.

NHS Lothian, local and national agencies, including Public Health Scotland, formed an Incident Management Team (IMT) at the beginning of August to investigate a cluster of cases at Pear Tree Nursery.

Officials said families must remain at home and should not mix with others until they go through the clearance process, which includes producing two negative samples.

The majority of samples are being processed at the E. coli reference lab in Edinburgh with results taking two weeks. Labs are processing more than 500 tests so there may be delays in getting results to staff and parents.

E. coli infections can develop in different ways such as by eating contaminated food, touching infected animals or coming into contact with their feces, contact with people who have the illness, or drinking contaminated water.

Breaking the infection chain
Graham Mackenzie, the consultant in public health medicine and chair of the Incident Management Team investigating the outbreak, said it was vital that parents and carers self-isolate.

“It is crucially important that families understand that this is a rapidly evolving situation and it is affecting the lives of hundreds of people. We need everyone to work with us to bring an end to this outbreak as swiftly as possible,” he said.

“If you have been given an exclusion order, it means that you must self-isolate at home, just as we have all done with COVID-19. You must not go to work or school, the shops, the playpark, or to parties and sleepovers.”

Mackenzie said after two negative samples families can return to normal.

“There is light at the end of the tunnel and as soon as enough exclusions are lifted and investigations are complete, nurseries will be able to reopen. However, if families choose to mix with others when they have been instructed to self-isolate, they are putting themselves and others at risk,” he said.

“As well as staying home, it is vital for siblings or those children leaving the nursery, taking up a new nursery place, and starting school for the first time to remain at home until their exclusion period is complete if they have been in contact with someone with E. coli or any other vomiting bug. This outbreak reinforces the importance of washing hands regularly, particularly before eating or preparing food, and after going to the toilet.”

The outbreak in Scotland comes at the same time as a warning from Public Health Wales about an increase in cases of diarrhea and vomiting, specifically those caused by E. coli, in the Wrexham and Flintshire areas.

The agency said it was important to remember that handwashing is one of the best ways to fight infections. By doing this regularly, but particularly before and after handling food, people can protect themselves and others from getting sick.

Data from UK laboratories shows there were 55 E. coli O157 cases in the first three weeks of August. The Public Health Agency in Northern Ireland has recently published an information leaflet for E. coli O157 patients.

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