As the magnitude of the E. coli outbreak linked to a Calgary daycare becomes clearer, questions are being raised about what went wrong, calls are emerging for greater food safety oversight and the Alberta government is promising to get to the bottom of the matter.
A total of 329 cases of shiga toxin-producing E. coli have been linked to the outbreak. While hospitalizations are declining, 33 people have been hospitalized since the outbreak began in early September, including 32 children and one adult.
Young children, specifically those under five years old, are particularly vulnerable to this type of E. coli.
More than twenty children have been diagnosed with a serious kidney complication, known as hemolytic uremic syndrome (HUS), since the outbreak was first declared.
As of Thursday, six children were still on dialysis.
Alberta Health Services believes the outbreak is linked to food prepared in a central kitchen and distributed to several daycares that share the facilities.
But the investigation has yet to identify an exact source.
“In my opinion, this is really a tragedy,” said Claudia Narváez, a professor in the department of food sciences and human nutrition at the University of Manitoba.
“The first thing that came to mind is… maybe, because this is a centralized children’s kitchen, it should be treated more carefully in terms of inspections?”
A number of health violations were documented in the kitchen immediately after its closure, including the presence of cockroaches and unsafe food handling practices.
Other infractions, cited months before, had been resolved according to the health authority.
“I would like to see more inspections and [authorities] be more strict when you have a central kitchen that supplies so many daycares,” Narváez said.
According to AHS, food facilities are typically inspected annually and sites with violations are visited more frequently, which was the case in this case.
The Prime Minister and the Minister of Health promise measures
In an interview on CBC Radio The final stretch On Thursday, Alberta Health Minister Adriana LaGrange said she wants to do everything she can to prevent something like this from happening again.
“This is a very serious situation,” LaGrange said. “I want to make sure we get to the root cause and get the results of this investigation.”
When asked if more frequent inspections are needed at facilities that supply food to children, he said finding the source is key.
“It’s not just childcare… we have over 2,600 schools, many of which have feeding programs,” LaGrange said.
“And if it requires more investigations, more oversight, then those will be recommendations that we will look at and take very seriously.”
And Prime Minister Danielle Smith is not ruling out a public inquiry.
“If there are any deficiencies in our regulatory environment, we have to correct them,” Smith said during an interview on the CBC show. West of center podcast on Thursday.
“I would certainly be willing to do a more thorough investigation once we have some of those answers.”
Asked to clarify his commitment to the idea of a public inquiry, Smith said: “Whatever form it takes, I mean we have to get to the answers so we can implement the regulatory changes, absolutely.”
Smith also said he believes stricter rules are needed for communal kitchens that prepare and distribute food to facilities that feed children.
“What we need to consider is having one common kitchen for 11 facilities and all the different potential problems that can cause,” he said.
“So there will be new regulations around that. I want to make sure we do a consultation to find out what it should be like.”
Doctors, who have been struggling to care for dozens of sick children, also want to know what went wrong.
“This is a very large outbreak of a contagious and preventable disease,” said Dr. Jim Kellner, a pediatric infectious disease specialist at Alberta Children’s Hospital.
“Something fell apart here. Something didn’t work.”
According to Kellner, who is also a professor of pediatrics at the University of Calgary, without an identified source, it is difficult to speculate what changes might be made.
He said there is already a lot of knowledge about E. coli infections and how to prevent them and that there are many safety regulations governing the food production chain, from farm to fork.
“Are we going to learn new lessons from this? Or will we be reminded of lessons we should have already learned about this?” Kellner said, adding that there is nothing new or unusual about the E. coli strain in this outbreak.
Dr. Michael Rieder, a professor of pediatric pharmacology at Western University, said answers may not come right away because these investigations can take time.
It’s possible, he said, that the contaminated food had already disappeared by the time inspectors began collecting samples.
“It could be difficult to find because you may not be able to trace the source, which is very frustrating for a lot of people,” said Rieder, whose lab is looking for ways to identify E. coli in food samples.
He believes this outbreak, which has attracted national attention (due to its size and severity), highlights the need to take food safety seriously.
“Public health isn’t sexy until it’s sexy,” Rieder said.
“I think it will help stimulate debate about how much food testing we should do, when we should do it, and where we should do it.”