Eight cases of E. coli infection have now been linked to a day care center in Greenwood, which has been closed to limit the spread of illness, state health officials say.
Of the cases linked to The Learning Vine, four are from the same strain of E. coli, known as shiga toxin-producing E. coli, according to the state Department of Health and Environmental Control. The others are still being tested.
The cases involve individuals at the center and their family members, said state epidemiologist Dr. Linda Bell. Two of those infected are hospitalized.
DHEC will not discuss any individual cases citing confidentiality concerns.
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Deputy Chief Derrick Rash of the Greenwood County Coroner’s Office confirmed that a child in the county has died of hemolytic uremic syndrome — a complication of E. coli. But he said the source of the infection has not been determined. DHEC would not comment on that case.
Bell said the agency is working to identify the source of the contamination at the day care facility and stop the spread of infection. But so far, she said, they have not found a common food source that would suggest a risk to the general population.
The illnesses occured over the course of the past month, Bell said. But if there is a common exposure, the onset of illnesses would be clustered in the same time frame, she said. Since they occurred over a period of time, she said, it suggests some sort of person-to-person transmission.
DHEC is recommending that everyone associated with the day care center be screened, she said.
“At this time, there is no evidence of ongoing transmission of the infection within the facility,” Bell said. “However, due to the possibility of bacterial shedding from individuals who do not have symptoms and out of an abundance of caution, DHEC and The Learning Vine have agreed to close the facility to reduce the risk of potential infection until all day care staff and attendees are tested.”
The day care center could not be reached for comment.
DHEC has finished an initial inspection of the center, including interviewing more than 50 people, and confirmed that the facility has performed the necessary cleaning.
The center can reopen once everyone has tested negative, Bell said.
E. coli symptoms can include severe stomach cramps, often bloody diarrhea, and vomiting, according to the U.S. Centers for Disease Control and Prevention. While most people improve in five to seven days, up to 10 percent go on to develop a condition called hemolytic uremic syndrome, which can lead to permanent damage or death.
While anyone can be infected with E. coli, young children and the elderly are most at risk for serious complications, CDC reports.
E. coli bacteria live in the intestines of humans and animals, with cattle the main source of infection in human people.
People can be infected after ingesting food, water or unpasteurized milk contaminated with trace amounts of human or animal feces, CDC reports.
Infection also can occur after someone comes into contact with the feces of infected people, such as by changing diapers, and by consuming food prepared by people who didn’t wash their hands well after using the bathroom.
Dr. Jeremy Byrd of Heritage Pediatrics & Internal Medicine in Simpsonville said it’s not hard for an infection like E. coli to spread through a childcare facility.
“In a day care setting, you have kids who are in diapers ... and it’s very easy for a diaper change to result in infection,” he said.
“It’s possible with anyone who hasn’t washed their hands adequately,” he added. “And kids are walking around putting their hands in their mouths, playing with toys, putting toys in their mouths. It’s always a concern to keep toys clean.”
To avoid E. coli and other infections, DHEC recommends washing your hands often using soap and warm water, especially after using the bathroom, before eating and when changing diapers.
About 265,000 of these infections occur nationwide every year, according to DHEC. There were 14 confirmed cases statewide last year and nine in 2013.