Drinking water blamed for E. coli outbreak

WALKERTON (CP) - Schools and day-care centres shut down Tuesday after more than 150 residents went to hospital battling stomach cramps, diarrhea and fever amid an outbreak of E. coli bacteria in this southwestern Ontario town.

As of late afternoon Tuesday, 160 people had been treated for the bacteria over the past two to three days and 11 admitted to hospital, said Diane Waram, director of patient care at the South Bruce Grey Health Centre. Four were airlifted to a hospital in nearby London, Ont., she said. Others were treated in hospitals in the surrounding communities of Owen Sound, 40 kilometres to the northeast, and Hanover.

About 400 people have telephoned those hospitals suffering from the outbreak - caused by what's called E. coli 0157 - that first began affecting residents late last week.

All three elementary schools and both high schools in Walkerton, a town of about 5,000 people, have been closed for the next two days because of the outbreak. Officials will meet on Thursday to determine if schools should reopen the following day.

Parents of children under five years old were asked to take their kids to health centres for blood tests if they'd been exposed to drinking water, either by drinking it or washing with it.

E. coli produces toxins that are particularly hard on the kidneys, Waram said, something especially dangerous for youngsters and the elderly.

''Children under five are at a greater risk of developing complications,'' she said. At the Walkerton Day Care Centre, approximately 25 per cent of the centre's 45 children called in sick Tuesday due to the outbreak. That prompted the centre to shut down until the end of the week.

''We're going to be closed for the rest of the week,'' said daycare supervisor Sharon Bross, who added that staff had been giving children only bottled water and boiling any water used for cooking or washing earlier Tuesday. One nursing home had isolated six residents believed to have been infected. Maple Court Villa had banned tub baths and was using only bottled or boiled water.

Health officials were still trying to determine the cause of bacteria outbreak.

The E. coli bacteria was detected in the community's water system over the weekend, and residents were being advised to boil their drinking water or use bottled water until further notice.

Ontario's Environment Ministry has been called in to test the town's water supply and a federal health investigator has also been asked to help determine what's behind the outbreak in this community 40 kilometres southwest of Owen Sound.

E. coli symptoms include stomach cramps, vomiting, fever and diarrhea. Symptoms can occur as quickly as 12 hours after ingestion of the bacteria or as long as 10 days.

The illness generally lasts about a week.

E. coli infection is related to hemolytic uremic sydrome (HUS), a condition which is a leading cause of kidney failure in children and the elderly. Symptoms of HUS include irritability, fatigue, puffiness around the eyes or ankles, paleness of the skin and decreased urine production.

Parents were being advised to keep an eye on their children for symptoms of HUS even after diarrhea clears up.

http://www.thestar.ca/thestar/editorial/updates/news/200005240_STOMACH-BUG-.html

-- Carl Jenkins (Somewherepress@aol.com), May 23, 2000

Answers

Three dead in Ontario e-coli outbreak

Wednesday, May 24, 2000 5:59:23 PM EST WALKERTON, Ontario, May 24 (UPI) -- Three people are reported to have died Wednesday and 700 infected in an e-coli outbreak in Walkerton, Ontario, some 90 miles (145 km) northwest of Toronto. Health authorities said a deadly strain of the e-coli bacteria has been found in the community's drinking water, and that some people were probably still drinking the water.

Schools in the area were closed Wednesday, and hospital emergency rooms were flooded with people reporting symptoms of the disease, including diarrhea, severe stomach cramps and vomiting. Health official said the very young and elderly were most at risk when infected, and the three who died Wednesday included a baby and an elderly woman.

Dr. Murray McQuigge, the medical officer responsible for controlling the disease, said about seven to 10 days after the start of the symptoms, "people can get into trouble with kidney disease," and some of those "may not survive." Local authorities have still not determined how e-coli got into the community's water supply, but some local residents told reporters there was flooding in the area recently as a result of heavy rain. The locals said if the outbreak was caused by flood water spilling into the drinking water supply, then people may have started being infected long before the epidemic reached the current stage. It takes two to 10 days before the symptoms start to show up. Till Tuesday, school children were still seen drinking water from taps, rather than bottled-water fountains.

Health authorities have issued warnings to people in Walkerton, a community of about 5,000, not to drink water from taps, or to boil the water for at least five minutes before drinking it. Restaurants have also been told to throw out juices and other beverages in which tap water may have been mixed in. Several people said they were planning to leave town for a few days until the outbreak subsides.

http://www.rapidcontent.com/isyndicate/upi.phtml? a=392c5698.2c27.34&c=upi.international_news.ft&d=20000524

-- Martin Thompson (mthom1927@aol.com), May 24, 2000.

Canoe

Thursday, May. 25, 2000

Four reported dead in deadly E. coli outbreak in southwestern Ontario

By ANGELA PACIENZA-- The Canadian Press

Antibiotic use risky in children with E.coli-study

WALKERTON, Ont. (CP) -- Residents of this southwestern Ontario town were angry and anxious today after the medical health officer predicted more people would die from an E. coli outbreak that has already claimed four lives.

Health officials hope the appearance of new cases has peaked but fear more fatalities and complications could arise since the symptoms can take up to a week to surface.

"More people are likely to die from this," said Dr. Murray McQuigge, medical officer of health for Grey-Bruce.

"And we know we're going to see more cases."

Three adults and one baby have died from complications associated with the epidemic. They include retired library worker Lenore Al, 66, and Edith Pearson, 83. Officials have not identified the two other victims.

At least three more children, who along with seniors are particularly vulnerable to the epidemic, were in critical condition at the London Health Sciences Centre. Two were receiving dialysis treatment after suffering total kidney failure.

As many as 700 people in the town of 5,000 have been stricken with some of the symptoms, which include diarrhea, cramps, nausea and fever.

"There's never been anything like this in Canada before of this magnitude, never," said McQuigge.

He said the town's water is still "grossly contaminated," almost two weeks after a severe storm caused massive flooding in the area.

Health officials were alerted to the outbreak last Friday by a pediatrician in nearby Owen Sound who had two cases of bloody diarrhea referred to him from a Walkerton medical clinic.

The public utilities commission assured officials the water was safe, McQuigge said.

Nevertheless, a warning was issued Sunday advising residents to start boiling their water. Confirmation that the water had been infected with E. coli was received Monday.

Some residents, including Heather Mulkern, whose two young children have come down with the symptoms, are concerned that the warning was issued too late.

"I didn't hear anything until Sunday, which is kind of irritating since they had some speculation about it since, I hear, Tuesday," Mulkern said. "Some of this could possibly have been prevented."

"I think it's just horrible that all of these people are having to deal with this."

Schools and day-care centres were closed Wednesday and officials were to decide today whether it was safe for children to return to their normal routines.

While hospitals have been strained for days, neighbourhood coffee shops and restaurants sat empty, with regulars too afraid to drink the water.

Mayor David Thomson said he was saddened over the deaths and expressed sympathy, "especially to the families who have lost loved ones."

A homemade sign on the drive into the town read: "E. coli please go away."

E. coli normally live in the intestines of humans and other warm-blooded animals, such as cattle. Most strains are harmless but some can be deadly. It can be transmitted by eating undercooked meat from a contaminated cow, or by drinking unpasteurized milk or apple juice.

The E. coli bacteria produces toxins, that, in severe cases, lead to kidney failure. The young and elderly are at greatest risk.

As officials and water company representatives distributed free bottled water to residents Wednesday, workers began draining the town's two reservoirs to try to determine what went wrong.

Finding the source of bacterial contamination within the unfiltered system will take more of this work and may never yield a clear explanation, consultant Steve Burns said Wednesday.

Dan Newman, Ontario's environment minister, said this isn't the time to assign blame.

"Today, I don't think is the day to point fingers at anyone," he said.

Ministry officials are working with officials in neighbouring municipalities to ensure the contamination doesn't spread, he said.

-- Rachel Gibson (rgibson@hotmail.com), May 25, 2000.

Doctor says utility knew water was contaminated WebPosted Thu May 25 09:40:55 2000 ET

WALKERTON, ONT. - The chief medical officer in the Walkerton area says a deadly outbreak of E. coli did not have to happen. Dr. Murray McQuigge says Walkerton's Public Utilities Commission knew the town's water supply was contaminated a week ago.

LINKS: Websites related to this story

Four people have been killed by E. coli, and three children are in a London hospital in critical condition. Hundreds of other people in Walkerton are suffering from infection.

McQuigge says his office first became aware there was a problem when two cases of bloody diarrhea were reported on Friday. He says his office called the Public Utilities Commission to ask if the water supply was safe.

He says his office was told everything was fine  even though the PUC had test results from the day before showing contamination.

FACT SHEET: The science of E. coli On Saturday, when more cases of bloody diarrhea were reported, McQuigge says "We again phoned the Walkerton PUC, twice, to ask if the water system was safe and secure. They said it was." McQuigge says on Sunday, his office acted on what it was seeing, and told people not to drink the water.

Two days ago, McQuigge's office confronted the PUC with evidence of contamination. He says that's when the PUC admitted it had the test results.

Grim outlook for children

Four people died on Wednesday. And the outlook for the three children in hospital is not good.

McQuigge says the PUC has also told his office that the machine which mixes chlorine into the water supply hasn't been working for some time.

There are fears that more people will die or get sick because it can take more than a week for symptoms to appear.

As many as 700 people are suffering with symptoms of severe cramps, bloody diarrhea, vomiting and fever.

"There's never been anything like this in Canada before of this magnitude, never," McQuigge says.

David Thomson, mayor of the municipality of Brockton, assured the public the water will not be turned back on until it's clear and clean. Free bottled water is being handed out.

Elderly people and children are the most vulnerable to the E. coli bacteria. Parents of children five years of age or younger are being asked to bring them in for tests, even if the kids show no signs of being sick.

Authorities are advising people in the Walkerton area to boil drinking water for at least five minutes or to drink bottled water.

The province's environment ministry is testing the water supply, trying to determine the source and state of the contamination.

Officials aren't sure how the outbreak started. There was extensive flooding in the area during a heavy rainstorm nearly two weeks ago. It's possible that sewage, or manure from farmers' fields, leaked into the wells that supply water to the area.

E. coli can be fatal in about three per cent of cases. It causes kidney damage in 10 per cent of people who become infected.

People who live in the Walkerton area are anxious, fearful and angry. They want to know why they weren't warned at first sign something was wrong.

http://cbc.ca/cgi- bin/templates/NWview.cgi?/news/2000/05/25/ecoli000525

-- Martin Thompson (mthom1927@aol.com), May 25, 2000.

It's getting worse. TV news at noon indicated a fifth person had died. Apparently the health officers knew about the e-coli an entire four days before telling the public--permitting people to continue drinking the contaminated water. Reminds me of all the "clean air" that happens during/after refinery/chem plant fires. I think they cross their fingers and just hope for isolated illnesses and no deaths. This one just got beyond them.

-- Rachel Gibson (rgibson@hotmail.com), May 25, 2000.

Early evening news says a "faulty chlorination plant" may have caused the problem.

-- Rachel Gibson (rgibson@hotmail.com), May 25, 2000.

This story just gets worse and worse. Apparently, the Ontario government privatized water testing sometime in the past few years!

Canoe

Friday, May 26, 2000

Could outbreak have been avoided?

LAWYER: RESIDENTS AFFECTED BY BUG LIKELY TO SUE CRISIS PROBE BY OPP WATER EXPERTS: 'WE WILL GET IT FIXED' TOWN'S SAFETY RESTED WITH 1 MAN RESIDENTS UNITE IN ANGER TORONTO HELPS OUT DRUG GETS GO-AHEAD DOCTOR LOST CHILD TO BUG

WALKERTON, Ont. (CP) -- Angry residents learned Thursday that five deaths and hundreds of illnesses from a massive outbreak of E. coli in the town's water could have been prevented. They spent the day demanding to know who's to blame.

"Why wasn't this information brought to the public right away?" an emotional Philip Englishman, 58, shouted at officials after the medical officer of health said the utility knew the water was contaminated days before any warning was issued.

"Somebody is going to pay," said resident Bob Ferguson, who was furious. "These people are being paid; they should be fired."

Earlier Thursday, Dr. Murray McQuigge, the chief medical officer of health, made the shocking allegation that the utilities commission knew for at least a week before people started dying that the water was contaminated.

"This could have been prevented," said McQuigge, who asked commission workers three times during the weekend if the water was safe to drink and each time was told it was.

By Sunday, McQuigge said he began to distrust the utility and ordered all residents to begin boiling their water after doctors told him about several cases of bloody diarrhea, a common symptom of an E. coli infection.

"When all the evidence we were getting was pointing to a contaminated water supply -- despite being told the public water system was safe -- the public health unit told the people of Walkerton not to drink the water," he said.

McQuigge also said utility officials had told him offhandedly that the town's chlorination system had been faulty for some time. Experts say E. coli bacteria is killed off by chlorine.

But residents got few answers as officials nervously addressed a barrage of questions from the nation's media.

Jim Kieffer, chairman of the tiny Public Utilities Commission, said neither he nor the mayor were told that a test had shown the water was contaminated until after the residents were ordered to start boiling water.

In the end, a shaken and weary Kieffer admitted that his manager didn't realize the potential threat to lives despite a report that showed the water was tainted.

"At the particular time, yes (that's true)," said Kieffer, sounding defeated.

Police and the Crown attorney in the area were meeting Thursday afternoon to discuss launching a criminal investigation into the E. coli outbreak, described as the worst in Canada's history. The province's coroner says there will be an inquest.

By mid-afternoon Thursday, officials announced the outbreak had claimed its fifth victim, another elderly person. Two more children -- one from Owen Sound, another from Walkerton -- were so sick they were airlifted to a hospital in London, Ont., to join other youngsters in critical condition there. One clutched a teddy bear as he was wheeled into the hospital emergency room.

Meanwhile, relatives prepared to bury their loved ones. Lenore Al, 66, will be buried 11 a.m. Friday at Sacred Heart Church.

At least 700 people have been affected and McQuigge has predicted that more will likely die since the symptoms -- diarrhea, nausea and fever -- can take up to a week to surface.

About 50 cases were reported to the hospital in Walkerton on Thursday, some showing similar symptoms but carrying a new, less dangerous form of the bacteria.

"It's different from E. coli in the sense that it's not as deadly," said Dr. William Knox, the hospital's chief of staff, at a news conference.

The Ontario Provincial Police, Environment Minister Dan Newman and McQuigge will meet today to discuss the possibility of criminal charges.

The province's Environment Ministry is investigating, and there was some suggestion Thursday that a provincial government policy downloading responsibility for regular E. coli testing of municipal water may have been part of the problem.

Newman said he "would keep an open mind" in considering changes to how municipalities test their water.

The Ontario Clean Water Agency has taken control of the community's utility commission for at least six months.

Residents were left to drink bottled water and many drove to nearby towns to bathe since the town's water is still grossly contaminated, almost two weeks after a severe storm caused massive flooding in the area.

Schools and daycares remained closed for the week.

While hospitals have been strained for days, neighbourhood coffee shops and restaurants sat empty, with regulars too afraid to drink the water.

E. coli normally live in the intestines of humans and other warm-blooded animals, such as cattle. Most strains are harmless but some can be deadly. It can be transmitted by eating undercooked meat from a contaminated cow, or by drinking unpasteurized milk or apple juice.

The E. coli bacteria produces toxins, that, in severe cases, lead to kidney failure.

The five victims of the outbreak include retired library worker Lenore Al, 66, and Edith Pearson, 83. Officials haven't identified the other victims.

-- Rachel Gibson (rgibson@hotmail.com), May 26, 2000.