The Food Safety Authority of Ireland has urged childcare workers and crèche owners to ensure they have robust hygiene practices in place to reduce the incidence of E coli.

The authority has said it is concerned at the high levels of E coli infection here, with 285 cases of human infection provisionally recorded last year.

There were nine outbreaks in children attending crèches, or who were cared for in the home by childminders.

This involved some 75 children and adults becoming ill, with seven being hospitalised last year.

The FSAI says young children and infants are particularly at risk from E coli infection, and children and workers in childcare settings can unwittingly spread infection.

Washing hands is the single most important way to stop the spread of these E coli. Young children should be helped to wash and dry their hands. Babies need to have their hands washed as often as older children.

As well as handwashing, infection can be prevented by using a safe water supply and preparing food hygenically.

Staff are asked to stay away from childcare facilities for 48 hours if they have had diarrhoea or vomiting, and they should contact the Department of Public Health for advice to prevent more cases.

The FSAI has just published a leaflet - How to Protect the Children in Your Care - which is freely available on www.fsai.ie.

 In the first known outbreak of Escherichia coli O26 in a U.S. child care center, neither severe illness nor a secondary household transmission was reported, according to results presented during the 51st Interscience Conference on Antimicrobial Agents and Chemotherapy.

Data on duration of Shiga-toxin-producing E. coli serotype O26 shedding are limited, but shedding can be prolonged. However, the need for separation of infected children who have this apparently low-virulence infection remains uncertain, according to Mathieu Tourdjman, MD, MPH, CDC Epidemic Intelligence Service Officer with the Oregon Health Authority.

“The study raised more questions than it answered,” Tourdjman said during his presentation. “Child care exclusion policies vary across country. Most frequently, the policy states that children infected with O157 should be excluded until at least two consecutive stool samples are negative. Because limited data on O26 are available for O26 infection, no consensus exists on whether similar exclusion should occur.”

The outbreak of E. coli O26 occurred in an Oregon child care center in October 2010. Children who attended the child care facility were aged in range from 6 weeks to 12 years. They were separated by age into six different classrooms.

According to Tourdjman, infected staff and parents of infected children provided demographic and clinical information. Secondary transmission to household members was assessed by screening stool specimens for Shiga toxin using PCR. Positive isolates were isolated and serotyped. Cases in this particular outbreak were defined as laboratory-confirmed O26 infection among attendees or staff during October 2010.

Results of the study revealed a total of 10 cases of E. coli O26: nine children (median age: 1 year) and one staff member. Patients were in three different classrooms and not clustered. Four patients reported diarrhea, including one with bloody diarrhea, but none of the patients progressed to hemolytic uremic syndrome or required hospitalization.

The findings of the investigation also revealed that duration of shedding ranged from 12 to 46 days (median 25 days), and a lack of secondary transmission to household members.

Tourdjman M. #L1-389. Duration of Shedding and Secondary Transmission of Shiga-Toxin-Producing Escherichia coli O26 During an Outbreak in a Child Care Center:: Oregon, October 2010. Presented at: 51st ICAAC. Sept. 17-20, 2011. Chicago.

Tampa Bay Online reports that changes in state laws on food safety inspections has led to mass confusion about jurisdiction, so much that health departments are now regaining powers to conduct kitchen hygiene inspections at child care facilities, at least for an interim period.

Marc Yacht, the retired former director of the Pasco County Health Department said he remains concerned about the "most vulnerable population" at nursing homes not having a regular food and hygiene inspection program.

Unintended consequences seem to have plagued the new law from the start, Yacht and other critics say.

Most Department of Children and Family inspectors have bachelor's degrees in social sciences, but they lack the training and experience for food inspections. The Department of Health inspectors have degrees in science or health and training in food safety.