Study fails to find E.coli source

A child follows good hygiene practice at the nursery

The source of an E.coli O157 outbreak which left five toddlers at a Fife nursery seriously ill has not been identified, more than a year on.

A total of 14 people fell ill at the Careshare Lauder Nursery in Dunfermline, in May 2006.

A report into NHS Fife's response said that despite a "detailed and exhaustive investigation", it was not possible to say what the source was.

The report said it may have resulted from bacteria brought into the centre.

Five children suffered haemolytic uraemic syndrome and nine other people became ill during the incident.

They were all subsequently released from hospital.

Potentially deadly

The privately-run nursery was closed for five weeks for an investigation and was allowed to reopen after cleaning teams disinfected the premises.

Health Protection Scotland (HPS) identified a rare strain of the potentially deadly E.coli 0157 bug, which is most commonly found in the intestines of cattle.

Humans can become infected by eating contaminated food or inadequately cooked meat and dairy products.

It can also be spread through direct contact with animals as well as person-to-person.

The initial response by the NHS Fife public health team of the first single case in the nursery was appropriate and consistent with national guidance Report finding

Report author and public health consultant Dr Mike Roworth, said: "Despite detailed and exhaustive investigation, we concluded that it was not possible to say what the source of outbreak was, but the most likely scenario was a single introduction of the bacterium into the Careshare Nursery Lauder, followed by person to person spread."

The report criticised a lack of early notification to the NHS board's public health team by hospital clinicians dealing with the stricken children.

It said: "The public health team reacted in good time to notifications of children with Haemolytic Uraemic Syndrome (HUS).

"However, hospital clinicians appear not to have notified the public health department as quickly as I would have expected."

The nursery underwent a rigorous inspection

Problems health bosses faced when they tried to contact parents of children at the nursery were also identified in the report.

A total of 115 children were attending the nursery for part or all of the week at the time of the outbreak, along with 27 staff.

The Careshare Lauder Nursery did not have a complete record of addresses, contact numbers or e-mail addresses, investigators found.

The report said the outbreak control team (OCT) - which eventually numbered 40 staff - responded in good time and appropriately to what happened.

'Full recovery'

No evidence was unearthed by investigators indicating that the outbreak was caused by any negligence on the part of the Careshare company or individual staff members.

Careshare managing director Jonathan Bell said he welcomed the findings.

He said: "Thankfully the children involved in last year's E.coli outbreak have made a full recovery.

"In the time since the outbreak at Lauder Nursery the building has been given a rigorous "deep clean" and the nursery was subject to a detailed investigation and an unannounced inspection by Fife Council environmental services."