Last week there was a group infection in children at the Mánagardí kindergarten in Reykjavík caused by E. coli bacteria of a type called STEC. An investigation into the cause and origin of the infection began on the same day as the diagnosis. The kindergarten was closed the next day. It is most likely a foodborne infection. Numerous food samples are being investigated at Matís, but the analysis of STEC in food is difficult and time-consuming. Results will be published with a press release on the websites of the Epidemiologist, the National Food Agency and the Reykjavík Health Authority when they are available.
Research on foodborne group infections is in the hands of a steering group, which in this case is appointed by an epidemiologist, Matvælastofnun, Reykjavík Health Authority, Department of Epidemiology and Virology of Landspítal, Matís, Health Care of the capital region and Children’s Hospital of the Circle.
After detailed information gathering by representatives of the epidemiologist and the capital region’s health care from the children’s parents, attention is focused on Thursday, October 17, on which day all the children who fell ill in the first few days were in the kindergarten. It is most likely a food-borne infection, as the children’s illness started at a similar time and spread across all the school’s departments. For the same reason, it is less likely that the infection is originally from the environment or between children. However, it is not possible to exclude those routes of transmission after the illness started and before a group infection was suspected and the kindergarten was closed.
On October 17, porridge was available in the morning, mince sauce or lentil dish (vegetable dish) and spaghetti for lunch and melons for fruit time. The Reykjavík Health Authority is conducting an on-site investigation and has taken numerous food samples for investigation, from the food that was offered that day. At the same time, health representatives have visited the kindergarten, reviewed procedures, assessed the situation and requested improvements as necessary. After the outbreak of the group infection, the kindergarten has been cleaned high and low, as well as toys and other equipment have been disinfected. The kindergarten is still closed and the decision on opening will be made by the operator in consultation with the steering committee. The Epidemiologist will issue instructions regarding when the children can return to school.
E. coli bacteria are part of the natural intestinal flora of humans and animals and can be introduced into water, meat, vegetables and other foods during their production. Different types of E. coli exist. Shigatoxin-producing E. coli (STEC) carry genes that produce toxins that cause the disease (virulence genes). However, their strains can be highly pathogenic.
Finding and culturing STEC strains in food can be difficult. First, virulence genes are screened and, if detected, E. coli strains are grown . Since a number of different E. coli strains are often found in each sample, it can be difficult to find the strain that carries the virulence genes, and the studies often have to be repeated. Sometimes the cause cannot be found.
The Food Agency reported on a screening of the presence of pathogenic bacteria in Icelandic meat on the Icelandic market in 2018. It stated that STEC virulence genes were found in almost 30% of lamb samples and 11.5% of beef samples. Comparable studies have not been carried out on vegetables, fruits or other foodstuffs in this country.
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