CALGARY — More than 350 people, mostly children, have been infected in an E. coli outbreak linked to multiple daycares in Calgary. Here's a timeline of key developments in the outbreak:
Aug. 31 to Sept. 3: Patients start showing up with gastrointestinal illnesses at various hospitals across Calgary, including Alberta Children's Hospital. Symptoms of E. coli typically appear three to four days after exposure, but can appear as early as one day after exposure to more than a week later.
Some parents believe their children were infected on or around Aug. 29. Meat loaf, fresh vegetables and fruit were listed on the online menu for the Fueling Brains daycares that day.
Sept. 3: Fueling Brains says on its website that it has been notified by Alberta Health Services of a potential E. coli outbreak and is working with health officials to investigate the source. It says it has sent a note to families and closed its daycares.
Some parents tell local media they received a notice, but others say they learned about the potential outbreak when they took their children to hospital.
Sept. 4: AHS declares an E. coli outbreak for six Fueling Brains locations and five additional sites that share a central kitchen. The health authority says there are 17 lab-confirmed cases linked to the outbreak. Twelve patients are in hospital and up to 50 children have visited hospitals.
Sept. 5: An environmental health inspection is completed at the central kitchen, KidsU Centennial-Fueling Minds Inc., which services the daycares. The inspection report, released a week later, shows critical violations.
Sept. 6: AHS says some of the 22 patients in hospital have severe symptoms. It says the number of lab-confirmed cases has grown to 96.
Sept. 7: The number of cases rises to 128. Twenty-five patients are in hospital. Nine are confirmed as having hemolytic uremic syndrome, a complication affecting the blood and kidneys.
Sept. 8: A lawyer in Calgary files a proposed class-action lawsuit against the daycares. Maia Tomljanovic says she has spoken with dozens of parents whose children have been infected, and she's aware there are many others. There are 142 cases, with 11 patients seriously ill.
Dr. Francesco Rizzuti, medical officer of health in Calgary, says four of the 11 daycares had no reported E. coli cases and would be allowed to reopen on Sept. 11 if that continued. He says the other facilities could reopen as early as Sept. 12, but children and staff would be required to show proof of a negative test before they could return. Deep cleaning would also be required.
Sept. 10: Alberta Premier Danielle Smith says she has asked the province's health minister and children and family services minister to do a "full assessment" of the outbreak. Alberta Health Services says there are 190 cases. Twenty-seven people are in hospital, with 20 having severe illness.
The health authority says it's "highly likely" the outbreak is linked to food from the central kitchen.
Sept. 11: A notice on the Fueling Brains website says mandatory testing is required for students and staff who attended five of the daycares — Braeside, Centennial, McKnight, New Brighton and West 85th — between Aug. 15 and Aug. 31.
The number of cases surpasses 200.
Sept. 12: The provincial government, including Alberta's chief medical officer of health, holds its first news conference on the outbreak. AHS releases the Sept. 5 inspection report that shows the kitchen lacked proper sanitization methods, had a pest infestation and food was transported without temperature control.
There are 264 cases and 15 patients are in hospital. Of those, 22 have hemolytic uremic syndrome. Six patients are on dialysis.
Seven daycare facilities are allowed to reopen, while five others and the central kitchen remain under a closure order.
At least one parent and the Opposition NDP call for a public inquiry into the outbreak.
Sept. 13: All closure orders for the daycares are rescinded by AHS. It says the operator is to make any decisions on reopening after the closure orders are lifted.
Sept. 14: The number of lab-confirmed cases grows to 310, but there are fewer patients in hospital with serious complications.
Eight children who were severely ill have been discharged from hospital.
Sept. 15: Smith says her government will immediately provide families $2,000 for each child affected by the outbreak.
She says the province will also look into new regulations for shared kitchens and food safety.
Late that night, Alberta's chief medical officer of health says he has been made aware of additional daycare sites in Calgary where children have tested positive for E. coli. Dr. Mark Joffe says the facilities would be closed out of an abundance of caution.
Sept. 16: The province's health delivery agency appears to revise Joffe's statement from the previous night, saying most of the additional facilities face only "partial closures" affecting specific classrooms.
AHS says initial results suggest the new cases are mostly from secondary transmission.
Sept. 18: Officials say the outbreak appears to have peaked.
There are 348 lab-confirmed cases, an increase of six from the weekend. Secondary lab-confirmed cases have also risen slightly to 27, while the number of patients receiving care in hospital has fallen to nine from 12.
The Opposition NDP again calls for a public inquiry.
Smith says she has committed to do a review but is not sure what form it will take.
Sept. 22: Officials report 349 lab-confirmed cases and 29 cases of secondary spread.
Sept. 25: The province opens its online portal for affected parents to apply for the $2,000 "compassionate payments." The form links to a list of 19 daycares that have been fully or partially closed due to the outbreak.
Sept. 27: The City of Calgary announces charges against the company that runs the shared kitchen for operating without a business licence. Fueling Minds Inc. and its two directors face a total of 12 charges under municipal business bylaws and face a total fine of up to $120,000.
Joffe says the likely source of the outbreak was meat loaf and vegan loaf served on Aug. 29. But he says the items were eaten or thrown out before they could be tested, so investigators don't know exactly what was contaminated or how.
Joffe says the cases have plateaued at 351, with 37 secondary cases and four children remaining in hospital.
Smith announces former Calgary police chief Rick Hanson will lead a panel to investigate what went wrong and recommend ways to make commercially prepared food safer in daycares.
This report by The Canadian Press was first published Sept. 27, 2023.
The Canadian Press