An outbreak of hundreds of E. Coli infections traced to a kitchen serving daycare centers in Calgary, Alberta, Canada, has been declared over. The kitchen remains closed until further notice.

The outbreak was declared on Sept. 4, and 11 daycare centers and the central kitchen serving them were closed. All 11 centers have been allowed to reopen, but the KidsU Centennial – Fueling Minds Inc. kitchen remains closed, according to Alberta Health Services.

The health department reported on Oct. 31 that final data validation is continuing. So far, 446 patients have been reported, including 356 laboratory-confirmed and 90 probable cases.

Thirty-eight children and one adult were hospitalized, with 23 of the patients diagnosed with the severe outcome of hemolytic uremic syndrome (HUS). Eight patients required dialysis. No patients remain in the hospital, and there have been no deaths. HUS attacks the kidneys and blood system and can result in complete organ failure, permanent brain damage, and the need for kidney transplants.

“While the outbreak has been declared over, much work continues, including supporting those individuals who continue to have E. coli-positive stools and further work regarding the source investigation,” according to Alberta Health Services.

1,581 children connected with the outbreak have been cleared to return to a daycare facility. Some individuals who tested positive for E. coli remain excluded from returning to daycare as students or staff. Alberta Health Services says it is continuing to monitor the lab results for the children and staff, and the individuals will require a rescind/clearance letter from AHS to return to daycare as students or workers.

The health department suspects that meatloaf and vegetarian loaf served at the daycare centers was the source of the outbreak, based on a traceback investigation. However, by the time the outbreak started, no food leftovers were available for testing.

Inspectors found several violations of health codes in the central kitchen, including cockroaches, pooling water on the floor, and a food thermometer stored in a bucket with uncleanable items.

“The operator indicated that cold foods were transported to other locations over 90 minutes without temperature control. Appropriate equipment for keeping food cold during transport was not available,” inspectors reported.

The kitchen remains under a closure order, and the criteria for rescinding the order have not been met, according to Alberta Health Services. For the kitchen to reopen, multiple steps must be taken, including the submission and approval of a food safety plan.

The daycare centers that received food from the central kitchen and were temporarily closed were:

• Fueling Brains Braeside — illnesses reported
• Fueling Brains West 85th — illnesses reported
• Fueling Brains New Brighton — illnesses reported
• Fueling Brains Centennial — illnesses reported
• Fueling Brains Bridgeland — illnesses reported
• Fueling Brains McKnight — illnesses reported
• Braineer Academy — cautionary closure
• Kidz Space — cautionary closure
• Little Oak Early Education (formerly Mangrove) — cautionary closure
• Almond Branch School — cautionary closure
• Vik Academy in Okotoks — cautionary closure