How E. coli got in daycare meat loaf, sickening hundreds, may never be known, says report

A report into a massive E. coli outbreak at Calgary child-care facilities that saw hundreds fall ill says it was likely tied to meat loaf at one meal, but how it got there can't be determined for sure.

The report released Monday by Alberta Health Services (AHS) says it's not possible to say if the bacteria came from a contaminated ingredient in the meat loaf or got into the meat loaf from elsewhere on the menu, or through an infected kitchen worker.

The E. coli outbreak, declared on Sept. 4, 2023, led to at least 448 infections.

Thirty-eight children and one adult were hospitalized for severe illness.

Of the severe cases, 23 were diagnosed with hemolytic uremic syndrome, a condition that damages blood vessels and kidneys and can lead to life-threatening kidney failure.

Eight received peritoneal dialysis, which is done to remove waste products from the blood when the kidneys are failing.

Another 33 secondary cases have also been linked, including household contacts and children in other daycare facilities.

There were no deaths.

Largest outbreak in AHS history

The outbreak was linked to Shiga toxin-producing Escherichia coli, or STEC for short.

"This is the largest gastrointestinal outbreak in AHS history and likely one of the largest STEC outbreaks involving child-care facilities anywhere," said the report.

"The central kitchen served up to 1,275 attendees and 250 child-care facility workers during the period in question, in addition to exposures to kitchen staff and people in the community who ate leftovers."

The eight-week outbreak was traced to Fueling Minds, a catering company and school lunch delivery service provider that prepared food for its Fueling Brains locations and other daycares in Calgary.

The report narrowed the E. coli down to a single meal served from the Fueling Minds central kitchen on Aug. 29, 2023.

"One meal originating from the central kitchen came out with extremely high odds as being the source of inspection. The beef meat loaf served at lunch on Aug. 29, 2023, was the probable food item containing the E. coli," said the report.

"Workers who ate beef meat loaf were 23 times more likely to become a confirmed STEC case than workers who did not eat beef meat loaf."

New report makes recommendations

E. coli is a type of bacteria that can cause bloody diarrhea. Some strains cause more severe illness. Shiga toxin-producing E. coli is different as it produces a toxin that can cause complications.

In response to the outbreak, the province launched a third-party review to determine how to prevent similar outbreaks in the future.

That report, by the Food Safety and Licensed Facility-Based Child Care Review Panel and also released Monday, made 12 main recommendations to protect the health and safety of children in licensed child-care facilities.

The Alberta government said it has already started work on implementing some of the changes, including increasing the frequency of inspections at child-care facilities, mandatory training programs for food workers and improving response times in child-care facilities where food safety concerns have been raised.

Planning is also underway to require all licensed child-care providers to prominently post their most recent public health inspection reports for parents to review.

Opposition responds

"It's our government's intention to act on every recommendation we can to protect children's safety and to restore trust in the system," Premier Danielle Smith said in a statement.

"Last year's E. coli outbreak had a devastating impact on families, and we are committed to making sure an event like that never happens in our province again."

Matt Jones, minister of jobs, economy and trade, said the government will make sure that child-care operators follow the new rules.

"We are going to put in tools to hold people accountable, and we're going to increase transparency so the parents can see an operators' track record," Jones said.

Diana Batten, Alberta NDP Critic for Childcare and Children and Family Services, criticized the UCP government's handling of the outbreak, saying it took too long to take accountability for what happened, and that it let previous health inspector's reports on violations at the Fueling Minds kitchen fall through the cracks. 

"The UCP government and the daycare provider allowed the well-being of children and staff at these daycares to be at risk by not addressing those critical health violations," Batten said in a statement.

"This cannot be allowed to happen again. However, it is still uncertain where public health will fall in Danielle Smith's dismantling of [AHS] making the path forward on today's recommendations unclear."

The Fueling Minds kitchen was closed after the outbreak and reopened in November under a different food provider.

The daycare operator offered a brief statement after the announcement.

"The health and safety of our kids and families is our top priority, and we look forward to reviewing the report in detail," it said.

Fueling Minds and its directors have been charged by the City of Calgary with serving food to the child-care centres without a licence.

They have pleaded not guilty and face fines up to $120,000.

A trial is set for September.