Report on Aboyne Nursery outbreak disappoints child's mother4th October 2012
The mother of a 22-month-old boy left with serious health problems after an E. coli outbreak in May at the Rose Lodge Nursery in Aboyne, Aberdeenshire, has hit out at a report into the incident.
The report, which was presented to NHS Grampian on Tuesday, claims that the outbreak was most likely caused by one youngster having contact with animal faeces in nearby fields or by drinking contaminated water at home, then spreading it to 3 other infants, 2 staff and a family member at home due to a failure of hand hygiene.
Representing the child’s mother, Paul Santoni of Freelands Solicitors and the Chairman of HUSH (Haemolytic Uraemic Syndrome Help - the UK E.coli Support Group) said the child was still "very seriously ill".
His statement reports that the child has been constantly hospitalised since admission on 19th May and spent 10 weeks in intensive care. An MRI scan has indicated that there has been some damage to the brain. He has lost his sight, has severe hearing loss, complete kidney failure and sections of the large and small colon were removed. The bowel may never return to normal and he is likely to be on dialysis for life. The long term effects are still unpredictable and uncertain other than that they will be very severe.
The mother has been permanently residing in the Glasgow hospital complex to care and attend to the child and does not wish her identity or the identity of the child to be known.
The statement added: "She has stated that the report does not answer anything for her. She does not understand how the staff contracted E.coli O157. Was it just their failure to wash hands? She does not know how the outbreak occurred. She would like to have a proper explanation. She believes there has to be more information available and that the report prepared does not really cover these.
"She specifically wants the public reminded about how aggressive E.coli O157 can be and how much her child has suffered and how much he will continue to suffer by virtue of contracting it.
"She believes that she and the child have been forgotten about and that she is very angry about that."
Mr Santoni states that in relation to the report both he and the child’s mother have some general comments and observations. The report appears to conclude that the outbreak entered the nursery probably through one of the children who was affected. What the report does not adequately explain is as follows:-
- What were the dynamics of the younger children within the nursery insofar as they would have contact with each other or ability to pass on the infection to each other?
- Much more fundamentally how is it that adult staff can be infected by the bacteria? Whilst it is easily understandable that all young children playing or using common objects in particular at a very young age could easily pass on the bacterium through ordinary contact, adults who are meant to be trained in cross infection control and apparently have taken cross infection control precautions should not have been infected.
- Were there fundamental flaws in the hygiene regime used by the adults in the nursery which resulted in either infection to them or cross infection to the children?
- If so, what were these?
- There appears to be no comment or investigation as to the number of children who were ordinarily at the nursery on each given day; of each age group; and in each particular room. Only children in one room appear to have been infected. The mother had understood that there were few children in her child’s room at the nursery on Tuesday 15th May, possibly only 3 potentially being those infected. Two of those children are believed to be siblings and live in the same house. The separation between their infection and the infection in the nursery is not adequately explained or explored.
- The mother understood that the reason why there were few children at the nursery on Tuesday 15th May was that there had been an earlier outbreak of diarrhoea affecting the nurseries’ children. She believes she was told this on Tuesday 15th May. She has raised this issue with the outbreak team but it does not appear to be featured in the report or commented on. It is not clear at what time of day the nursery were notified of the preliminary infections or the infections of the children in turn.
- If one of the children was shown to have diarrhoea on 15th May was this at the nursery or after nursery?
- There appears to be no proper reporting of the consequences of the preliminary conditions and whether this should have alerted staff to take extra precautions.
- We wrote to the outbreak team on 29th June asking various questions about the outbreak and were advised that these would be answered in terms of the report. They have not been fully addressed. There does not appear to have been sufficient interaction with the mother of "case 3" or our firm on our behalf to understand the concerns being expressed or questions that require to be answered or to take account of our input and views. The mother was interviewed formally on 20th May in Aberdeen and not since. Surely if the mother has raised significant issues which may contradict essential facts then these should have been cross checked before publication?
In conclusion, Mr Santoni simply echoes his client’s comments that the report fails to answer fundamental and important questions and bluntly puts the mother of being in a position of being not much better informed than she was prior to the report being issued.
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