Mystery over source of deadly outbreak

What appeared initially to be a simple stomach upset has baffled public health experts who, while saying there was no risk to those living in and around Oldmeldrum, in Aberdeenshire, admitted the cause of the current bout of infections may never be known.

Rebecca MacRae, aged two, was yesterday described as "serious but stable" in an intensive care unit at Glasgow’s Yorkhill Hospital where her mother, Nicola, has been maintaining a bedside vigil.

Late yesterday afternoon, Rebecca was taken off a ventilator which had been helping to keep her alive, but her parents have been warned by doctors that she has only a 50:50 chance of survival and may already have sustained brain damage as a result of her infection.

Her sisters, Louise, aged four, and Chloe, 11 months, are being treated at the Royal Hospital for Sick Children in Aberdeen, where their condition is described as satisfactory.

Tests yesterday also confirmed that Rebecca’s father, Ross, an assistant greenkeeper at Oldmeldrum golf club, and her brother, Kyle, six, have also been infected, although neither is showing any serious symptoms of the infection.

Mrs MacRae and the family’s remaining child, Kevin, five, are not believed to be infected.

Speaking at the family home in Oldmeldrum, Mr MacRae, 26, said he and his wife were clinging to the hope that Rebecca would pull through.

Mr MacRae said: "We just can’t believe it. Having one was bad enough, but for another two to go into hospital is unthinkable.

"I just don’t know what to think about it. I just feel as if somebody is trying to take something away from us.

"We just keep on going and keep on going and just hope for the best, that she will pull through."

He added: "I am not feeling 100 per cent, but Kyle appears to be fine. He doesn’t appear to have any of the symptoms but we will have to be monitored."

Mr MacRae said he had never heard of E.coli 0157 until his family were struck down by the illness. And he explained that the family’s nightmare began last Tuesday when he changed Rebecca’s nappy and discovered blood.

"We knew she had diarrhoea but the blood obviously meant there was something wrong, and that was when it all started off," said Mr MacRae.

He said he had no idea how the family could have succumbed to the infection. Their home, near the centre of Oldmeldrum, is on the public water supply and they had not recently visited a farm.

"The boys go to the park with friends and, apart from that, they walk back and forth to school," Mr MacRae said. "Louise recently went on a visit to a vet’s with her nursery but that was a few weeks ago and no other kids have been affected - so I don’t think that can be the cause."

Communicable disease experts with NHS Grampian were continuing their attempts to identify the potential source of the bug last night. But Dr Helen Howie, a consultant in public health medicine with NHS Grampian, said the source of the infection may never be known.

"There are wide range of sources where you can acquire this infection from and sometimes, unfortunately, we cannot find out for definite where an outbreak began," she said. "We might never know."

She explained: "This is an infection we normally see in the summertime, when people are out in the country and come into contact with animals or animal faeces, which is the most likely source of infection in Scotland.

"We will be talking through with the family all the possible risk factors to try and establish what the most likely cause is, but often we cannot prove the source for definite."

She stressed, however, there was no risk to wider public health. "I think what are dealing with essentially is a family cluster," Dr Howie continued. "This infection can be quite easily spread within households. It doesn’t take much of the bacteria to spread within a family."

Kyle and Kevin are both pupils at Meldrum Primary School, and Dr Howie said: "From my perspective, there is no risk within the school. But, having said that, we will still be in contact with the school, because obviously there will be anxiety in the school. Managing the anxiety in the community is part of what we do."

She also emphasised that, while there was no apparent risk to the wider community, members of the public should take common-sense hygiene precautions to prevent any risk of infection spread.

She added: "Anyone who does have symptoms of diarrhoea and/or vomiting should not be at work or school, and should remain at home until 48 hours after their symptoms have completely settled."

There have already been 65 cases of E.coli O157 in Grampian this year, compared with 61 cases for the whole of last year.

Scotland was the scene of the world’s worst E.coli outbreak in November 1996, when 21 mainly elderly people died and almost 500 people were taken ill in an outbreak that was later traced to the consumption of meat products from a butcher’s shop in Wishaw.

E.coli 0157 was first identified as a cause of human illness in the United States only 20 years ago, when it was linked to the consumption of hamburgers and branded the "burger disease". The increasing number of major outbreaks led to the establishment in 2001 of an E.coli task force by the Food Standards Agency in Scotland.

The task force’s report revealed that the biggest danger from E.coli O157 was via human contact with the droppings of ruminating animals such as cows and sheep. Research showed that almost one quarter of cattle herds in Scotland and many sheep and goats carry and excrete E.coli O157.

The task force’s report also stated: "The genetics of the organism are beginning to be understood, but we are still only at the frontier of this work."