Hemolytic Uremic Syndrome

E. coli From Lawn Sprinklers Sends Children to the Hospital Last Summer. Information Parents Need to Know!

Did you know that your child could be infected with E. coli from lawn sprinklers depending on the water source? Several parents in Utah towns last summer learned this the hard way.

This outbreak brings to light some warnings and even bigger questions.

But first. The outbreak.

The Outbreak

During the warm summer months of July, August, and September, an outbreak of a seriously bad bug, Shiga toxin-producing Escherichia coli (STEC) O157:H7 caused at least 13 illnesses.

All Children.

Seven of those children became sick enough to require hospitalization, with two of them developing a serious complication known as hemolytic uremic syndrome – a type of kidney failure associated with bacterial toxins.

Fortunately, all children recovered from their illnesses.

Outbreak Investigation Revealed Municipal Irrigation Water as Source

Not unlike other outbreak situations where a group of seemingly unrelated people become sick with the same type of illness, investigators developed a set of interview questions to get a better understanding of what could have caused these illnesses and how they are related.

These preliminary interview responses included exposure to irrigation water.

How Did These Children Come in Contact with Irrigation Water, and How Could it Be Related to This Outbreak of E. coli From Lawn Sprinklers?

You may be asking yourself; how could this happen.

First, how would these children come in contact with irrigation water?

Secondly, why is irrigation water contaminated with the harmful bacteria, Escherichia coli?

In this water municipality, homes have two water sources. One is the typical water source coming from the city’s treated water system. The other is “untreated, pressurized, municipal irrigation water” or UPMIW.

It was this UPMIW exposure from water pumped to homes that was determined to be the source of the outbreak.

What Exactly is Untreated, Pressurized, Municipal Irrigation Water?

So, what does untreated, pressurized, municipal irrigation water mean?

In this case, the primary source of this water is melted mountain snow.  For this area, snow melt from more than 30 miles away. This water travels by river and is collected in an underground pipeline to several open reservoirs withing the city and surrounding communities. This water is then pumped to the residential connection to homes.

This untreated water is not routinely monitored or tested and is meant for outdoor landscaping irrigation, such as for lawn and gardens. According to the municipality, this water is not suitable for drinking or recreational activities.

Other sources of irrigation water include a number of public wells, nearby rivers, and creeks.

This untreated, pressurized, municipal irrigation water is meant to conserve drinking water and reduce water treatment costs. It is not intended for human consumption or recreational activities, according to the agency.

E. coli from Lawn Sprinklers and Other Recreational Activities Was Common Exposure Link

Nearly all of the children involved in this outbreak (twelve of the thirteen) were reported to have come in contact recreationally with this untreated municipal water in the week prior to becoming sick.

These are typical recreational activities many children participate in as the temperature rises.

Five were reported as playing with hose water.

Three were reported as playing with inflatable lawn water toys.

Two were reported as playing with water tables.

Two were reported as drinking the water,

One was reported as running through water sprinklers.

The one child that did not indicate exposure to the untreated municipal water was not a resident of the area but did report spending time in the city in the week before becoming sick.

Kids began falling sick around three days after exposure.

Patient Samples Were Compared to Collected Irrigation Water Samples

All patient samples were genetically similar to each other, indicating that their illnesses were caused by a common source.

After discovering what linked the sick patients, the city collected samples from the different water sources as well as bird feces and sediment in the water supply area.

Five of the nine potential water sources were positive for genetically similar strains of this harmful bacterium.

What Are the Symptoms of E. coli Infection?

This particular strain of E. coli, STEC produces a toxin that can cause more serious infections.

Some illnesses may be mild. However, others can become quite serious with additional complications.

The most common combination of symptoms includes:

  • Severe stomach cramps
  • Diarrhea (often bloody)
  • Vomiting
  • Fever (if present) usually under 101 °F

These symptoms usually begin around three to four days after exposure, with most resolving within five to seven days.

Young children, the elderly, and those with weakened immune systems are at higher risk of becoming sick when exposed to STEC and also more likely to become seriously ill if infected.

In fact, children are more likely to experience a type of kidney complication known as hemolytic uremic syndrome.

What is Hemolytic Uremic Syndrome?

Hemolytic uremic syndrome, or HUS, is a type of kidney complication that develops in around 5 to 10% of those diagnosed with STEC infections.

People experiencing STEC symptoms require prompt hospitalization to recover.

The toxin produced by the harmful E. coli strain can break down red blood cells. These damaged blood cells can block the filtering pathways in the kidneys, causing them to fail. Symptoms usually begin around 7 days after initial diarrheal symptoms begin (just as it is improving).

Symptoms of HUS:

  • Decreased frequency of urination
  • Feeling very tired
  • Losing pink color in cheeks and inside lower eyelids

With appropriate care, most people with HUS will recover within a few weeks. However, in some cases, HUS can cause permanent damage or become fatal.

E. coli from Lawn Sprinklers and In Irrigation Water Poses a Big Question – How Safe Is Your Garden?

According to reports, none of these patients indicated eating non-commercial produce irrigated with untreated municipal water. But it does pose the question of how safe this irrigation water is for the garden.

While of course you will want to wash any fruits and vegetables prior to eating or preparing food with them, this irrigation water contamination event does bring to light some potential risks.

Children are more likely to find the temptation of a ripe strawberry in the garden too irresistible to take the time to bring inside to wash. They are more likely to munch on a fresh, juicy cucumber right off the vine.

Who am I kidding. I fall for those temptations as well. Especially if it came directly from my own garden.

But if the water used to nourish these delicious edibles could be tainted, this might be a recipe for disaster.

Stress the importance of washing all fruits and veggies before eating and heed all untreated water warnings.

Stay in Touch with Make Food Safe!

If you’d like to know more about food safety topics in the news, like “E. coli From Lawn Sprinklers Sends Children to the Hospital Last Summer. Information Parents Need to Know!” check out the Make Food Safe Blog. We regularly update trending topics, foodborne infections in the news, recalls, and more! Stay tuned for quality information to help keep your family safe, while The Lange Law Firm, PLLC strives to Make Food Safe!

By: Heather Van Tassell (contributing writer, non-lawyer)

Heather Van Tassell

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