Victoria is set to record its highest number of infections from a dangerous bacterium that causes violent illness and has hospitalised two children with kidney failure.
The Department of Health is investigating two separate cases in which previously healthy toddlers have developed a serious kidney condition linked to the virulent strain of bacteria after visiting the same petting farm.
The rare condition, known as haemolytic uraemic syndrome (or HUS), is caused by Shiga toxin-producing E.coli (or STEC) bacteria, which lives in the guts of many farm animals.
It can spread through contact with the waste of infected animals and can cause bloody diarrhoea.
One three-year-old, who has spent the past four weeks in the intensive care unit of Monash Children’s Hospital, has suffered permanent brain damage and may require a kidney transplant.
In May, a two-year-old spent 17 days receiving dialysis in the same intensive care unit.
The situation has prompted local health authorities to advise the farm to increase handwashing stations and to display a sign at its entrance warning of the risk of infection and the importance of handwashing.
Visitors have been advised to not bring any dummies, toys or prams into the calf pen. The Age has chosen not to name the farm, as health experts have said the bacteria is present in most farms and there is no evidence this one has acted inappropriately.
More than 160 cases of STEC have been recorded across the state this year, compared with 156 cases for all of 2023. If current trends continue, the state’s figures will eclipse the 235 cases recorded last year.
One Melbourne mother, who does not want her name published for privacy reasons, said her two-year-old son had become extremely unwell after visiting the petting farm in May.
She initially assumed he had a bad bout of gastro. “He had pretty bad vomiting,” she said. “He couldn’t keep anything down. He had diarrhoea.”
When the mother discovered blood in her son’s faeces, she sought medical attention.
A blood test at Frankston Hospital revealed that her son had HUS, and the toddler was transferred to the intensive care unit of Monash Children’s Hospital, where he remained on dialysis for 17 days. He also required two blood transfusions.
“It’s scary at the start because you don’t know what’s going to happen,” she said.
Her son made a full recovery. But she said the other child, with whom she has a mutual friend, was still unwell.
“The illness has impacted the child’s brain,” she said. “The kidneys haven’t recovered, and they aren’t sure if they need a transplant. The family are very upset that this happened once already, and then again to their child.”
She said petting farms needed to be doing more to communicate these infection risks to visitors.
While she washed her son’s hands before they ate lunch at the farm, she said it was tricky to stop a toddler from putting their hands in their mouths.
Deputy Chief Health Officer Dr Claire Looker said the department had not yet identified a common source for the reported HUS cases.
“The Department of Health investigates all reported cases of haemolytic uraemic syndrome (HUS) to identify potential sources of infection and prevent further cases,” she said.
She said the rise in recorded STEC cases was linked to improved testing and reporting practices.
Dr Nick Larkins, a nephrologist from Perth Children’s Hospital who has treated many children with HUS, said the bacteria lived harmlessly in the guts of many farm animals, particularly cattle, sheep and goats. He said many animals carried the bacteria without becoming sick themselves.
Larkins said that unlike E.coli outbreaks in food processing, incidents at farms were not a reflection of poor hygiene. “It could have been any farm,” he said.
He said HUS was most commonly triggered by the Shiga toxin entering a person’s blood and creating small blood clots that block the kidneys, causing them to “shut off”.
This process usually begins just as the diarrhoea is settling and the child appears to be getting better, he said.
Parents should seek medical attention if their children have pus or blood in their stools, reduced urine output, lethargy, pale lips or small dots on their skin, according to Larkins.
He said children under the age of five, as well as those with suppressed immune system, were particularly susceptible.
He said the condition was frightening because previously healthy children could end up on dialysis within days. He said dialysis helped manage fluid retention and prevented dangerous spikes of potassium, which can cause life-threatening heart rhythm changes.
He said most children make a full recovery following treatment.
Associate Professor Norelle Sherry, the deputy director of the Doherty Institute’s Microbiological Diagnostic Unit Public Health Laboratory, said more STEC cases were probably being detected because of better and more frequent testing of people with more mild gut issues.
“In the past, we would only test for it when someone had severe illness, like bloody diarrhoea,” she said.
While everyone had E.coli in their guts, Sherry said, the STEC strain was incredibly virulent, affecting the lining of the gut and sometimes causing bloody diarrhoea.
“For the small number of E. coli strains that acquire this Shiga toxin gene, they go from being the good guys to being quite nasty,” she said.
She said transmission occurred through exposure to animals, particularly cattle, and by eating undercooked meat and drinking unpasteurised milk. It can also be spread through the environment and survive for months in soil and water, contaminating crops and drinking water.
Sherry warned that parents needed to be aware of the risks of visiting petting zoos with young children. Children’s hands should be washed after any contact with animals, ideally with soap and water.
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