The Directorate of Health
Status of Food Safety Investigation on E. coli Outbreak Among Children
30th October 2024
Last week, an outbreak of E. coli (STEC) infection occurred among children at Mánagarður preschool in Reykjavík. Investigations into the source of the infection began on the same day the first diagnosis was made, with the preschool closing the following day.
It is suspected that the outbreak was caused by foodborne transmission. Numerous food samples are currently being analyzed by Matís, though detecting STEC in food is a complex and time-consuming process. Updates will be shared through press releases on the websites of the Chief Epidemiologist, the Food and Veterinary Authority, and the Public Health Board as they become available.
The investigation is being led by a steering group with representatives from the Chief Epidemiologist, the Food and Veterinary Authority, the Reykjavík Public Health Board, the Department of Microbiology and Virology at Landspitali Hospital, Matís, the Primary Health Care of the Capital Area, and the Landspitali Children’s Hospital.
After gathering information from the parents of affected children, investigators have focused on Thursday, October 17, as all the children who initially fell ill were present at the preschool that day. Given the simultaneous onset of symptoms across all departments, the infection is likely foodborne rather than environmental or transmitted child-to-child. However, these other routes cannot be completely ruled out later on, as the illness emerged before the outbreak was officially suspected and the preschool was closed.
On October 17, children at the preschool were served oatmeal for breakfast, a meat sauce or lentil dish (vegeterian option) with spaghetti for lunch, and melons as an afternoon snack. The Reykjavík Public Health Board is conducted an on-site investigation, taking samples from these foods for analysis. Health inspectors have also visited the preschool to assess conditions, review procedures, and recommend any necessary improvements. After the outbreak started, the preschool has been thoroughly cleaned, and toys and equipment were disinfected. It will remain closed, with reopening dates to be determined in consultation with the steering group. The Chief Epidemiologist will advise on when children can safely return to school.
About E. coli and STEC Detection
E. coli bacteria are naturally present in the intestines of humans and animals and can spread through water, meat, vegetables, and other food products during production. There are many types of E. coli, including STEC strains, which carry genes for toxins that cause illness. However, the severity of illness can vary based on the strain.
Detecting and isolating STEC strains in food samples can be challenging. Initial testing screens for the toxin genes, and if detected the E. coli strains are cultured. Since multiple E. coli strains can exist within a single sample, isolating the strain with the toxin genes can be difficult, often requiring repeated testing. In some cases, identifying the pathogen may not be possible.
A 2018 study by the Food and Veterinary Authority screened for pathogenic bacteria in Icelandic meat, finding STEC toxin genes in nearly 30% of lamb samples and 11.5% of beef samples. Similar studies have not been conducted for vegetables, fruits, or other food products in Iceland.
The Chief Epidemiologist
The Food and Veterinary Authority
The Reykjavík Public Health Board