A deadly strain of E. coli spread from child to child at a Washington state day care, killing one and sickening three others despite what health officials determined were appropriate hygienic practices.
The four children were hospitalized, and Elizabeth Winter of the Washington state Department of Early Learning said her department was notified Friday that one of them, a 4-year-old boy, had died.
Fletch Family Daycare - a tidy single-story yellow rambler on a large lot in Vancouver, Wash. - is closed.
The other three children have been released, said Dr. Alan Melnick, health officer with the Clark County, Wash., health department. He declined to provide any further details on the child who died.
Melnick said the department learned of the first hospitalization involving the E. coli O157:H7 bacteria strain on March 19.
Health officials determined that the business' hygienic practices were acceptable, but closed it down in April 2 when it became apparent that E. coli was spreading from person to person, Melnick said in an interview with Portland's KGW-TV.
"We believe we have it confined," Melnick told reporters Friday.
Winter said the center, near Portland and operated by Dianne and Larry Fletch, has been open since 1990 and no complaints have been filed against it. Lately, it has been caring for about 22 children.
"This is a very difficult time for the family who has suffered such an incredible loss," the Fletches said in a statement Friday. "It is also a difficult time for our day care families and the children who were his friends. It is an especially difficult time for us as day care providers."
The statement said the day care has worked closely with the health department to put measures in place to control the spread of the illness.
The Fletches did not immediately return phone messages from The Associated Press seeking additional comment.
E. coli is a common and ordinarily harmless bacteria, but certain strains can cause abdominal cramps, fever, bloody diarrhea, kidney failure, blindness, paralysis and death.
The strain involved in this case, E. coli O157:H7, is best known for its role in large outbreaks traced to ground beef or produce.
However, person-to-person transmission can be a problem in day-care settings or nursing homes without sufficiently thorough hand washing after toilet use or diaper changing. In some cases, especially in young children, infection can lead to life-threatening complications.
Investigators have not pinpointed a precise source of the outbreak, but Melnick said the infection was spread from person to person.
Health investigators have tested the 22 children, as well as four adults, Melnick said. Seven additional people, a mix of staff and children, showed no symptoms but had E. coli in their stool, he said.
Symptoms can take as long as 10 days to appear after exposure so the health department is checking with staff and the children's families daily.
Melnick said the day care will remain closed until affected staff show no presence of the bacteria on two consecutive tests. Children who tested positive will have to meet the same criteria before being allowed to attend any day care or school, he said.
By Associated Press Writer Abby Haight