Two outbreaks of diarrhea in nurseries in Norway after farm visits, April to May 2009

As the parents of two young children file a lawsuit against the Cleveland County Fair, part of the 106 sickened and one death from E. coli O157, Eurosurveillance reports on two separate outbreaks of shiga-toxin producing E. coli in two nurseries where the children had recently visited farms  in Norway in 2009. The nursery outbreaks probably wouldn’t have been noticed except for the increased awareness in Norway at the time due to an on-going outbreak of E coli O157 that sickened 13 children and led to one death.

A table of petting zoo outbreaks is available at

Abstract below.

During a 2009 nationwide outbreak of sorbitol-fermenting Escherichia coli O157 in Norway, the Norwegian Institute of Public Health was notified of diarrhea outbreaks in two nurseries. A link to the nationwide outbreak was suspected and investigated, including retrospective cohort studies. Both nurseries had recently visited farms.

Fecal specimens were obtained from symptomatic children as well as from the farm animals and tested for Campylobacter, Salmonella, Yersinia, Shigella and pathogenic E. coli, and isolates were further characterized.  Nursery A had 12 symptomatic children, and we found the same strain of C. jejuni in feces from children and lambs. Nursery B had nine symptomatic children, including one child with bloody diarrhoea carrying enterohaemorrhagic E. coli (EHEC) O26. EHEC O26 with a similar multiple-locus variable number tandem repeat analysis (MLVA)-profile was found in sheep.  Five children had enteropathogenic E. coli (EPEC) O76. 

Animals were not tested for EPEC O76. We found no significant association between illness and risk factors for either nursery. The isolated pathogens differed from the one involved in the nationwide outbreak. In each nursery outbreak, the pathogens isolated from children matched those found in farm animals, implicating animal feces as the source. Hygiene messages are important to prevent similar outbreaks.

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About Douglas Powell

A former professor of food safety and the publisher of, Powell is passionate about food, has five daughters, and is an OK goaltender in pickup hockey. Download Doug’s CV here. Dr. Douglas Powell editor, retired professor, food safety 3/289 Annerley Rd Annerley, Queensland 4103 61478222221 I am based in Brisbane, Australia, 15 hours ahead of Eastern Standard Time