Updated: E. coli exposure to elementary students last month results in serious illnesses

BLOUNTVILLE — More than 1,000 elementary school students from three public school systems in Sullivan County potentially were exposed to E. coli on field trips last month, Sullivan County's head health official said Thursday.The students who went to the Appalachian Fairgrounds were from the Kingsport, Sullivan County and Bristol, Tennessee, school systems.At least three children, two from Bristol and one from Washington County, were in hospitals out of the Tri-Cities with E. coli O157:H7 Thursday linked to the event. They are among students who Sept. 26-27 visited farm animals at the Gray fairgrounds or student siblings and have developed serious health issues from E. coli.Public elementary school students from Washington County also were exposed at the animal exhibit event, Dr. Stephen May, medical director of the Sullivan County Regional Health Department, said. As far as May knows, he said no private school students were exposed.LIAM'S STORY"We were told 7-14 days is what it will take for his red blood cells to return to normal working order, and after that, the rest of his body will begin to heal," Emily Berkley of Jonesborough said of her 3-year-old son, Liam, who was at Vanderbilt Children's Hospital in Nashville Thursday evening.She said his older brother and sister both went to the fairground event and that his older brother was also hospitalized at Niswonger Children's Hospital in Johnson City but has made a full recovery.Liam was diagnosed with hemolytic uremic syndrome, which can cause kidney failure, at Niswonger before being taken to Nashville."She (the doctor) is almost certain he'll need a blood transfusion soon, and it's very likely he'll start dialysis at some point, as well," Berkley said. "They also went through the slew of other potential complications, all of which just fill you with absolute dread. My kids just wanted to go on a field trip, man. They didn't bargain for all of this."STORY OF RIVER AND ELIJAHDeidre Hefflin of Bristol, Tennessee, on Thursday evening had two sons with E. coli at East Tennessee Children's Hospital in Knoxville.River, 15 months, was being moved to the pediatric intensive care unit with E. coli and hemolytic uremic syndrome. He'd been to Bristol Regional Medical Center and then Niswonger Children's Hospital before heading to Knoxville."Things have gone downhill fast," Hefflin said. Elijah was about to be admitted at the Knoxville facility Thursday evening.Of four brothers, Hefflin said only Grayson, 5, went to the event with his kindergarten class and ate a lunch packed by his school, Avoca Elementary. She said Grayson and an older brother, 7, have shown no symptoms of E. coli issues so far."We have been told this will be home for a while, 1-2 weeks expected at least," Hefflin posted on Facebook Thursday afternoon. "Michael is en route with Elijah and will be going to the ER to then be admitted. Our older boys aren't able to be here with us."NO NUMBER OF TOTAL CASES GIVENMay said Thursday he couldn't provide exact numbers of confirmed or suspected cases but that a number of students have been confirmed as having the Shiga-toxin-produced E. coli.May also said parents of the students, who the medical director said were in pre-kindergarten through second grade, have been informed of the E. coli danger by their respective health departments, the Sullivan County Regional for that county and the multi-county Northeast Regional Health Office in Johnson City for the Washington County students."We're still working on tracking down the specifics," May said, adding that schools being out on different fall break schedules has made that process more difficult. For instance, Kingsport City Schools was out on fall break Oct. 2-6, while Sullivan County is out Oct. 9-13."We've had a number of children who've been confirmed ill by culture," May said."We've had a number that had to be hospitalized, two in very serious condition," May said. "We've had a few suspected adults, and they are in the process of being tested."Kingsport City Schools Assistant Superintendent of Administration Andy True said the school system sent parents of students in affected KCS classes, kindergarten and second grade, a notice Monday provided by the county health department and later a link to a survey.Sullivan County Director of Schools Chuck Carter, heading a system on fall break, could not be reached for comment Thursday afternoon.E. COLI IS A BACTERIAE. coli, an abbreviation for Escherichia coli, is a bacteria found in the environment, foods and intestines of people and animals, with some types harmless and other able to cause serious illness, according to the Centers for Disease Control. Not all strains are harmful.May said the type of E. coli in question is common in animal and even human digestive tracts but can make humans exposed, particularly children, very sick.Serious cases can cause hemolytic uremic syndrome, which can cause kidney failure. Symptoms vary but often include severe stomach cramps, diarrhea that is often bloody, and vomiting, while a fever also is possible. It can spread by hand to mouth contact once a person is infected.He said adults usually do not get the renal failure, another name for kidney failure, from E. coli but that younger children are much more prone to that. However, for all people who have a serious case, he said the diarrhea can be bad."You'll see diarrhea you won't forget," May said.Most people with the infection start to get better in five to seven days, and the infection usually hits within three to four days but can do so from one to 10 days.He said parents should contact a doctor for any child who was at the event and have had diarrhea for more than three days or diarrhea with a temperature of more than 102, bloody diarrhea or so much vomiting they cannot keep liquids down and pass little urine.WHAT WAS EVENT?No one interviewed knew for sure what group or groups held the animal event.May said the students in question visited animals at an exhibit that included goats, ponies, cattle and other farm animals.He said the Northeast Tennessee region, where Dr. David Kirschke is the medical director, is taking the lead on handling the exposure site since it is in Washington County, part of that department's service area.May said the Sullivan County Health Department sent a letter to parents dated Friday, Oct. 6, asking any who suspect their child might have E. coli from the Sept. 26-27 event to contact the department at 423-279-2777. The department also plans to send out a survey to parents. May said the Northeast department did the same Monday, Oct. 9.Katie McClellan, public information officer for the Johnson City-based Northeast regional health office, referred questions to her and Kirschke about the E. coli incident to school officials. However, they could not be reached for immediate comment in Washington County and Johnson City schools.May said bringing young students to see animals "is great" but that eating around the animals or without first washing hands is not.After touching or being around animals and before eating, he urged using "copious amounts" of soap and water to wash hands."Soap and water is better than alcohol-based gels," May said.Look for updates and continuing coverage on this developing story online and in print editions.