Health officials intervene after child dies, another ill with bacterial infection at Quebec daycare - CBC.ca

Quebec Public Health is encouraging parents at a private daycare in the lower Laurentians to administer preventive antibiotics to their children after one child died and another was hospitalized with a bacterial infection.

Myriam Sabourin, a spokesperson with the regional health agency, CISSS des Laurentides, would only confirm that two children were infected by the Kingella kingae bacteria due to patient confidentiality concerns.

However, a staff member at the daycare in Sainte-Anne-des-Lacs said a boy, aged one and a half, died last month. 

That child had Kingella kingae and two viruses, the staff member said, so it's not clear if the child died from the common bacteria that rarely leads to infections.

A boy of the same age then developed a Kingella kingae infection two or three weeks later and recovered after being treated in hospital with antibiotics, the staff member said. CBC is not naming the daycare to protect the privacy of the children.

According to a letter that was sent to parents this week by Quebec Public Health and obtained by CBC News, staff who were in contact with the daycare group are also encouraged to take preventive antibiotics.

Infection usually affects bones, joints

The bacterium is usually responsible for infections of the bones or joints in children under four years old, the letter says.

Rarely, the infection can move into the blood or a heart valve. Outbreaks are uncommon, but do occur in places with young children, the letter says.

"The bacteria is often present in the throats and saliva of many children without causing illness.… Unless there is an allergy, a combination of two antibiotics will be prescribed," it says.

A persistent fever for more than two or three days or any difficulty with movement in a child under four years old could indicate infection, the letter says. Going limp, complaining of limb pain and refusing to use their hands are all signs of infection as well.

In those cases, parents are encouraged to see a doctor and bring a copy of the letter. They should also notify the daycare, the letter says. 

A spokesperson for the regional health authority said there have been a few isolated cases in the Laurentians in recent years, but this is the first time there were two cases that seem to be related to a daycare setting.

Expert says common bacteria rarely causes infections

Dr. Earl E. Rubin, a division director of pediatric infectious diseases at the Montreal Children's Hospital, said it is a common bacteria found in the upper airways — and especially common in daycares. 

While studies have shown a majority of children in a daycare may be colonized by the bacteria, it's unusual that it leads to infection, he said.

"Colonization means that the bacteria is just sitting in your throat, in your nose and it's not doing anything. We are all colonized with a lot of different bacteria," said Rubin.

When it comes to infections, there may be either a new strain that's been introduced that people are not immune to, or a strain that has different properties that allow for easier transmission and invasion to cause disease, he said.

"Certainly, if you have a more serious illness where one or two of those children are becoming more sick, there is a greater concern that there is a greater virulence to that strain," said Rubin.