An outbreak of Escherichia coli O157 infection linked to paddling pools.

In a one month period in the summer of 1993 a community outbreak of Escherichia coli O157 infection affected six children living within an area of 1.5 miles radius in south west London. Three children developed haemolytic uraemic syndrome, one of whom died. E. coli O157 phage type 2 was isolated from faeces in five cases and serological tests showed the sixth child had antibodies to E. coli O157 lipopolysaccharide. E. coli O157 phage type 2 was isolated from a faecal specimen from this child's mother who was a secondary case. Three of the cases, whose onset dates were within three days of each other, had all been exposed to a paddling pool where disinfection procedures were found to be inadequate. Samples of water taken from this pool contained E. coli, although not the O157 serotype. A fourth case had played at a different paddling pool in the three days before becoming ill. Action has been taken to improve disinfection procedures at municipal paddling pools in the London borough concerned.