The number of lab-confirmed E. coli cases in an outbreak linked to several daycares in Calgary jumped to 231 on Monday, according to Alberta Health Services (AHS), an increase of 190 from the day prior.
AHS says 26 people remain in hospital and all but one of the patients are children.
"It is important to note that the majority of individuals who get sick from E. coli generally improve on their own and without specific treatment within 10 days, but a small proportion may develop more severe complications," reads a statement from AHS.
Of the confirmed cases, 21 have the severe illness Hemolytic Uremic Syndrome or HUS.
"For children, where we see that they're evolving into the Hemolytic Urine Syndrome or develop it, those children are pretty much all hospitalized," said Dr. Stephen Freedman, an emergency physician at Alberta Children's Hospital
"Children who are not at that point, but sometimes even just because of the dehydration or the pain or the inability to drink, sometimes those children need to be hospitalized as well.''
As the cases climb, several of the daycares that were closed under the AHS order were allowed to reopen.
None of the daycares that reopened Monday morning had cases of E. coli linked to them.
Officials believe the source of the outbreak is a central kitchen that provided catering services to the 11 daycares that were closed.
Braineer Academy, Little Oak Early Education, Almond Branch and Fueling Brains Bridgeland all had their closure orders rescinded because they did not have cases linked to their location and had met AHS conditions to reopen.
Monday evening, Kidz Space and Vik Academy in Okotoks also had their closure orders rescinded.
"It was very distressing for us and for all the families. It was quite a roller-coaster ride for us emotionally because, for the first few days, everyone wasn't sure of the severity of the events," said Hoyt Sangtian, the co-owner of Braineer Academy.
Sangtian says though no E. coli cases have been connected back to Braineer Academy, they were closed and ordered to conduct a deep clean of the space before children and staff could return.
With the caterer believed to be the source of the outbreak, Sangtian says his northwest daycare cut ties with the central kitchen and the only food offerings now included are pre-packaged, commercially-bought snacks and food parents provide for their own child.
"As soon as we heard from AHS with the closure order, we terminated our contract with the caterer," he said.
"We haven't received any response from them. They're not available."
Five daycares in Calgary and Okotoks are still listed as closed under the AHS exclusion order.
Alberta's Health Minister and Chief Medical Officer of Health are among those scheduled to speak at a 9 a.m. update about the E. coli outbreak in Calgary on Tuesday.
