In August 2015, routine infections disease surveillance conducted by the Kansas Department of Health and Environment, detected two individuals diagnosed with E. coli O103. Both attended a daycare located in Trego County. Additional ill persons who also attended the daycare reported illness with similar symptoms.

Twenty four children attended daycare in the same room as the two children with laboratory confirmation of E. coli O103. Of the 24 exposed children, 10 (42%) developed clinical symptoms; two were confirmed cases and eight were probable. Case-patients’ ages ranged from 8 to 24 months (median 13 months), and seven (70%) of the ill individuals were male. Common symptoms
included diarrhea and fever. Bloody diarrhea and vomiting were also reported. No hospitalizations or ER visits were reported None of the case-patients developed hemolytic uremic syndrome (HUS).

An additional case was laboratory confirmed with E. coli O103, likely through secondary transmission from an ill sibling. Prior to the onset of illness of an initial case, a visit to the Trego County Fair occurred, where exposure to cattle or other STEC reservoir animals was likely. Additionally, given the onset dates of symptomatic children, it is likely that secondary transmission was person-to-person.