E coli outbreak at nursery is linked to dirty nappies STAFF failing to wash their hands after changing nappies may have caused an outbreak of E coli at a nursery. One child remains in hospital almost five months after seven people were struck down with the bug at the Rose Lodge Nursery in Aberdeenshire in May. A report by NHS Grampian on the outbreak yesterday revealed that one of the possible reasons for the spread of the infection was staff failing to wash their hands properly after handling nappies. However, the report said that the bug could have been passed on through private drinking water contaminated with animal faeces from nearby fields, or due to issues with hand hygiene at a relative's home. The bug originated in the baby unit of the Aboyne nursery, which cares for 35 children. Four infants, one relative and two members of staff were all struck down with E coli 0157, which can cause fever, nausea, vomiting and stomach cramps. Three of the infants were hospitalised. The report advised the nursery to stop the use of a communal bowl for handwashing in the baby room and said the water at a sink in the nappy-changing area might have been too hot for effective handwashing. It also warned staff of the potential for contamination of the nursery floor from parents" shoes. Six recommendations were made in relation to improving guidelines and advice on the bug for Health Protection Scotland, NHS Grampian, the Care Inspectorate and the Scottish Government. The report stated that one child remained in hospital at the time the document was being compiled, in August. An NHS Grampian spokeswoman yesterday revealed the child was still at Aberdeen Royal Infirmary as a result of the outbreak. She said: "We can confirm that a child remains in hospital." The health board said it could release no further details of the child's condition. Nursery manager Lauren Ferguson also refused to comment on the child's health but said changes had been made at the nursery in relation to the report. She said: "We have worked very closely with NHS Grampian on all the advice given and have implemented that accordingly." When the outbreak was discovered, the nursery closed its baby room, excluding all children and staff associated with the unit. The nursery remained open to unaffected families with children over two years old. At the time, owner Julie Grant said: "The nursery has a high standard of hygiene and rigorous infection control procedures, and the management of the nursery praise the professionalism of all the staff in their efforts to minimise the impact to all concerned. Our thoughts are with the children and families affected by the virus and we thank all our parents and staff for their support at this difficult time. E coli 0157 bacteria are commonly carried in the gut of a variety of farm animals and can be found in their faeces. Careful handwashing can prevent infection arising after handling clothes and footwear that are dirty following outdoor play or work, handling animals or raw meat, and visiting the toilet. Untreated water supplies can also be a source of the bacteria. Careful handwashing before preparing or handling food and thorough cooking can prevent infection being passed on through the food. The infection is very easily spread in households.