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Seventh-grader develops severe complication

When two of her three children complained of stomach aches a couple of days after Halloween, Polly Ackerman thought too much candy was the culprit. Her second-grade son Mason recovered but Emma–who’s in kindergarten–was sick one day and felt better the next.
This pattern continued for about five days until Emma began experiencing what Polly called “severe diarrhea.”
“That Saturday night we were up every hour with her as she had diarrhea and severe stomach cramps,” said Polly, who is a registered nurse.
By Sunday morning, Emma’s stools showed specks of blood which Polly said was confirmed by a hemocult test.
The Ackermans took Emma to a Kearney clinic that is open on Sunday afternoons where the pediatrician who saw the child admitted her to Good Samaritan Hospital.
There Emma was treated for dehydration and observed to see if the diarrhea would slow. That didn’t happen as Polly said her daughter had 19 stools in a 14-hour period.
Speculation that the child had hemolytic uremic syndrome (HUS)–the most common complication of E. coli 0157:H7–was later confirmed.

Polly described HUS as a result of E. coli 0157:H7 bacteria in the digestive tract that begin making toxins that enter the bloodstream and start destroying red blood cells. Red blood cells are normally smooth but when attacked by the toxin become broken and stuck in the kidneys.
“Nothing can filter through the kidneys so they quit working,” she explained. “It can also damage other organs like the pancreas, central nervous system or anything with blood flowing through it.”
As it became clear that Emma’s kidneys were not functioning properly, Polly said the pediatric doctor ordered that she be sent to the Children’s Hospital in Omaha where she could undergo pediatric dialysis.
The next day, on Nov. 9, Emma was taken to the Omaha hospital by ambulance. On Nov. 10, doctors surgically inserted a catheter in her stomach for dialysis where a machine draws out fluids since the kidneys cannot.
Surgeons also secured an intravenous line in Emma’s chest so she could receive fluids and blood could easily be drawn from her body.
Although doctors speculate that Emma has been infected with E. coli 0157:H7, Polly said tests have not yet confirmed that.
On Monday, Polly said doctors are optimistic that Emma will recover but the disease has to work its course.
“All we can do is watch laboratory values and adjust what goes in intravenously like sodium or potassium,” she explained. “We’ll continue to do that until her body is done fighting the illness and her kidneys are back working.”
Recovery time unknown: Doctors say that could take from two weeks to a month.
“We just don’t know because every child is different,” she said.
Polly said Emma was comfortable and alert and appreciates the cards and gifts that have been sent.
Polly was quick to point out that only 5-10% of children who get E. coli 0157:H7 become as violently ill as Emma.
“My concern is that people need to know about E. coli and where it comes from,” she said. “People also need to know the importance of hand washing before eating and after going to the bathroom because that’s how it’s transferred.”
She added that the support of family and friends who live in Omaha and nearby and from the Gothenburg community has helped the Ackerman family through Emma’s ordeal.
Cards and letters can be sent to Emma care of: Children’s Hospital, 8200 Dodge Street, Omaha, NE, 68115.

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