An ongoing outbreak of E.coli in East Lothian has seen a further three nurseries forced to close. 

A total of 47 cases have now been confirmed and families are being urged to follow self-isolation advice in an effort to contain the spread of the infection. 

We previously reported the Church Street Pear Tree Nursery in Haddington, as well as its partner nursery in Meadowpark, were forced to close due to an outbreak. 

Cases of E.coli have now also been confirmed in a Musselburgh private nursery located on Bridge Street. 

All staff and pupils have effectively been told to self-isolate and urged to avoid mixing with others until they have been cleared by a health protection team. 

Meanwhile, partner location, Musselburgh Private Nursery on Stoneybank Terrace, has been closed as a precaution alongside West Road Pear Tree Nursery. 

The Musselburgh nursery was closed following reports of symptoms and families have also been formally excluded, or told to self-isolate. 

Families at the West Road Pear Tree Nursery have been told to provide samples only if their children show symptoms of the bacterial infection. 

Dr Graham Mackenzie, consultant in public health medicine and chair of the Incident Management Team (IMT) investigating the outbreak said it was vital that parents and carers follow the instruction to self-isolate.

He added: “It is crucially important that families understand that this is a rapidly evolving situation and it is affecting the lives of hundreds of people.

"We need everyone to work with us to bring an end to this outbreak as swiftly as possible.

“If you have been given an exclusion order, it means that you must self-isolate at home, just as we have all done with Covid-19. You must not go to work or school, the shops, the playpark or to parties and sleepovers."

After the individuals have been cleared they will be informed by the health protection team. 

Plans to re-open Church Street Pear Tree Nursery are underway after many exclusion orders for staff and pupils were lifted.

Mr Mackenzie added there is "light at the end of the tunnel" for those forced to self-isolate under exclusion orders. 

He added: "As soon as two negative samples have been returned, families will be allowed to return to normal. We have already lifted scores of exclusion orders for pupils, parents and staff. There is light at the end of the tunnel and as soon as enough exclusions are lifted and investigations are complete, nurseries will be able to re-open.

“However if families choose to mix with others when they have been instructed to self-isolate, they are putting themselves and others at risk.

“They may unknowingly come into contact with someone who has the infection, but not yet been confirmed. That would not only mean that they could develop the infection, but that they would start the exclusion period all over again because they have come into contact with a confirmed case.”

NHS Lothian joined forces with local and national partner agencies at the beginning of August to form the IMT after a cluster of cases first emerged in the Church Road nursery. 

A general information line on 0800 22 44 88 has been created through NHS24 to help families answer many of the questions they may be facing.

Dr Mackenzie said: “We have provided lots of information for parents and carers and we know that it can get confusing. These FAQs and information line should help.

“As well as staying home, it is vital for siblings or those children leaving nursery, taking up a new nursery place and starting school for the first time to remain at home until their exclusion period is complete if they have been in contact with someone with E-coli or any other vomiting bug.

“This outbreak reinforces the importance of washing hands regularly, particularly before eating or preparing food, and after going to the toilet.”