UPDATE (6/18): The East Tennessee Children's Hospital said five of the seven children hospitalized for E. coli have been discharged from the hospital.

The hospital said it is still treating two others, and one of those children remains in the Pediatric Intensive Care Unit.

In all, the ETCH said it has treated 12 total children over time. Of those 12, the ETCH said seven that have been reported on were children who contracted the disease through drinking raw milk.

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The ETCH said the other five were children who attended the Kids Place, Inc. Millertown Child Care Center, which was closed temporarily following an E. coli outbreak.

WBIR 10News received a copy of a state evaluation sent to Kids Place, Inc. Millertown dated June 5, which states the Knox County Health Department had sent the state an investigation of "serious potential environmental violations" at the child care center.

The evaluation noted there were no particular violations, but shows Kids Place, Inc. Millertown was ordered to notify parents and cease child care services to any child on its premises by the end of the day on June 5 pending an investigation and approval by the Tennessee Department of Human Services to reopen.

After receiving the copy of the state evaluation, 10News reached out to Kids Place, Inc. for a comment. They issued the following statement as a response on Monday, June 18.

"The Tennessee Department of Human Services (DHS) letter was received June 5. Initially, there was confusion over whether the entire Kids Place facility or just the Baby House for toddlers (where the cases were reported) should be closed. Today, with the exception of E. coli cases still being treated, parents have returned their children to the Baby House. We appreciate their continued support and confidence. Normal operations have resumed, and our thoughts remain with all the families who were affected.

Kids Place continues to appreciate the guidance it received from the Tennessee Department of Human Services (DHS) and the Knox County Health Department throughout the outbreak.

As WBIR pointed out, when DHS lifted the Safety Plan following Kids Place completing the compliance steps, the state said: “We appreciate your cooperation with the Safety Plan as implemented.”

During the course of WBIR's coverage of the outbreak, Kids Place, Inc. was still operating on Thursday, June 7 -- days after the Safety Plan Agreement was reportedly sent to them. The order was imposed again on June 7 and lifted the week after on June 12.

In a letter sent to the child care facility's program director on June 11, the DHS thanked Kid's Place, Inc. for cooperating with the orders and lifted the closure.

According to a statement from Kids Place Inc. at the time, they said they initially closed the Baby House for toddlers after a sick child came to the day care that was later sent home.

The Knox County Health Department also announced Thursday it is no longer asking an area dairy farm to halt operations after an outbreak of E. coli exposure.

"While the investigation thus far has revealed no specific problems with French Broad Farm, the risk in consuming raw milk cannot be mitigated," the department announced Thursday afternoon. "Even with safety precautions in place at a dairy and adherence to the strictest dairying procedures, there is no way to ensure raw milk, while legal, is safe for consumption. This is why health officials recommend the public consume only pasteurized milk and dairy products."

Health officials were expected later Thursday to update the public on its investigation into how about a dozen area children became ill from bacterial exposure. French Broad Farm's raw milk is one possible source of the outbreak that health officials are reviewing.

Original Story (Tuesday, June 12):

Kids Place, Inc. Millertown Child Care Center reopened Tuesday morning to children and their parent, after being cleared by the Knox County Health Department and The Tennessee Department of Human Services.

The facility has been closed after nearly a dozen children tested positive for E. coli in the past two weeks. Some of those children attended Kids Place Inc.

RELATED: E coli alert issued

​​​​​​"TDHS made this decision after detailed conversations with the Knox County Health Department who has been investigating this outbreak and assures us the necessary precautions have been taken for the health risk to be mitigated," the department wrote in a statement released Monday afternoon. "We want parents to know their children’s safety has been our number one priority throughout this entire process."

The child care center has agreed to a series of precautions including staff education and a new policy requiring children to remove their shoes before entering the early childhood center which includes the baby house where all E. coli cases at the center have occurred, according to TDHS.

Kids Place said it has decided to keep the baby house closed until Monday, June 18, out of an abundance of caution.

The East Tennessee Children's Hospital says 11 children have tested positive for E. coli in the past two weeks.

The hospital is still treating six children, but now only two are still in serious condition in the pediatric intensive care unit. That's down from four from last week.

The hospital listed two other children in good condition and fair condition.

The Knox County Health Department (KCHD) says more than 10 cases have been reported in fewer than two weeks. No new cases were reported over the weekend, but the incubation period for E. coli is two to 10 days.

The state and county health departments are still investigating the source of the outbreak.

The common link among most of the cases is the drinking of raw milk from a local cow-share dairy, French Broad Farm in Knox County. The farm has been shut down as investigators are testing milk and manure samples. KCHD says no one should consume any raw milk distributed from their dairy before distribution was stopped last week.

Some of the other cases are traced to a local child care facility called Kids Place, Inc, where some farm animals are kept. All of the infected children were housed in the Baby House. KCHD worked with the facility on infection control steps, and believe the health threat has been mitigated, but the state has not yet cleared them to reopen.

A press release from Kids Place,inc. said a sick child came to the daycare and three others were later diagnosed with E. coli.

As of Monday, the KCHD said they are still working to confirm the cause of the infections and if the two separate suspected sources are linked.

"While it would be rare, it’s possible that our community is experiencing two unrelated E. coli clusters at the same time. The investigation is ongoing," KCHD said in a statement.

Tracking the outbreak

KCHD believes the majority of the cases are linked to raw milk consumption.

"When we made the announcement about the raw milk consumption and we named the farm, that was because a public action needed to be taken: throw the milk away, we don't want more kids getting sick," Dr. Martha Buchanan of the Knox County Health Department said.

But it is also looking into cases that are linked to Kids Place, Inc., a child care facility in Mascot.

"What are the common things about these cases? And in this case that day care was common for some cases. So then at that day care what were the things that might have been an exposure. We didn't see any foods in there that might have put at risk for E. coli, so we found the possibility of a link to animal exposure," Buchanan said.

In a statement, Kids Place Inc. said a child came to the facility sick and was sent home. The statement also said the children in the Baby House do not have access to farm animals on a nearby private farm, nor to the goats, dogs and ducks at the facility.

The health department says it recommended Kids Place, Inc. close the Baby House, where they were finding the cases. The health department says the kids were sent home and the risk was mitigated.

But the state Department of Human Services ordered the entire facility to close on Tuesday.

"Right now what we're doing is working with that day care to get an action plan in place, to do environmental cleaning, to change some of their policies," Buchanan said. "And as soon as they've satisfied that environmental cleaning in that section, have a new infection control plan, we're satisfied they have policies in place and we've done education with their staff, we will let them reopen. I'm not sure when that's going to occur."

The Tennessee Department of Human Services said it's not ready to allow children to return to the child care facility as it continues to evaluate the circumstances surrounding the case. However, the Knox County Health Department said it has lifted its closure order and Kids Place, Inc. is waiting for approval from the Tennessee Department of Human Services.

Knox County Health Department head Dr. Martha Buchanan said Kids Place, Inc. successfully completed mitigation steps which included environmental cleaning, infection control education of the staff by the health department, a written infection control plan regarding animal exposure, closing of the pool at the facility until June 18 and completion of food and facilities inspections.

“Thank you for your cooperation with the Knox County Health Department in our efforts to reduce the spread of E. coli,” Buchanan wrote to Kids Place. “As discussed, the Tennessee Department of Human Services as your regulatory authority will have final say regarding lifting their closure; however, from the public health perspective, the imminent health threat has been mitigated and it is safe for the Baby House to resume operations.”

East Tennessee Children's Hospital told 10News Friday that it believes one of the patients in its care is sick with E. coli linked to Kids Place, Inc.