Swimming pools are boarded up and playgrounds are empty. Anxious parents keep children _ those who are not hospitalized _ inside and away from others. Nervous restaurant owners boil everything, even melons. A small plane equipped with loudspeakers flies low, warning citizens to wash up.
Japan is in the midst of its worst outbreak of food poisoning in recent years, with five dead and more than 8,200 sickened, the national Health Ministry said Monday. The outbreak has spread to 32 prefectures and to almost every region except the northern island of Hokkaido.
More than 6,100 of the ill live here in Sakai, an industrial city across Osaka Bay from Kobe. Most of the sick are children, including 600 who remain hospitalized. Two young girls _ one with a cerebral hemorrhage and another with a damaged heart _ are struggling to live.
Doctors believe virtually all those poisoned were infected by a strain of E. coli bacteria called O157, and many appear to have contracted it from something in their school lunches.
Atsuka Tsuge, 7, never likes her school lunches anyway, especially because teachers force students to eat every bite. Now, after five days in the hospital with severe pain and fever, the little girl, wearing a glittery headband and clutching a favorite book about a pig that went shopping, does not want to spend another hour in a hospital overflowing with sick children.
"The anger and anxiety over what has happened is in every corner of this city," said her mother, Michiyo Tsuge, who sat beside her daughter at Sakai City Hospital awaiting the latest blood test. "Nobody can relax. We don't know where this came from, and we don't know how to stop it."
Health officials Monday ordered schools in the hardest hit areas to test their water supply for O157. They also ordered food preparers, including those who make school lunches, to preserve leftovers for two weeks to help epidemiologists track the source of bacteria.
A task force, based in Sakai's City Hall, is coordinating efforts nationwide. It has established an emergency hot line, and 500,000 leaflets are being distributed warning area residents to take precautionary measures. In a country where meat is often eaten raw, people are being warned to cook everything, including meat, at high temperatures.
The first cases of poisoning showed up in May in Okayama Prefecture in southwestern Japan, causing the death of two children. On July 11, Atsuka and other children started showing up at the hospitals here curled up in pain, with fever, vomiting and, in the worst cases, kidney failure. Ten days later, city officials still are not sure what caused the epidemic.
Raw eel in sushi was first suspected and still has not been ruled out, because many of the children who were rushed to hospitals ate it at school. But doctors announced Sunday that in one case south of Tokyo they believe a boy was poisoned by eating six slices of raw beef liver, a local delicacy. Authorities now speculate that there may be several causes of the poisonings.
There are hundreds of strains of E. coli, most of which live in the intestines of animals and usually pose no threat to humans. In fact, E. coli bacteria are commonly found in the human intestinal tract and serve to ward off other, more harmful bacteria.
But the strain known as O157, first discovered in humans in 1982, is particularly virulent. It can damage the lining of the intestine and cause bloody diarrhea, kidney damage and, in the severest cases, death.
In Japan, slaughterhouse inspections are carried out by local government employees who visually inspect the meat. No government inspections are required in processing plants where meat is cut and packaged for sale.
Atsushi Oda, an official in the Ministry of Health and Welfare, said the government is considering more stringent inspection regulations because of the current outbreak.