Maine sucks at going public: Two toddlers contracted E. coli at fair

It’s fair season in the U.S. and elsewhere, and that means, reports of children stricken with various forms of deadly E. coli.

Tcourtlynn.petting.zoohe Maine CDC confirms two children contracted E. coli last month at the Oxford County Fair.

The CDC has not released the names or the conditions of the children due to confidentiality laws.

It’s not unusual: UK spike in Salmonella cases linked to snakes

Public Health England have linked a spike in Salmonella cases to an unlikely source – snakes.

It’s not unusual.

You see a reptile, I see a Salmonella factory.

In the UK, 70 cases have been reported so far in 2015 involving people handling reptiles.

Professor Jeremy Hawker said the bug was primarily contracted from handling raw and frozen mice which are then fed to snakes.

He also warned that it could be caught from furniture, clothes and household surfaces contaminated by infected droppings.

But Welsh crooner Tom Jones has a simpler message that snake owners should take to heart.

Handwashing is never enough: NW Washington Fair organizers emphasize safety after E. coli outbreak

I applaud the event coordinators for the Northwest Washington Fair for making health and safety a priority following an outbreak of shiga toxin-producing E. coli in April that sickened at least 25.Second Opinions: Necessary or Not?

claudia.e.coli.petting.zoo.may.14Whatcom County Health Department (WCHD) inspectors confirmed in June the outbreak originated in a barn at the fairgrounds. In light of this, Steve VanderYacht, president of the fair’s board of directors, said the fair organizers aren’t taking any chances.

“This year’s focus at the fair is health and safety,” he said. “Through our close consultations with the health department and outside groups, we’ve learned that the surest way to prevent the spread of E. coli is through proper, thorough and frequent handwashing, so we’re doing everything we can to make sure our visitors have the access and tools necessary to do so.”

Event staff were trained as “hand washing ambassadors” during a special training session on August 12. Hand washing ambassadors will man three of the hand-washing stations to teach proper technique to families and kids. As an extra incentive, kids who visit all three stations earn the chance to win prizes.

But handwashing is never enough.

In 2013, 49 were sickened with shiga toxin-producing E. coli at the Ekka, Queensland’s state fair in Brisbane. STEC genes were detected in the bedding of animals in the Ekka’s nursery.

Go hang out at petting zoos or the exhibits at county and state fairs and watch what little kids do; we have. So have others.

And while some studies suggest inadequate handwashing facilities may have contributed to enteric disease outbreaks or washing hands was protective against illness, others suggest relevant infectious agents may be aerosolized and inhaled.

In the fall of 2009, an E. coli O157:H7 outbreak at Godstone Petting Farm in the U.K resulted in 93 illnesses – primarily little kids.

ekka.petting.zooThe investigation into the Godstone outbreak identified evidence of environmental contamination outside the main barn, indicating acquisition of illness through both direct animal or fecal contact, and indirect environmental contact (e.g. contacting railings or soiled footwear).

Aerosolization of potential pathogens is also possible, as suggested in an E. coli O157:H7 outbreak at a county fair in Oregon, in which 60 people fell ill.

Ihekweazu et al. subsequently concluded that in the Godstone outbreak,

“handwashing conferred no demonstrable protective effect. …

“Moreover, from the findings of many previous published studies, it must be assumed that all petting or open farms are potentially high-risk environments for the acquisition of VTEC O157 infection (an STEC).”

A table of petting zoo outbreaks is available at, and a list of risk factors at petting zoos and animal contact events at fairs can be found in: Erdozain G, Kukanich K, Chapman B, Powell D. 2012. Observation of public health risk behaviours, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011. Zoonoses Public Health.

5 now sick with E. coli from ND fair

A fifth case of E. coli possibly linked to the Red River Valley Fair was confirmed Tuesday by the North Dakota Department of Health.

red.river_The case joins four others that have been confirmed in the last two weeks. All five cases are from eastern North Dakota and four out of the five have been hospitalized, said Michelle Feist, an epidemiologist with the Health Department.

Feist said the investigation into the root causes of the E. coli outbreak is ongoing. She asks anyone who experienced illness after attending the fair, especially gastrointestinal illness like diarrhea or vomiting, to fill out a survey on the Health Department website to determine if their cases are related.

Handwashing is never enough: Rise in infections tied to animal encounters in Kentucky

Northern Kentucky health officials are urging residents to wash their hands if they encounter animals at county fairs after seeing a surge in intestinal infections in the region.

goat.petting.zooThe Northern Kentucky Health Department has received reports of E. coli, campylobacteriosis and Salmonella in local residents in recent weeks.

Of the three illnesses, the Ccmpylobacteriosis infection, causing diarrhea, abdominal pain, nausea and fever, is the most prevalent. Thirty-five cases have been reported from January through the third week of July this year. That compares with 18 cases in the first seven months of 2014, health department records show.

Seven salmonella cases have been reported to the health department in both the first and second quarters of 2015, and fewer than five E. coli cases were reported in each quarter, according to health department records. The department is not seeing increases in the two illnesses but is advising hand-washing to prevent all three diseases, because it’s the best way to prevent getting sick.

Many of the recent cases in the region are still under investigation, said Kelly Giesbrecht, a regional epidemiologist for the health department. “However, animal exposure seems to be common” so far among those who’ve contracted the illnesses.

About half of those with the illnesses are children, she said.

Health officials have seen the diseases associated with several types of animals, Giesbrecht said. Among them: cows, calves, goats, reptiles, chickens, ducks and puppies.

“Areas around the animals can become contaminated as well, so it’s important to keep those as clean as possible, and wash hands if coming into contact with surfaces,” Giesbrecht said


3 kids sick: E. coli outbreak linked to North Dakota fair

Three children sickened in a recent E. coli outbreak in eastern North Dakota reported attending the Red River Valley Fair earlier this month, prompting state health officials to investigate whether animals there were the source of the infection.

red.riverOfficials said Monday it’s still early in the investigation, but they’re asking anyone who attended the fair, which ran from July 7 to 13, and developed diarrhea or bloody diarrhea for more than 24 hours within 10 days of the fair, to contact them.

The shiga toxin-producing infection from Escherischia coli, or STEC infection, can cause nausea, cramping, diarrhea, vomiting and bloody diarrhea, symptoms that can be severe enough to require hospitalization.

One of the children has developed a complication from the infection which can affect red blood cells and cause kidney damage and kidney failure, said Michelle Feist, a state epidemiologist with the Division of Disease Control.

“Although the cases reported having contact with animals at the fair, we are looking into other possible exposures as well,” said Feist.

Red River Valley Fair General Manager Bryan Schulz expressed shock at the announcement, saying he’d heard no details from health officials other than a call early Monday inquiring from where the fair’s animals had come.

“We haven’t had a petting zoo for three years,” Schulz said. “I’m not sure where they’re getting this from.”

Schulz said while fair officials have been moving away from having petting zoos precisely because of concerns over E.coli, people at the fair could have reached through cage bars in the rabbit display area or petted baby pigs held by workers in the Ag Education Center.

 A table of petting zoo outbreaks is available at

 Best practices for planning events encouraging human-animal interactions

Zoonoses and Public Health

G. Erdozain , K. KuKanich , B. Chapman  and D. Powell

Educational events encouraging human–animal interaction include the risk of zoonotic disease transmission. It is estimated that 14% of all disease in the US caused by Campylobacter spp., Cryptosporidium spp., Shiga toxin-producing Escherichia coli (STEC) O157, non-O157 STECs, Listeria monocytogenes, nontyphoidal Salmonella enterica and Yersinia enterocolitica were attributable to animal contact. This article reviews best practices for organizing events where human–animal interactions are encouraged, with the objective of lowering the risk of zoonotic disease transmission.

 Erdozain G, Kukanich K, Chapman B, Powell D. 2012. Observation of public health risk behaviours, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011. Zoonoses Public Health. 2012 Jul 30. doi: 10.1111/j.1863-2378.2012.01531.x. [Epub ahead of print]

Observation of public health risk behaviors, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011Outbreaks of human illness have been linked to visiting settings with animal contact throughout developed countries. This paper details an observational study of hand hygiene tool availability and recommendations; frequency of risky behavior; and, handwashing attempts by visitors in Kansas (9) and Missouri (4), U.S., petting zoos. Handwashing signs and hand hygiene stations were available at the exit of animal-contact areas in 10/13 and 8/13 petting zoos respectively. Risky behaviors were observed being performed at all petting zoos by at least one visitor. Frequently observed behaviors were: children (10/13 petting zoos) and adults (9/13 petting zoos) touching hands to face within animal-contact areas; animals licking children’s and adults’ hands (7/13 and 4/13 petting zoos, respectively); and children and adults drinking within animal-contact areas (5/13 petting zoos each). Of 574 visitors observed for hand hygiene when exiting animal-contact areas, 37% (n=214) of individuals attempted some type of hand hygiene, with male adults, female adults, and children attempting at similar rates (32%, 40%, and 37% respectively). Visitors were 4.8x more likely to wash their hands when a staff member was present within or at the exit to the animal-contact area (136/231, 59%) than when no staff member was present (78/343, 23%; p<0.001, OR=4.863, 95% C.I.=3.380-6.998). Visitors at zoos with a fence as a partial barrier to human-animal contact were 2.3x more likely to wash their hands (188/460, 40.9%) than visitors allowed to enter the animals’ yard for contact (26/114, 22.8%; p<0.001, OR= 2.339, 95% CI= 1.454-3.763). Inconsistencies existed in tool availability, signage, and supervision of animal-contact. Risk communication was poor, with few petting zoos outlining risks associated with animal-contact, or providing recommendations for precautions to be taken to reduce these risks.

Aerosolization of pathogens? Petting zoo returns to Minn. fair after 2014 E. coli outbreak

Zerebko Zoo Tran, a traveling petting zoo, is returning to the 2015 Rice County Fair, a year after it was suspected to be the source of an E. coli outbreak.

courtlynn.petting.zooIn 2014, the Minnesota Department of Health identified 13 people from four different events who developed E. coli after visiting the Zerebko Zoo Tran traveling petting zoo.

 But Rice County Fair officials say fair goers shouldn’t be worried. Rice County Fair Executive Director John Dvorak said they were comfortable bringing Zerebko Zoo Tran back.

“The biggest factor is that they were extremely cooperative in working with the department of health, and others with the investigation,” Dvorak said.

Dvorak said the fair has also made changes to the facilities fair goers can use to clean up after visiting the zoo. In the past, the fair supplied hand-washing stations that used a chemical to sanitize hands. This year, the fair is bringing running-water hand washing stations with soap.

“E. coli is best cleaned away by friction, so by bringing the running water hand washing stations, that will help get rid of anything that could be spread,” Dvorak said.

Operational changes have been made in the fairground’s barns, like keeping an extra eye to keep walkways clear of waste and making layout changes within the barns so animals never have to step outside to go to a different part of the barn, he said.

Wally Zerebko, owner of Zerebko Zoo Tran, said after the incident in 2014, he contacted several experts and had all of his animals tested. He also had the company’s vet mention the problem at a conference, which led to them finding a vaccine they could give the animals.

Family wants answers: Daughter, 5 others stricken with E. coli O157 in 2011 after trip to UK petting farm

In June 2011, 11-year-old Megan Oldfield took a school trip to a petting farm in East Yorkshire and was left fighting for life with kidney damage.

Megan OldfieldMegan Oldfield needed dialysis for two weeks after contracting the infection following a visit to Cruckley Animal Farm in East Yorkshire.

She fell ill in the week after the school trip and was rushed to Leeds General Infirmary where she was put on dialysis for two weeks.

Megan still needs regular check ups on her damaged kidneys and is vulnerable to further infections throughout her life.

Her dad James, 34, a gas engineer, was quoted as saying, “Seeing my little girl fight for her life because she contracted an infection that might have been prevented was very hard to witness and something I will never forget.

“She went from perfectly healthy to being hooked up to a life saving dialysis machine in a matter of days and nothing could have prepared us for the horrific battle she would have to face.

A Health Protection Agency (HPA) report into the farm the month after Megan’s visit found insufficient hand washing facilities for visitors.

The owners of the attraction – which closed permanently later the same year – deny responsibility.

Megan’s family have now instructed specialist solicitors Irwin Mitchell to investigate the cause of his daughter’s illness.

Lawyers at the firm have received details of a Health Protection Agency (HPA) report into Cruckley Animal Farm which was commissioned following the HPA being notified of ‘six cases (five primary and one secondary) of E-coli O157 with possible links to Cruckley Animal Farm between 7th and 18th July 2011’

The Health Protection Agency report, dated July 2011 found:

  • Hand wash facilities provided were deemed insufficient for the volume

of visitors

  • Location of hand wash facilities also considered not to be adequate,

especially in regard to the covered picnic area, which was located too far from

hand wash facilities

  • As a result, it was considered unlikely that the visiting public washed their hands after interaction with animals and before eating
  • There was a lack of explicit information about the risk of contracting an infection from animals

The HPA report stated: “Two improvement notices were issued which required (a) improved segregation of visitors from animals and increased number of hand washing facilities with hot and cold running water, (b) improved provision of information to visitors.”

The report confirmed that there was strong evidence that the farm was the source of the infection as, “it was the single common link identified in all six cases”.

The HPA concluded: “A lack of explicit information about the risk of infection from animals was also noticed, and this was of concern due to the lack of adequate hand washing facilities in eating areas.”

34 sickened: Dairy barn likely source of E. coli outbreak in Washington state

The strain of E. coli O157:H7 that caused an outbreak among people at the Milk Makers Fest in April has been found in the north end of the dairy barn where the event was held, according to a report released Wednesday, June 3.

royal.petting.zoo“The bottom line here is we can’t expect an environment like a barn to ever be completely free of pathogenic bacteria,” said Tom Kunesh, environmental health supervisor for the Whatcom County Health Department.

So why take little kids into that environment, as schools routinely do?

About 1,325 Whatcom County first-grade students, plus the teachers and parents who accompanied them, from all school districts in Whatcom County went to the annual event April 21-23 at the Northwest Washington Fairgrounds in Lynden.

Disease investigators calculated case counts based only on lab-confirmed infection with E. coli O157:H7 or physician-diagnosed hemolytic uremic syndrome (HUS), a type of kidney failure.

  • 25 people were confirmed cases.

o          9 of these cases were considered secondary cases (the ill person didn’t attend the event but had close contact with someone who did attend).

  • No one died.
  • 10 people were hospitalized.
  • 6 people developed HUS.

Multiple samples from the environment where the event was held were collected on two different days (April 30 and May 13) and submitted for laboratory testing. The samples indicated that several areas of the north end of the Dairy Barn at the Northwest Washington Fairgrounds were contaminated with the same strain of E. coli that made people ill. Negative results do not rule out contamination in other parts of the barn.

The outbreak strain of E. coli O157:H7 was identified in the following areas of the Dairy Barn:

  • Manure bunker
  • Hay maze area
  • Bleachers by east wall
  • Bleachers by west wall

Any environment where animals have been kept, such as barns, should be considered contaminated. E.coli O157 can survive in the environment up to 42 weeks (Varma, 2003 JAMA).

As part of the investigation, officials interviewed many of the confirmed cases to find out what they did during the event before they got ill. Officials also interviewed “controls,” meaning people who attended the Milk Makers Fest but did not get ill to find out what they might have done differently.

The results of analyzing the data collected during the interviews are not final, but a few preliminary findings stand out:

  • Event attendees who reported washing or sanitizing their hands before eating lunch were less likely to become ill.
  • Children who reported always biting their nails were more likely to become ill.
  • Leaving animal areas without washing hands might have contributed to an increased risk of transmission.
  • Eating in animal areas might have contributed to an increased risk of transmission.

Recommendations for Event Organizers:

  • Evaluate and update plans for cleaning and disinfection before, during, and after events, particularly surfaces with high levels of hand contact (such as seats, door or fence handles, and hand railings).
  • Evaluate and update measures to restrict access to areas more likely to be contaminated with animal manure.

o          This is especially important for people at higher risk for severe illness. These people include young children, pregnant women, adults older than 65, and people with weakened immune systems.

  • Ensure access to hand washing facilities with soap, running water, and disposable towels.
  • Display signs and use other reminders to attendees to wash hands when leaving animal areas.
  • Store, prepare, or serve food and beverages only in non-animal areas.


Terrible idea: UK kids meet animals at a raw milk farm

In the fall of 1998, I accompanied one of my four daughters on a kindergarten trip to the farm. After petting the animals and touring the crops – I questioned the fresh manure on the strawberries –we were assured that all the food produced was natural.

raw.milk.petting.zooWe then returned for unpasteurized apple cider. The host served the cider in a coffee urn, heated, so my concern about it being unpasteurized was abated. I asked: “Did you serve the cider heated because you heard about other outbreaks and were concerned about liability?” She responded, “No. The stuff starts to smell when it’s a few weeks old and heating removes the smell.”

But it’s all smiles at one Rimington farm as children enjoy the sunshine and all the farm has to offer.

Gazegill Farm in Rimington welcomes school groups and visitors to come to the farm and to have a look around.