Petting zoos in Switzerland as public health problem

Animal petting zoos and farm fairs provide the opportunity for children and adults to interact with animals, but contact with animals carries a risk of exposure to zoonotic pathogens and antimicrobial‐resistant bacteria.

The aim of this study was to assess the occurrence of Shiga toxin‐producing Escherichia coli (STEC), Salmonella, extended‐spectrum β‐lactamase (ESBL)‐producing Enterobacteriaceae and methicillin‐resistant Staphylococcus aureus (MRSA) in animal faeces from six animal petting zoos and one farm fair in Switzerland. Furthermore, hygiene facilities on the venues were evaluated.

Of 163 faecal samples, 75 contained stx1, stx2 or stx1/stx2 genes, indicating the presence of STEC. Samples included faeces from sika deer (100%), sheep (92%), goats (88%), mouflons (80%), camels (62%), llamas (50%), yaks (50%), pigs (29%) and donkeys (6%), whereas no stx genes were isolated from faeces of calves, guinea pigs, hens, ostriches, ponies, zebras or zebus. Salmonella enterica subsp. enterica serovar Stourbridge (S. Stourbridge) was detected in faecal samples from camels. A total of four ESBL‐producing E. coli strains were isolated from faeces of goats, camels and pigs. PCR and sequencing identified the presence of blaCTXM15 in three and blaCTXM65 in one E. coli. Antimicrobial resistance profiling using the disk diffusion method revealed two multidrug‐resistant (MDR) E. coli with resistance to ciprofloxacin, gentamicin and azithromycin, all of which are critically important drugs for human medicine. Multilocus sequence typing identified E. coli ST162, E. coli ST2179, extraintestinal high‐risk E. coli ST410 and E. coli ST4553, which belongs to the emerging extraintestinal clonal complex (CC) 648. No MRSA was detected.

On all animal petting venues, there were inadequacies with regard to access to hygiene information and handwashing hygiene facilities. This study provides data that underscore the importance of hygiene measures to minimize the risk of transmission of zoonotic pathogens and MDR, ESBL‐producing E. coli to visitors of animal petting venues.

Animal petting zoos as sources of shiga toxin-producing Escherichia coli, salmonella and extended-spectrum Beta-lactamase (EXBL)-producing Enterobacteriaceae

Zoonosis and Public Health

Meret Isler, Ramona Wissmann, Marina Morach, Katrin Zurfluh, Roger Stephan, Magdalena Nüesch‐Inderbinen

https://doi.org/10.1111/zph.12798

https://onlinelibrary.wiley.com/doi/abs/10.1111/zph.12798

166 sick: Over half under 5 from Salmonella in pet bearded dragons

Reptiles are one of the fastest growing sectors in the United States pet industry. Reptile-associated salmonellosis (RAS) continues to be an important public health problem, especially among children.

We investigated an outbreak of human Salmonella infections resulting from serotypes Cotham and Kisarawe, predominately occurring among children. An outbreak of illnesses was identified in persons with exposure to pet bearded dragon lizards. Human and animal health officials, in cooperation with the pet industry, conducted epidemiologic, traceback and laboratory investigations. Onsite sampling was conducted at two US breeding facilities, one foreign breeding facility, and a large pet retail chain. A total of 166 patients in 36 states were identified with illness onset dates from 02/2012-06/2014. The median patient age was 3 years (range, <1-79 years), 57% were aged ≤5 years, and 37% were aged ≤1 year. Forty-four patients (37%) were hospitalized, predominantly children. Sampling at breeding facilities and a national pet store chain resulted in isolation of outbreak serotypes at each facility; isolation proportions ranged from 2%-24% of samples collected at each facility.

Epidemiologic, microbiologic and traceback evidence linked an outbreak of uncommon Salmonella serotypes to contact with pet bearded dragons. The high proportion of infants involved in this outbreak highlights the need to educate owners about the risk of RAS in children and the potential for household contamination by pet reptiles or their habitats. Strategies should be developed to improve breeding practices, biosecurity and monitoring protocols to reduce Salmonella in the pet reptile trade.

 

 

Outbreak of human infections with uncommon salmonella serotypes linked to pet beareded dragons, 2012-2014, 18 April 2020

Zoonoses Public Health

Kiebler CA1Bottichio L1Simmons L1Basler C1Klos R2Gurfield N3Roberts E4Kimura A4Lewis LS5Bird K5Stiles F5Schlater LK6Lantz K6Edling T7Barton Behravesh C1.

doi: 10.1111/zph.12701

https://www.ncbi.nlm.nih.gov/pubmed/32304287

11 sick: E. coli O157 outbreak linked to Minnesota state fair

The Minnesota State Fair has been connected to an outbreak of an E. coli strain, according to the Minnesota Department of Health (MDH).

To date, disease doctors have identified 11 cases of E. coli 0157 among Minnesotans who were at the State Fair between Aug. 25 and Sept. 2. All of them fell ill between Aug. 29 and Sept. 6.

Ages of those sickened range from 2 to 43 years old. Six of the cases required the patient to be hospitalized, including one person developing hemolytic uremic syndrome, which the MDH says is a potentially fatal complication.

One person is still in a hospital being treated.

Investigators are working to determine the source of the outbreak, with evidence so far indicating that it most likely began with contact with livestock.

Most of the 11 patients visited the Miracle of Birth exhibit and made physical contact with calves, goats, sheep or piglets, but others suffering from the E. coli strain did not make direct contact with animals, leading the MDH to consider the possibility that those people made contact with contaminated surfaces.

“This serves as a strong reminder to always wash your hands after being around livestock and their enclosures,” the MDH says.

Fortunately, there is “little chance” of ongoing exposure to the strain since the fair has ended.

Erdozain GKukanich KChapman BPowell 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.

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.

 

Missed phone calls, changing stories: How E. coli spread at the San Diego County Fair

More than 1.1 million people had already passed through the gates of the San Diego County Fair this summer by the time an E. coli outbreak forced the closure of all animal exhibits and rides.

News that a 2-year-old boy had died after picking up the particularly nasty infection, which was also contracted by three other children with animal contact at the fair, stirred alarm within the community. Many had already roamed the midway, stuffed themselves full of fair food and passed through the venue’s cavernous livestock barns en route to pig races, pony rides and the petting zoo.

Paul Sisson of The San Diego Union Tribune reports hundreds of emails and other documents obtained through Public Records Act requests show that, while the public health team was able to move quickly, more frequent county case reviews, a more modern medical records system and more prompt and accurate responses from families with infected children might have gotten the investigation started days earlier.

The decision to shut down the animal exhibits on June 29, records show, came after four days of a behind-the-scenes scramble by the county’s public health department. With one death already on the books, they decided to notify the public even though testing had not yet confirmed that all four of those first four cases had E. coli infections.

It quickly became clear those initial instincts were accurate. In the following weeks, an additional seven people, plus two more whose infections weren’t confirmed, came forward, including another young boy who nearly died after suffering severe complications that attacked his kidneys.

Records show that zeroing in on the fairgrounds was no simple task. Epidemiologists had to eliminate a broad range of possible locations, from restaurants to a busy daycare center, before they were able to zero in on the fairgrounds.

And there was plenty of other work that had to be done simultaneously. County records show that the department investigated 435 disease cases in June alone. Of those, there were 43 cases of shiga toxin-producing E. coli reported that month, forcing disease detectives to sift out the 11 eventually confirmed to be part of the outbreak.

Determining whether there are connections between cases requires interviews with each subject or their legal guardians. Depending on the type of pathogen involved, it’s a process that often relies on frail human memory to recall the finest possible details of possible exposure routes from foreign travel and foods consumed to places visited and close contact with others.

The investigative process doesn’t get started until the health department is notified, usually after a test result administered in a doctor’s office or hospital comes back positive.

Subjects often aren’t interviewed until weeks after they got infected because many infections have incubation periods measured in days or weeks and it usually takes time before individuals decide to seek medical attention and additional time for medical providers to make a diagnosis.

Often, those charged with reading these particularly fragile tea leaves learn to trust their instincts, and that was certainly the case with the fairgrounds outbreak.

Emails show that the county’s epidemiology team first began to suspect that it might have an outbreak on its hands on June 24, the day that 2-year-old Jedidiah King Cabezuela (right) was admitted to the intensive care unit at Rady Children’s Hospital with severe kidney problems.

While discussing his condition, an epidemiologist noted that the boy had visited the fair before he got sick. And, she said, the county had been notified just before Cabezuela’s death of another boy, this one 9 years old, who tested positive for the type of toxin produced by the E. coli strain causing so much difficulty for Cabezuela.

Though the 2-year-old and 9-year-old hadn’t eaten the same foods at the fair, and the older boy’s parents said he didn’t visit animal areas, the fact that both visited the same location was enough for the epidemiologist to suggest that the department “should at least keep an eye on” the 9-year-old, even though he never got sick enough to need hospitalization.

By Tuesday, June 25, the public health department received the news that Cabezuela died overnight, and that information pushed the team to begin a relentless search for similar shiga toxin-producing E. coli infections.

They quickly found a report of a 13-year-old girl who had a positive toxin test after visiting the fair on June 8. Her parents had told interviewers that she had contact with animals and had eaten fair food afterward without first washing her hands.

Another girl, this one age 11, had also had a positive test but her parents had not returned repeated calls for an interview. It would not become clear that she, too, had visited the fair and had contact with animals until her parents were finally reached on June 28, the same day that the county announced it would close all public animal exhibits.

Then there was the 9-year-old boy mentioned in that prescient June 24 email. His parents initially said that he had no animal contact at the fair, but in subsequent interviews those parents remembered that, yes, their son did visit the livestock barn when the family visited on June 13.

With three, then four cases all reporting food consumption and animal contact at the fairgrounds, food inspectors descended on five different food vendors who sold items that the kids reported eating and found no traces of E. coli contamination.

Food poisoning ruled out, officials concluded that the E. coli exposure was most likely down to animals and, with the cooperation of the fair board, shut down all public access to animal exhibits and rides on June 29. Testing never did pinpoint the exact source of contamination, though the fair’s petting zoo and pony rides were ruled out.

Once public health nurses do their phone interviews and build up as clear a picture as they can of the circumstances surrounding each individual case, epidemiologists can begin looking for patterns, keeping an eye out for clusters of patients in specific geographic areas or with other commonalities such as foreign travel or consumption of tainted food.

A table of petting zoo outbreaks is available at https://www.barfblog.com/wp-content/uploads/2017/08/Petting-Zoo-Outbreaks-Table-7-26-17.xlsx

A timeline of the E. coli outbreak at the San Diego County Fair

May 31– San Diego County Fair opens

June 8 –11-year-old and 13-year-old girls visit fair

June 10 –13-year-old becomes ill

June 12 –11-year-old becomes ill after a second fair visit

June 13 – 9-year-old boy visits fair

June 15 – 2-year-old Jedidiah Cabezuela visits fair

June 16 – 9-year-old becomes ill

June 18 – Investigator call parents of 11-year-old, get no reply

June 19 – 13-year-old reports visiting animal areas at fair; Jedidiah becomes ill; county holds weekly analysis meeting

June 20 – Jedidiah admitted to Rady Children’s Hospital

June 21 – 4-year-old and 38-year-old who later test positive for E. coli infections visit fair

June 22 – Jedidiah diagnosed with severe E. coli infection; 6-year-old Ryan

Sadrabadi, 2-year-old Cristiano Lopez and his mother, Nicole Lopez, and another 2-year-old girl, visit the fair

June 23 – Family confirms Jedidiah visited fair’s animal exhibits; one-year-old girl later confirmed to have E. coli infection visits the fair

June 24 – Jedidiah dies from kidney failure; 9-year-old’s fair attendance confirmed, animal contact denied; County epidemiologist raises red flag about possible case cluster at fair; Nicole Lopez becomes ill, treated at Kaiser La Mesa

June 25 – County learns of Jedidiah’s death, begins exploring fair connections in depth

June 26 –Ryan, 2-year-old girl and 1-year-old become ill

June 28 – Family of 9-year-old revises statement, confirms visiting livestock barn; Family of 11-year-old confirms she visited sheep exhibit at fair; County announces E. coli cluster at Del Mar Fairgrounds; County inspects five food booths visited by first four cases, no E. coli found; Cristiano becomes ill

June 29 – County inspects all 160 food booths at fair, finds no E. coli contamination; All animal areas at the fair are closed; four-year-old becomes ill

June 30 – Ryan becomes ill diagnosed with E. coli infection

July 1 – 6-year-old’s case reported to county

July 2 – Cristiano admitted to Kaiser Permanente San Diego Medical Center with worsening symptoms, diagnosed with E. Coli infection

July 3 – 2-year-old girl and 4-year-old’s cases reported to county

July 4 – Fair closes with an attendance that exceeds 1.5 million; Cristiano’s infection reported to county; Cristiano transferred to Rady Children’s Hospital, undergoes dialysis for hemolytic uremic syndrome that attacks his kidneys

July 6 – 38-year-old becomes ill

July 9 – 38-year-old’s infection reported to county

July 10 – 30-year-old’s and 1-year-old’s infections reported to county

July 29 – Three families file claims against fair board, alleging they weren’t properly warned of E. coli risk

July 31 – Environmental and animal testing fail to reveal a clear source of outbreak, but exposure in fair’s livestock barn deemed “likely”

Best practices for planning events encouraging human-animal interactions

Zoonoses and Public Health

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

http://onlinelibrary.wiley.com/doi/10.1111/zph.12117/abstract?deniedAccess

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.

Petting zoo illnesses make me sad because the food and ag community has failed

I’m a fan of agritourism, whether that’s touring a bunch of backyard chicken coops or learning about animals, I see value in this stuff. It’s not without risk though – and managing that risk is imperative. A while ago someone asked me about the types of food businesses I like to frequent, from a food safety perspective, and I thought about it a while and came up with this: I like to eat food from places where the people involved in making decisions are constantly worried about making people sick. Like it’s their nightmare. Not places that tell me not to worry about stuff.

My petting zoos/animal interaction wants are the same.

A few years ago my friend (and Carolina Hurricane superfan), Dr. Megan Jacob and I took a couple of visits to animal education/interaction sites to get some ideas about what people do (visitors and organizers). From those visits we saw a lot of stuff that made us think we need to take a different approach. Lots of signs saying to wash hands. Don’t bring food around the animals, don’t bring strollers.

And not a lot of people following the messages. I don’t blame the visitors. I blame us (or at least the collective us) for not doing a better job at saying why it’s important, not having enough people there with reminders and actively helping visitors reduce their risks.

A couple of years ago Gonzalo Erdozian esteemed member of the barfblog team, looked at what was available at a bunch of small petting zoo sites/events in Kansas and Missouri – and came up with some great suggestions after finding lots of risky practices (abstract is below). Reducing risks at fairs and petting zoos isn’t a simple thing – it’s a mix of having the tools, people to point patrons to them, and explaining the risks (without being jerks).

Gonzo found that the reminders really worked.

After those visits, Megan and I, with the help from some others put together a workshop for NC folks who run these events and sites. We learned a whole bunch more from the participants – one of the biggest takeaways for me was that organizers were reluctant to engage in these discussions because although they knew that there was a risk, they didn’t want to alert people who were there that it was risky because maybe they wouldn’t come. I’m not sure what the correct word for that is, but it seems paternalistic or something. One philosophy we’ve followed at barfblog is that people can handle risk discussions and we’re kinda responsible to have them. And let the participants choose.

I home almost daily past the Kelley Building, ground zero for an E. coli O157:H7 outbreak in 2011 linked to 25 illnesses at  the NC State Fair. The building wasn’t considered to be an animal contact area – a petting zoo – but was a spot that was a popular cut-through from an entrance gate to the midway area. Organizers of the fair led a commission to look at what happened, and made changes – having more handwashing stations, passive reminders and actively having actual people reminding; further limiting access to non-petting zoo animal buildings; and, increasing cleaning and sanitation.

People brought food, strollers, and their hands touched a lot of likely contaminated handles and rails.

Over the weekend news broke of another tragic cluster of illness linked to fair/animal interactions. 

A 2-year-old boy died and three others were sickened upon contracting the E. coli virus after coming into contact with farm animals at the San Diego County Fair, according to authorities.

The child was hospitalized after visiting the county fair two weeks ago, and died Monday after complications stemming from the virus, the San Diego County Health and Human Services Agency confirmed on Friday. The other three children did not need medical attention.

A 2-year-old boy died and three others were sickened upon contracting the E. coli virus after coming into contact with farm animals at the San Diego County Fair, according to authorities.

The child was hospitalized after visiting the county fair two weeks ago, and died Monday after complications stemming from the virus, the San Diego County Health and Human Services Agency confirmed on Friday. The other three children did not need medical attention.

The frustrating nexus of these (and all the other illnesses) is that it’s good for folks to learn about agriculture and farming and food by seeing and interacting – and that very situation is risky.

What doesn’t help is when the agricultural community scoffs at these illnesses (I haven’t heard it on this one, but have in the past) essentially saying that handwashing is common sense, so these illnesses happen because people are ignorant. Except that all falls apart because we (the folks in the know) haven’t done our job telling folks how they can manage some of the risk of getting sick, and how organizers are also trying to reduce the risk to patrons. By missing that, we’re not doing everything we can to ensure that the safe behaviors take place. And that makes me sad.

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]

Outbreaks 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.

 

 

Father of Tennessee E. coli victim ‘Nutritionist recommended raw milk’

James Zenker never imagined his young son would battle for his life at just two-years-old.

“It’s affected his kidneys; they shut down,” Zenker said. “It affected his intestines; he couldn’t digest any of his food and its affected his brain — he has a substantial brain injury.”

His son William got E. coli after drinking raw milk linked to French Broad Farm. Zenker said a nutritionist recommended the raw milk to help William fight allergies.

“He’s not able to speak and not able to do the same activities as before he was ill,” Zenker said.

The vast majority of nutritionists, dieticians and physicians I encounter – and it’s frequent with my brain status and trips to emergency – know shit about microbial food safety.

The odd ones do, and they are food safety heros.

But when hospitals continue to serve raw sprouts to immunocompromised people, when they won’t be sold at WalMart in the U.S., I gotta question their food safety credibility.

To reiterate, I stared the Food Safety Network (the original FSN) over 25 years ago as an incoming graduate student in 1993 in the wake of the Jack-in-the-Box outbreak, combining my science and journalism learnings, and because a constant refrain I observed was, I never knew foodborne illness could be so serious.

That’s why I continue to do it as a form of community service (I haven’t been paid since 2016).

Of the 15 children sick with E. coli in Tennessee that has now been linked to consumption of raw milk and contact with ruminants from French Broad Farm, William is the last one left in the hospital. His father said East Tennessee Children’s Hospital saved his son’s life.

The Knox County Health Department said an investigation concluded that the outbreak was caused by two separate sources, the exposure to farm animals and exposure to raw milk.

“While it is rare, it appears we had two sets of children sickened by two different strains of E. coli O157 at the same time. The epidemiological evidence overwhelmingly supported the two-source theory: consumption of raw milk and some type of contact, most likely indirect, with ruminant animals,” said KCHD Director Dr. Martha Buchanan.

William has had several blood transfusions during his recovery and still needs more. His home church Temple Baptist in Powell (no relation – dp) hosted a replacement drive Tuesday for William and the community.

“It’s so encouraging to see people take time out of their busy day and donate from their own life to help Will and others affected by E. coli,” Zenker said.

If you would like more information about future blood drives click here: 
Blood drives scheduled to help children infected with E. coli.

‘Close to 10 children hospitalized for E. coli’ in Tennessee: raw milk, farm animals may be sources

Kristi Nelson of Knox News reports East Tennessee Children’s Hospital said Tuesday it’s treated “close to 10” children, all younger than 4, for a “serious outbreak” of E. coli-caused illness over the past 10 days. 

The Knox County Health Department has confirmed two likely sources of the outbreak are unpasteurized milk and farm animals.

Most of the ill children are known to have consumed raw milk from a local cow-share dairy, French Broad Farm in Knox County, the health department said in an alert issued Tuesday evening. The health department recommends consumers dispose of all raw milk or other unpasteurized products they may have from this farm.

“People need to be aware that if they choose to drink raw milk, they’re taking a risk,” said Dr. Martha Buchanan, health department director.

The health department is also investigating whether any of the affected children were exposed to E. coli after interacting with farm animals at a local child care facility. The facility, which officials declined to name, is not currently operating, Buchanan said.

Four of the children are in the Pediatric Intensive Care Unit with kidney failure, said the hospital’s chief medical officer, Dr. Joe Childs, who is director of the PICU. There have been no fatalities related to the outbreak, hospital staff said, but life-threatening infections can occur when the strain of E. coli releases a toxin, shiga, that harms small blood vessels, of which the kidneys have many. Childs said the damage to the blood vessels is usually “temporary,” but children can get very ill, require surgery to place catheters, and may have nonfunctioning kidneys for weeks. 

“We are concerned that some of these cases do have exposure to the consumption of raw milk,” or milk sold unpasteurized, Childs said. “Tennessee is a state where that’s legal, to obtain raw milk. … The FDA and the American Academy of Pediatrics strongly discourage the consumption of raw milk and raw milk products because there’s a lot of things that can be in milk and there’s no real good way to decontaminate it other than pasteurizing it.” 

Farm animals quarantined following crypto at Rhode Island petting zoo

I’m getting too old for this shit.

As John Prine famously sang, all the news just repeats itself.

Animals at a Middletown farm are being quarantined after three people got sick, Rhode Island health officials announced last week.

The Rhode Island Department of Environmental Management said one child and two adults came down with cryptosporidiosis after having contact with goats during “pet and cuddle” events at Simmons Farm on West Main Road on March 25 and 31.

“I have never been so sick,” one woman, who did not want to be identified, told NBC 10 News. “I had visited the farm on Saturday, March 31 and by Friday evening, I was extremely ill and it progressively got worse from there.”

She said she went to the hospital April 10 and a doctor asked if she had been to a farm.

“Today, I have had my first real meal and my stomach is already gurgling,” she said. “Up until tonight, I had six Saltines.”

About 60 goats and five cows are being quarantined, Simmons Farm owners told NBC 10 News. They will also be screened.

‘You could make animals sick’

Gonzalo and Kate, after all those farm/petting zoo/animal experience visits, have you ever seen a sign like this:

It’s accurate, zoonoses go both or lots of other ways.

Many thanks to the barfblog.com subscriber who sent it along.

Going to a petting zoo? People need to be a lot more careful than they thought

 https://barfblog.com/2012/09/going-to-a-petting-zoo-people-need-to-be-a-lot-more-careful-than-they-thought/

The other parents hate me.

Even Amy changed her phone ring to the Debbie Downer noise from Saturday Night Live.

I’m Dougie Downer.

Every time there’s a sausage sizzle, I don’t complain, I cook for the kids and their families, and use a thermometer.

People think I’m weird.

The chicken coop at the daycare is still empty. And while no one will say it, I’m sure they blame me for depriving their little ones of chick interaction (and Salmonella).

This is nothing new; I’ve been causing angst or disgust for about 20 years, going with my kids on those field trips to the farm (the oldest of five daughters is 25; I’m ancient).

Besides, Gonzalo Erdozain did most of the work on this petting zoo paper, and he’s got a little one, so he can torment the parents of Roman’s future classmates.

Kansas State University came out with their version of our petting zoo paper and quoted me, as saying “People have to be careful — a lot more careful than they thought.”

Powell is co-author of the paper “Observation of Public Health Risk Behaviors, Risk Communication and Hand Hygiene at Kansas and Missouri Petting Zoos – 2010-2011″ that was published recently in the journal Zoonoses and Public Health.

courtlynn.petting.zooThe paper’s main author is Gonzalo Erdozain, a master of public health student at the Kansas State University who works with Powell. Erdozain, Manhattan, visited numerous petting zoos and fairs in Kansas and Missouri in 2010 and 2011 and found many sanitary problems at the facilities. Article co-authors include Katherine KuKanich, assistant professor of clinical sciences at Kansas State University, and Ben Chapman of North Carolina State University.

When visiting petting zoos, Powell said parents need to be vigilant in watching their children and they need to put a health plan in effect for the visit. In Erdozain’s study, he observed children touching their faces after petting the animals, eating or drinking in the petting zoo, eating petting zoo food and sucking on a pacifier while at the zoo. Children were also seen picking up animal feces.

Another factor to watch for is the presence of high-risk animals — those most associated with zoonotic diseases, including chicks, young ruminants like goats, sheep and cattle.

Zoonotic diseases can be passed from animal to human, or vice versa.

Washing hands before and after encountering animals and the animal feed is one of the most recommended method to fight germs and bacteria from the animals and surrounding area of animal pens, Powell said.

“Hand-washing tool selection may also contribute to the success of hand hygiene as a preventive measure, as some outbreak investigations have reported alcohol-based hand sanitizer was not protective against illness, especially when hands are soiled,” Powell said.

Powell said Erdozain’s study found that visitors were five times as likely to wash their hands when a staff member was present. This observation, Powell said, is consistent with a study published last year that showed the importance of a little encouragement.

To help maintain a safe and healthy environment, Powell said petting zoos should constantly remind visitors to wash their hands when exiting the pens. Keeping clean and useful sinks near the exits of all facilities with a stand by attendant would help decrease the likeliness of a widespread illness due to forgetful hygiene, he said.

Strict governmental regulation and enforcement would be one way to ensure this happens but is an unlikely solution. Powell said that it is up to the zoos to help keep watch on what is happening within their pens and to make sure that the proper facilities are in place and are noticeable to visitors — children and adults alike.

“Providing hand hygiene stations, putting up some good signs, having staff supervise, avoiding high-risk animals and logical facility design are easy and inexpensive — and not doing so is inexcusable,” Powell said.

I’m fine with animal interactions; but people, and organizers, should be a lot more careful than they thought. That’s what I told my 3-year-old’s daycare as they prepared for a chicken coop. They hate me.

A table of petting zoo outbreaks is available at http://bites.ksu.edu/petting-zoos-outbreaks.

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]

Abstract below:

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.

True: His idea of football is soccer, not gridiron

Who’s that smooth-talking Paraguayan (or Argentinian, or Spanish, or American, it was all confusing) dude talking on pet safety and Super Bowl parties on KSHB in Kansas City?

It’s Dr. Gonzalo Erdozain of Kansas City Veterinary Care, who tells you what is pet safe and what to look out for.

Gonzalo did his Masters of Public Health with me, published a couple of peer-reviewed papers on petting zoo safety, got his Doctor of Veterinary Medicine, and this one time, took me to the emergency room.

So he’s in Chapman-and-Blaine-land of students who help out their advisors.

All the best to you and your family.