The Clark and Champaign county health departments say they’re investigating 23 possible cases of cryptosporidiosis linked to dairy calves brought to the region for youth 4-H projects.
The calves were sold to children. A Clark County epidemiologist says hydrogen peroxide is the only known disinfectant for killing the parasite. No other information has been released.
The U.S. Centers for Disease Control (CDC) is working with Wisconsin health, agriculture, and laboratory agencies, several other states, and the U.S. Department of Agriculture Animal and Plant Health Inspection Service (USDA-APHIS) to investigate a multistate outbreak of multidrug-resistant Salmonella Heidelberg infections.
Portrait of the cute baby bull calf
Public health investigators used the PulseNet system to identify illnesses that may have been part of this outbreak. PulseNet, coordinated by CDC, is the national subtyping network of public health and food regulatory agency laboratories. PulseNet performs DNA fingerprinting on Salmonella bacteria isolated from ill people by using techniques called pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS). CDC PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks.
Twenty-one people infected with an outbreak strain of Salmonella Heidelberg have been reported from eight states.
Among 19 people with available information, illnesses started on dates ranging from January 11, 2016 to October 24, 2016. Ill people range in age from less than 1 year to 72, with a median age of 21. Sixty-two percent of ill people are female. Among 19 ill people with available information, 8 (42%) reported being hospitalized, and no deaths have been reported.
WGS showed that isolates from ill people are closely related genetically to one another. This close genetic relationship means that people in this outbreak are more likely to share a common source of infection.
Epidemiologic, traceback, and laboratory findings have identified dairy bull calves from livestock markets in Wisconsin as the likely source of infections. Dairy bull calves are young, male cattle that have not been castrated and may be raised for meat. Dairy bull calves in this outbreak have also been purchased for use with 4-H projects.
In interviews, ill people answered questions about any contact with animals and foods eaten in the week before becoming ill. Of the 19 people interviewed, 15 (79%) reported contact with dairy bull calves or other cattle. Some of the ill people interviewed reported that they became sick after their dairy bull calves became ill or died.
One ill person’s dairy calves were tested for the presence of Salmonella bacteria. This laboratory testing identified Salmonella Heidelberg in the calves. Further testing using WGS showed that isolates from ill people are closely related genetically to isolates from these calves. This close genetic relationship means that the human infections in this outbreak are likely linked to ill calves.
As part of routine surveillance, the Wisconsin State Laboratory of Hygiene, one of seven regional labs affiliated with CDC’s Antibiotic Resistance Laboratory Network, conducted antibiotic resistance testing on clinical isolates from the ill people associated with this outbreak. These isolates were found to be resistant to antibiotics and shared the same DNA fingerprints, showing the isolates were likely related to one another.
WGS identified multiple antimicrobial resistance genes in outbreak-associated isolates from fifteen ill people and eight cattle. This correlated with results from standard antibiotic resistance testing methods used by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory on clinical isolates from two ill people in this outbreak. The two isolates tested were susceptible to gentamicin, azithromycin, and meropenem. Both were resistant to amoxicillin-clavulanic acid, ampicillin, cefoxitin, ceftriaxone, chloramphenicol, nalidixic acid, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole and had reduced susceptibility to ciprofloxacin. Antibiotic resistance limits treatment options and has been associated with increased risk of hospitalization, bloodstream infections, and treatment failures in patients.
Traceback information available at this time indicates that most calves in this outbreak originated in Wisconsin. Wisconsin health and agriculture officials continue to work with other states to identify herds that may be affected.
Camping wasn’t a big part of my youth. My mom’s idea of camping (or roughing it as she calls it) was a hotel that didn’t have a working air conditioner. When I was a teenager we went camping a couple of times and rented a trailer in a campground beside Darien Lake (a Western New York amusement park). Most of my camping time was spent chasing girls around the park and riding roller coasters. I camped a few more times in high school – which really just meant underage drinking in the woods.
And it always rained. 
Since my teenage years I’ve met many people that had great experiences at the organized extension of my definition of camping – summer camp.
Looking back, I think I missed out.
We plan on sending our boys to overnight camp, likely through 4-H. Through my extension position I’ve had a chance to interact with lots of the camp organizers and I’ve been impressed with what they do for food safety and infection control: It’s not that they never have problems; it’s that they seem to know how to handle things when people get sick.
This management thing and good risk decision making was exemplified by Curt Sinclair, director of a 4-H camp in Illinois. According to The News-Gazette, Sinclair was faced with a difficult decision when a norovirus outbreak hit his camp. With 10 staff and 30 campers ill, he shut down the camp for a week, canceling a session so the site could be cleaned and sanitized and letting the virus run it’s course in the staff.
“I can’t run the camp on Sunday if they’re still contagious,” said Sinclair. “We all need to stay separate. They need to be resting back at home. To run camp would be irresponsible.”
Campers and counselors alike began showing symptoms of the virus — diarrhea, vomiting and general body achiness — early Thursday.
“From about 2 a.m. till 11 a.m. is when we were having most people ill. It ended up being about 10 staff members and then a little over 30 children,” he said.
“The CDC recommends that 48 to 72 hours after you feel better, you should refrain from working in close quarters and in food service,” he said.
“It can spread very rapidly in a group setting with a lot of people. They’re very close, playing with the same hockey sticks,” he said.
“This response to this unfortunate outbreak of a virus is going to reinforce the trust of the public in what we stand for and how we run our operation. It was the right thing to do. (It) will benefit the camp long-term more than if we had tried to wing it somehow,” Sinclair said.
Although details are limited at this point, officials believe sausage from a Frederick County 4-H Country Butchering event back in late January is to blame for an outbreak of salmonella connected back to a benefit pancake breakfast earlier in March in Thurmont, MD.
Sausage that was bought by some guests was tested by the State Health 
Department Laboratory and did contain salmonella.
The Frederick County Health Department is recommending that anyone who still has sausage from the event should get rid of it.