NC health director Laura Gerald said today that reported cases linked to the Cleveland County (NC) fair rose to 106 including secondary cases.  Tragically, Gage Lefevers died early this week and an additional 12 individuals have been hospitalized as a result of the outbreak.

In 2009 I had a Campylobacter infection. Not sure of the source, but I was part of an outbreak of at least 2. Jack, who was then 1, also caught the bug. He displayed symptoms 13 days after my first diarrheal explosion. Suffering from a foodborne pathogen-related illness often leads to someone cleaning up your vomit and loose poop – which has a tendency to spread everywhere. Or your 1-year-old sticks his hands in the toilet while you shower. That’s how secondary cases occur.

According to Steve Lyttle of the Raleigh News & Observer,

Officials have interviewed more than 150 people who attended the fair but did not get sick. Gerald said investigators also have tested the soil at the fairgrounds.

“While we are making progress in our investigation, we have not yet determined a specific cause,” she says. “We may not be able to pinpoint a single source, but hope to have more conclusive results within a month.”

A table of petting zoo outbreaks is available at http://bites.ksu.edu/petting-zoos-outbreaks,  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. 2012 Jul 30. doi: 10.1111/j.1863-2378.2012.01531.x. [Epub ahead of print]