Published Date: 2002-08-27 23:50:00
Subject: PRO/AH/EDR> E. coli O157, county fair - USA (Oregon)
Archive Number: 20020827.5168
E. COLI O157, COUNTY FAIR - USA (OREGON)
A ProMED-mail post
ProMED-mail, a program of the
International Society for Infectious Diseases
Date: 27 Aug 2002
From: ProMED-mail <email@example.com>
Source: The Oregonian 27 Aug 2002 [edited]
[Our thanks to Corona Freitag <firstname.lastname@example.org> Medicine Resident at
Oregon Health Sciences University for submitting this article as well. Mod.MPP]
E. coli wave hitting crest
In what is shaping up to be the largest _E. coli_ (O157) outbreak in
Oregon, public health officials Monday [26 Aug 2002] put the number of
confirmed cases in the Eugene-Springfield area at 36, and 6 other cases
await confirmation from lab reports. Monday's slowdown relieved officials,
who saw the number of confirmed cases mushroom over the weekend from 4 to 31.
"It looks like we've hit the crest of the wave of the disease," said Dr.
Sarah Hendrickson, Lane County Public Health officer.
Individuals, however, continue battling symptoms of infection. One more
patient was admitted to Sacred Heart Medical Center in fair condition with
confirmed _E. coli_ symptoms; 2 other patients were in good condition; and
3 infected children who were transferred over the weekend remained at
Doernbecher Children's Hospital in Portland.
Dr. Mel Kohn, state epidemiologist at the Department of Human Services,
warned that there may be additional unrecognized cases of infection and
emphasized that children with bloody diarrhea should not be given
antibiotics, which can promote the development of hemolytic uremic
syndrome. Over-the-counter medications also should be avoided, he said.
In Eugene, public health workers from Portland and Lane County continued
interviewing both infected individuals and members of 2 control groups to
help pinpoint the source of contamination.
Attendance at the Lane County Fair remains the one common denominator among
the infected group, Hendrickson said. "The data is very preliminary, but we
are still looking hard at the animal enclosures." Those areas included a
cattle tent, horse barn and six exposition halls that housed goats, sheep,
rabbits, pigeons, pigs, chickens, ducks, and guinea pigs.
Investigators will use the data they collect from the interviews to trace
the transmission path and to help develop a strategy to prevent future
outbreaks. Determining the contamination pathway "is often a complicated
question," said state epidemiologist Kohn. "We want to be sure to make
decisions based on the best information we have available. That's why we
are putting so much energy into doing a thorough investigation." Kohn
estimated that more firm conclusions as to the source of contamination
would be available later in the week.
Many forms of _E. coli_ are tolerated by the human body. The strain that
causes illness, known as O157:H7, lives in the intestines of healthy
cattle. It is found in undercooked beef, unpasteurized milk and fruit
juices, sprouts, lettuce, sewage-contaminated water, and in farm animals.
Most outbreaks of O157:H7 seem to occur from ingesting contaminated food or
water, but some transmission from animals to humans has been documented. In
2000, outbreaks in Pennsylvania and Washington that were traced to visits
to a dairy farm and a petting zoo resulted in 56 illnesses and 19
hospitalizations. Canada and Great Britain also have reported outbreaks
stemming from farm animal contact.
In 2001, 25 people who attended the Ozaukee County Fair in Wisconsin became
ill from _E. coli_ infection. The outbreak was traced to contact with
cattle and to animals in the fair's petting zoo.
The Centers for Disease Control and Prevention issued guidelines in 2001
for venues that brought the public into contact with farm animals. The Lane
County Fair follows the recommendations, which include making visitors
aware of the possibility of bacterial transmission, separation of farm
animals from food, presence of hand-washing areas with running water, soap,
and disposable towels, and signs emphasizing the need for hand-washing.
That last recommendation is the best preventative available, Hendrickson said.
"There have been Northwest U.S. outbreaks associated with undercooked
hamburger, with raw milk consumption, with swimming lakes, petting zoos,
and with day care centers," Hendrickson said. "Keeping these germs out of
your mouth is the key to not getting sick. Wash your hands before you put
your hands in your mouth. Wash your hands before you eat."
[Byline: Alice Tallmadge]
[The number of outbreaks of this potential lethal pathogen related to
animal contact in a petting zoo is increasing. As stated in the posting,
parents and their children must wash their hands appropriately following a
visit to a petting zoo, and one might consider not taking small children
there at all. This is just as vital as the need to adequately handle and
cook ground beef. - Mod.LL]