Published Date: 2003-08-23 23:50:00
Subject: PRO/AH/EDR> E. coli O157, petting zoo - USA (PA): confirmed
Archive Number: 20030823.2128
E. COLI O157, PETTING ZOO - USA (PENNSYLVANIA): CONFIRMED
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Date: Fri, 22 Aug 2003
From: Marguerite Hawkins <marguerite.hawkins@phila.gov>
Child 1 was a 3-year-old female who visited the zoo for a party on 26 Jul
2003, became ill on 2 Aug, and was culture-positive for _E. coli_ O157:H7
on 3 Aug 2003. She was evaluated in the Emergency Dept. and released. The
culture result was reported to the Dept. of Health on 7 Aug 2003. The only
risk factor identified was being at the zoo, although the mother denied that
her child had petted any animals [there].
Child 2 was at the zoo on 27 Jul 2003, became ill on 2 Aug, and had a stool
culture positive for _E. coli_ O157:H7 on 5 Aug 2003. She was admitted to the
hospital and discharged on 7 Aug 2003. The culture result was reported to
the Dept. of Health on 13 Aug 2003. Investigation revealed that the child's
risk factors included eating a steak in the week prior to illness (purchased
at a grocery store and prepared by the mother, who reported it was not pink
in the middle) [i.e. it was well cooked] and visiting the Philadelphia Zoo,
including the petting area.
At finding a potential common exposure (the zoo), we contacted the zoo
veterinarians (15 Aug 2003). Despite biannual testing of all of their
animals, they elected to close the areas in which humans come in contact
with animals until further evaluation and investigation were completed.
On both 16 and 19 Aug 2003, the zoo performed rectal swabs on the animals
(all animals were swabbed twice, 3 days apart). The specimens collected on
16 Aug were sent to the Philadelphia Dept of Public Health for culture, and
those collected on 19 Aug 2003 were done at the zoo. No cultures were
positive for _E. coli_ O157:H7 at either laboratory.
No new cases of _E. coli_ were reported to the Philadelphia Dept. of Public
Health following the cases of these 2 children; nor were any cases
identified in the surrounding counties. The cases were reinterviewed, and
no other risk factors for infection were identified. Both have recovered
without sequelae.
We concluded that this was not a common-source exposure, and the zoo
reopened its petting areas yesterday, 21 Aug 2003.
--
Marguerite Hawkins, MD, MS
Medical Epidemiologist
Philadelphia Dept of Public Health
Philadelphia, PA
<marguerite.hawkins@phila.gov>
[ProMED thanks Dr. Hawkins for contributing this information.
No positive cultures from the petting zoo denizens were found, and 1 of the 2
children had another potential source -- the steak. As noted in ProMED-mail
posting 20030701.1617 referenced below, steaks are a less common source of
the organism, although the injection of the steaks with tenderizers and
flavor enhancers could introduce organisms from the surface into the inside
of the meat, where inadequate cooking -- denied in this case -- could allow
bacteria to survive. In any case, the zoo appears to have been exonerated. -
Mod.LL/JW]
See Also
E. coli O157, petting zoo - USA (PA): suspected 20030821.2100E. coli O157, frozen steaks - USA (Midwest): recall 20030701.1617
2002
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E. coli O157, petting zoo - New Zealand 20020724.4849
2000
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E. coli, petting zoo - USA (Pennsylvania) 20001105.1929
E. coli O157, petting zoo - USA (Washington) 20000609.0925
1999
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E. coli, VTEC, cattle, petting zoo - Canada (Ont.) (02) 19991016.1840
E. coli, VTEC, cattle, petting zoo - Canada (Ontario) 19991012.1821
E. coli, VTEC, open farm - UK (Wales) 19990627.1090
E. coli, VTEC, open farm - UK (Wales) (02) 19990709.1149
.............ll/pg/jw
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