Public health investigators from the N.C. Department of Health and Human Services have determined that the petting zoo at the Cleveland County Fair was the initial source of exposure to E. coli that resulted in 106 illnesses and one death. According to results presented today in Shelby, weather may be one of the factors that played a role in widespread contamination of the area surrounding the petting zoo exhibit.
“Our sincerest sympathies go to those families that have experienced illness and loss in this outbreak,” State Health Director Laura Gerald said. “Our goal in this and any other public health investigation is not to assign blame, but to identify how to prevent this kind of event from happening again.”
E. coli are naturally occurring bacteria that normally live in the intestines of people and animals. While most E. coli are harmless, the shiga toxin producing E. coli (STEC) type identified in this outbreak is very infectious and can easily cause illness. Ruminant animals, such as sheep, goats and cows, are natural hosts for STEC.
Despite stringent protocols at agricultural fairs in North Carolina, transmission of E. coli is still possible. As a result of recommendations following the public health investigation of an E. coli outbreak at the North Carolina State Fair in 2004, the N.C. General Assembly enacted Aedin’s Law, which outlines specific measures governing animal contact exhibits at agricultural fairs to protect public health and safety. Those measures, monitored by the N.C. Department of Agriculture and Consumer Services, include fencing and staffing around exhibits, education to inform the public of health and safety issues, and adequate hand washing facilities. Vigilant hand washing after animal exposure is an effective method to reduce transmission of illness.
The Cleveland County investigation, which began October 8, involved a case control study of those who became ill as well as an additional 160 individuals who attended the fair but did not become ill. Local health department personnel in Cleveland, Gaston, Lincoln, Catawba, Rutherford and Union counties conducted 266 extensive interviews in the weeks following the outbreak.
In addition to the case control study, analysis by the State Laboratory of Public Health and United States Department of Agriculture confirmed two specific strains of E. coli in cases from the outbreak that were matched to environmental samples taken from the fairgrounds. Investigators noted that heavy rains during the run of the fair, from September 29 through October 8, resulted in runoff that may have spread contamination from the petting zoo into nearby areas.
Cleveland County Fair officials have cooperated fully in the investigation and as of October 19, announced that all public events at the fairgrounds would be closed pending the completion of the public health investigation.
“An investigation of this size and scope requires a team effort and our local health departments have done outstanding work,” Gerald said. “We look forward to working with local and state partners as well as fair officials to identify recommendations to reduce the risk of exposure to future fairgoers.”