2011 North Carolina State Fair E. coli Outbreak At least 27 North Carolina residents became ill with E. coli O157:H7 infections after visiting the N.C. State Fair in October 2011.  Residents of 8 North Carolina counties were part of the outbreak.
Investigators from the N.C. Division of Public Health and the N.C. Department of Agriculture and consumer Services announced that the Kelley Building, which is a permanent structure on the fairgrounds, was the most likely source of the E. coli outbreak.  Sheep, goats and pigs were…

2011 English Animal Farm Outbreak Cruckley Animal Farm in Foston-on-the-Wolds, England is closing its gates permanently following an outbreak of E. coli O157:H7.  The family-run farm was linked to at least six cases of the life-threatening infection as of August 2011.  The owners, John and Sue Johnston, expressed sorrow at the illness and stated that “the health and safety of our visitors has always been our top priority,” thus with the news the farm was the likely source of illnesses, they decided to close.  The…

2011 Snohomish County Petting Zoo At least 6 people who visited the Forest Park Petting Zoo in Everett, Washington, in June 2011 became ill with E. coli O157:H7 infections.  The Snohomish County Health Department investigated the E. coli outbreak and determined that there was a “clear association between disease and being in the open animal interaction area of the forest Park Animal Farm.”  Investigators determined that direct interaction with calves, and indirect exposure to contaminated surfaces were both…

2009 Utah Rodeos Outbreak Utah state and local health officials and the CDC noted a cluster of E. coli O157:H7 cases in the summer of 2009.  The illnesses were associated with attendance to rodeos, but not all the same one.  The vast majority of the 14 cases (93%) had food histories containing ground beef, unsurprising for rodeo visitors.  
However, a traceback on the meat products provided at the rodeos found no contamination.  Environmental samples gathered at the rodeo sites and from the animals did…

2009 Godstone Park Farm and Plan Barn E. coli Outbreak in Surrey, England A final report of the Outbreak Control Committee of the Surrey and Sussex Health Protection Unit describes an outbreak of E. coli O157 (VTEC O157 PT21/28) occurring in August and September 2009.  This was the largest documented outbreak of VTEC O157 associated with farms in the UK.  Individuals became infected either through direct or indirect contact with farm livestock.  Outbreak strains were recovered from humans visiting the farm, animals housed in the petting barns, and…

2009 “Feed the Animals” Exhibit E. coli outbreak at the Western Stock Show In January 2009, the Communicable Disease and Consumer Protection Divisions of the Colorado Department of Public Health noticed an increase is in the number of laboratory confirmed cases of E. coli O157.  Thirty cases were identified—including nine hospitalizations and 2 cases of HUS.  All the children had visited the National Western Stock Show in Denver, Colorado.  A case-control study found the risk of E. coli infection was associated with touching animals in the “Kids Zone”…

2007 Petting Zoo E. coli O157:H7 outbreak in Pinellas County, FL In May and June 2007, seven Florida children were infected with E. coli O157:H7.  Six of the children had visited a Day Camp petting zoo, and the seventh was a sibling.  Two of the children were hospitalized, all seven recovered.  The petting zoo was closed on the recommendation of the health department.  The CDC’s report on the incident was published in its publication, the Morbidity and Mortality Weekly Report (MMWR).

2005 Big Fresno Fair Petting Zoo E. coli Outbreak At least six children were infected with E. coli O157:H7 – one gravely – visiting the petting zoo at the 2005 Big Fresno Fair.  Angela Malos was two years old at the time of her visit to the petting zoo.  She developed HUS (hemolytic uremic syndrome) and was hospitalized for months.  Her kidneys were severely damaged and a series of strokes left her with impaired movement and vision.  Her case settled in 2010 for 2.2 million dollars.

2005 Campylobacteriosis Outbreak Associated with a Camping Trip to a Farm In June 2005, King County Public Health was notified that a several children on a school trip had been ill with diarrhea, abdominal pain, and fever following the trip. Campylobacter was isolated from the stool of the ill individual, and later in the week, two more cases of campylobacteriosis were reported in persons who had been on the same camping trip, held at a private farm. 
Ultimately, fifty percent, or 14 of 28 people on the trip experienced symptoms of campylobacteriosis…

2005 Florida State Fair, Central Florida Fair, and Florida Strawberry Festival E. coli Outbreak The AgVenture Farms E. coli O157:H7 outbreak was first recognized after two separate HUS case reports were reported to the Florida Department of Health in mid-March.  The two cases (a 5-yr-old girl and a 7-yr-old boy) both reported having visited a fair with a petting zoo (AgVenture) a few days prior to becoming ill. The two children visited the same fair and did not have any other common risk factors. 
A total of 22 confirmed, 45 suspect and 6 secondary cases from 20 Florida…

2004 E. coli Outbreak Associated with the North Carolina State Fair in Raleigh In late October 2004 the North Carolina Department of Health and Human Services (NCDHHS) conducted an E. coli O157:H7 outbreak investigation among attendees at the 2004 State Fair. 108 cases were identified with 15 who experienced HUS. The majority of cases occurred in children. This is one of the largest outbreaks attributed to a petting zoo.  Illness was associated with animal contact and hand-to-mouth activities.  One interesting finding was that the use of alcohol-based hand…

2003 Fort Bend County Fair E. coli Outbreak – Rosenberg, Texas In 2003, 25 people (fair visitors and animal exhibitors) became ill with hemolytic uremic syndrome and one case of a related disease, thrombotic thrombocytopenic purpura. All seven laboratory-confirmed cases had an indistinguishable PFGE pattern which matched 10 isolates obtained from environmental samples taken from animal housing areas.  Environmental samples…

2002 E. coli Outbreak at a Petting Zoo in Zutphen, The Netherlands Heuvelink et al (2002) reported that a young child developed a Shiga toxin 2 producing strain of Escherichia coli (STEC) O157 infection after visiting a petting zoo in Zutphen, The Netherlands.  The STEC strains were isolated from the fecal samples from goats and sheep on the farm and were indistinguishable from the human patient isolate.

2002 Lane County, Oregon, Fair E. coli Outbreak The Oregon Department of Human Services (Oregon, 2002) initially documented a patient with bloody diarrhea, who attended the Lane County Fair held during August, 2002. Epidemiologists identified 82 ill persons, 22 who were hospitalized, and 12 with HUS.  This is the largest E. coli O157:H7 outbreak recorded in Oregon.  Although not confirmed, health officials postulated that possible exposures leading to the outbreak occurred at animal enclosures, including the cattle tent, horse…

2002 Wyandot County, Ohio, Fair E. coli Outbreak The Ohio Wyandot County Health Department received a report of an E. coli O157 outbreak in September, 2001 (CDC memorandum, February, 2002). A total of 92 cases were identified, including 27 laboratory-confirmed E. coli O157 infections. Two cases were diagnosed with hemolytic uremic syndrome. Eighty-eight cases reported attending Wyandot County Fair before becoming ill. The source of the outbreak was not fully identified; however, the most likely source was believed to be contact…

2001 Lorain County, Ohio, Fair E. coli Outbreak The Department of Health and Human Services, Public Health Services (CDC memorandum, February, 2002) reported that 23 cases of E. coli O157:H7 infection were associated with the attendance at the Lorain County Fairgrounds in September, 2001. Additional cases were identified as likely due to secondary transmission from attendees at the fairgrounds. An investigation associated illness with environmental contamination at the Cow Palace. This included attending a dance in the…

2001 Ozaukee County, Wisconsin, Fair E. coli Outbreak The Ozaukee County Public Health Department and Wisconsin Department of Health and Family Services (2001) investigated an outbreak of E. coli O157:H7 associated with animals at the Ozaukee County Fair in August, 2001. A total of 59 E. coli O157:H7 cases were identified in this outbreak, with 25 laboratory confirmed cases (25 “primary cases” and 34 probable cases). Bacteriological testing of water at the Ozaukee County fairgrounds and the Fireman’s park did not indicate…

2001 E. coli Outbreak at a Petting Zoo in Worcester, Pennsylvania An article published by WebMD Medical News on April 23, 2001 (Bloomquist, 2001), reported an outbreak of E. coli O157:H7 among visitors to the Merrymead Farm petting zoo in Worcester, Pennsylvania. In all, 16 children who had visited the zoo contracted E .coli, and it was suspected that another 45 people became ill from the bacteria.  The report indicated that one week after visiting the zoo, one of the children came down with violent stomach cramps and was hospitalized.  A few…

2000 Cryptosporidiosis Outbreak at a Farm in Wellington, New Zealand An outbreak of Cryptosporidiosis was linked to a two-day farm educational event in the Wellington region of New Zealand. Twenty-three cases were laboratory-confirmed. The route of infection was most likely from an infected animal. (Stefanogiannis et al, 2001).

2000 E. coli Outbreak at a Dairy Farm Crump et al (2002) discussed an outbreak of E. coli O157:H7 among visitors to a dairy farm in Pennsylvania in September, 2000. A case control study among the visitors was conducted to identify the risk factors of infection, along with a household survey to determine the rates of diarrheal illness. The total number of confirmed or suspected E. coli O157:H7 cases was 51. The median age among the patients was four. Eight of the cases developed hemolytic uremic syndrome (HUS). The…

2000 Snohomish County, Washington, Petting Zoo E. coli Outbreak The Snohomish Health District, Communicable Disease Department (June, 2000) reported five cases of bacterial diarrhea caused by E. coli O157:H7 in children in Snohomish County in May 2000. Three of the children visited a petting zoo several days before they became sick. The fourth child did not visit the petting zoo, but lived on another farm where cattle were raised. An ensuing investigation of the farm by Snohomish Health District (SHD) and by the Washington Department of…

2000 Medina County, Ohio, Fair E. coli Outbreak A cluster of E. coli O157:H7 isolates was observed in Medina County, Ohio, in August of 2000. In the case-control investigation, 43 culture confirmed E. coli O157:H7 cases were identified. The environmental investigation suggested that contamination of a section of the water distribution system supplying various vendors was the likely exposure. Water samples collected for this study did not indicate any coliform bacteria. But, a subsequent Halloween event arranged on the same…

1999 E. coli Outbreak at a Social Event in a Cow Pasture in Petersburg, Illinois An outbreak of E. coli bacteria was reported in Petersburg, Illinois, in 1999 (Nando Times, 1999). The outbreak took place among 1,800 people who attended a party called “Cornstalk” held in a cow pasture.  State health officials reported that 202 individuals became ill, and that 20 were hospitalized. However, none of the reported illnesses were considered serious.  The source of contamination was not identified.

1999 E. coli Outbreak at an Agricultural Fair in Ontario, Canada Warshawsky et al (2002) investigated an outbreak of E. coli O157:H7 associated with a large agricultural fair which occurred between September 10 and September 19, 1999, in Ontario, Canada. The 7 cases of E. coli O157:H7 were associated with animal contact at the agricultural pavilion of the regional fair. Subtyping revealed that five of the seven cases were an uncommon E. coli O157:H7 strain (PT 27) while the remaining two were a more common strain (E. coli O157:H7 PT 14).  The…

1999 Washington County, New York, Fair E. coli and Campylobacter jejuni Outbreak The New York State Department of Health investigated one of the largest waterborne E. coli O157:H7 outbreaks in United States history.  The outbreak occurred at a fair in Washington County, New York, in August of 1999 (New York State Department of Health, March, 2000).  E. coli O157:H7 and/or Campylobacter jejuni infections were identified among 781 persons.  Of these cases 127 persons were ill with E. coli O157:H7, 71 individuals were hospitalized, 14 persons exhibited hemolytic…

1999 E. coli Outbreak at a Fair in North Wales, London Payne et al (2003) reported an outbreak of Vero toxin (Shiga toxin) producing E. coli O157:H7 (VTEC O157:H7) causing gastroenteritis among people visiting an open farm in North Wales, London in June 1999.  A case-control study identified an association between attendance on the second day of the festival, eating ice cream or cotton candy and contact with cows or goats and illness.  Investigators suggested that foods on open farms should only be eaten in the dedicated clean areas,…

1998 E. coli Outbreak at an Agricultural Fair in British Columbia, Canada The British Columbia Center for Disease Control observed a cluster of E. coli O157:H7 infections.  Subsequent molecular subtyping identified nine isolates with an indistinguishable genotype pattern.  Three individuals were hospitalized, though none developed hemolytic uremic syndrome (HUS).  Seven of the nine had an onset of illness within ten days of visiting a large agricultural fair.  Despite in-depth interviews, no common source of infection could be identified.

1998 Puyallup, Washington Fair E. coli Outbreak An outbreak of hemorrhagic colitis due to E. coli O157:H7 was identified among visitors to the Puyallup Fair in Puyallup, Washington, during September of 1998 (CDC Memorandum, March 1999). Two children were initially confirmed as being ill from E. coli O157:H7.  The investigation identified three confirmed and five probable cases of E. coli O157:H7 illness.  Investigators suspected illness was due to consumption of contaminated hamburgers. However, animal contact also occurred…

1998 Wisconsin County Fair Swine Flu Case In September 1988, a woman was fatally infected with swine influenza virus in Wisconsin.  The victim had attended a county fair and visited the display area of the pig barn. Veterinarians at the fair indicated that pigs in the display area had illnesses consistent with swine influenza.  (Wells et al., 1991)  The case likely acquired influenza infection through direct transmission from pigs at the fair (see additional information about swine influenza and County Fairs).

1997 Minnesota Zoo Cryptosporidiosis Outbreak In July 1997, the Minnesota Department of Health (MDH) reported an outbreak of cryptosporidiosis among children who visited the Minnesota Zoo (MMWR Weekly, October, 1998). A total of 369 cases were reported, of which 73 had Cryptosporidium identified from stool samples.  The onset of illness (i.e. vomiting or diarrhea) occurred 3 to 15 days after exposure to the contaminated zoo fountain.

1997 E. coli Outbreak at Farms in Cornwall and West Devon, United Kingdom Milne et al (1999) investigated an E. coli O157:H7 outbreak associated with a farm in the United Kingdom during June and July, 1997. A Vero cytotoxin producing Escherichia coli O157:H7 infection was observed in three children, one who lived on an open farm and two who visited the farm during school parties. Two of the three children developed HUS: one with severe neurological impairment.  Isolate patterns from the three children and environmental samples were indistinguishable by…

1995 Cryptosporidiosis Outbreak at a Farm in Dublin, Ireland Sayers et al (1996) reported a Cryptosporidium outbreak during the summer of 1995, involving 13 children. The children had participated in a summer project and visited an open farm in Dublin, Ireland. The investigators concluded that the outbreak was associated with playing in the sand on a picnic area beside the stream where animals had access. This outbreak emphasizes the potential risk associated with children visiting open farms.

1995 Cryptosporidiosis Outbreak at a Farm in Wales, United Kingdom In April 1995, an outbreak of Cryptosporidiosis was reported among 43 children and four staff who visited a rural farm (Evans and Gardner, 1996). The likely source of infection was contact with the calves.

1994 E. coli Outbreak at a Farm Visitor Center, Leicestershire, United Kingdom Shukla et al (1995) investigated an outbreak of seven cases of E. coli O157:H7 infection associated with a visit to a farm in Leicestershire, United Kingdom, during the summer of 1994.  The ensuing investigation found that the common factor linking all the cases was a visit to a farm visitor center in the three weeks before the onset of the illnesses. The microbiologic data supported this link, as the strains of E. coli O157:H7 isolated from nine animals on the farm were…