The Whatcom County Health Department (WCHD) is investigating an outbreak of shiga toxin-producing E. coli O157 associated with the Milk Makers Fest that was held at the Northwest Fairgrounds in Lynden on 4/21 –4/23/15.

Over a thousand primary school children from all of the school districts in Whatcom County attended the event. Most of the cases involve children who attended the event. Several older children involved with the event and some adults and close contacts of cases have also become ill.

WCHD is continuing to interview cases to determine if there was a common food or water source or activity, such as the petting zoo or other contact with livestock.

Washington State Department of Health Communicable Disease Epidemiology is assisting with the outbreak investigation.

Cumulative total: 22 cases* (7 cases have been hospitalized), 19 probable cases ** At least one child has developed hemolytic uremic syndrome (HUS).

*Cases include those with positive labs (preliminary presumptive positive O157 and final confirmed positives), and clinical cases with close contact with a case with positive or presumptive positive labs. ** Probable cases are cases with clinical symptoms and were associated with the event, but lab results are not available or labs were not done.

It is certainly not like we have not seen this before:

For more information on the risks of zoonotic exposures, see Fair Safety Dot Com.

According to WCHD, shiga toxin-producing E. coli (STEC) infections are caused by bacteria found in the guts of many mammals, some of which can cause severe infections. It takes only a relatively few (hundreds) of bacteria to cause infection. The bacteria can contaminate food, water, or surfaces where they can go from hand to mouth. Secondary cases are common among household members. Illness occurs 1-8 days after infection, and can be mild or severe. Symptoms include cramping diarrhea, which can become bloody after a few days. Usually there is no fever, or only a low grade one. Maintaining hydration can reduce the risk of complications. Severe disease can result in hemolytic-uremic syndrome (HUS). Antibiotics and antimotility (antidiarrheal) medicines can increase the risk of HUS in STEC infections.

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