Colorado State University Extension
SafeFood Rapid Response Network


SAFEFOOD NEWS - Fall 1999 - Vol 4 / No. 1

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From County Fair to Cow Pasture:
E. Coli O157:H7 in the News

In September, three unrelated water/food-borne outbreaks made E. coli O157:H7 headline news across the nation.

New York County Fair:

The largest outbreak occurred in New York State, where hundreds of people who had attended the Washington County Fair in Albany, NY, became sick. As of September 17, 1999, the New York State Health Department had reported a total of 1,013 suspected and confirmed cases of E. coli O157:H7 infection resulting from this outbreak. Of these, 122 cases had been culture-confirmed through a special laboratory test, 65 people had been hospitalized, 11 children had developed Hemolytic Uremic Syndrome, a severe complication of E. coli infection, and two people had died (a 3-year old girl and a 79-year old man). Nearly all individuals are thought to have consumed water (or products made with water) piped from a contaminated well serving the Fair. In addition to the primary cases, about 10 secondary cases have been reported in which the infection was spread from person to person because of poor sanitary practices.

Using a type of DNA testing, state health officials matched the strain of E. coli O157:H7 in 12 water samples from a contaminated well on the Washington County fairgrounds to the E. coli bacteria recovered from 25 patients. As the Health Department noted, "The technique proves beyond a doubt that these 25 individuals were infected with bacteria whose DNA are identical to E. coli O157:H7 recovered from the fairgrounds' water supply." It is believed the well became contaminated from animal feces, though the specifics as to how this occurred are still being investigated.

The New York State Health Department has responded to the outbreak by issuing a summary order directing managers of fairgrounds without public water supply systems to:

• Assess water systems prior to holding any public events on the fairgrounds;
• Disinfect systems through chlorination or other measures;
• Monitor water supplies prior to the start of public events; and
• Monitor water supplies daily during public events.

To help prevent secondary transmission of the infection, the NY Health Department sent letters to schools and day care centers emphasizing the need to exclude symptomatic children and practice careful handwashing. Letters were also sent to nursing homes and hospitals with recommendations regarding employees and residents with diarrhea.

Petersburg, Illinois Corn Fest:

Over 300 people, including 22 who were hospitalized, became infected with E. coli O157:H7 after attending a September 4 concert and cookout in a cow pasture near Petersburg, Illinois (approximately 25 miles northwest of Springfield, Illinois). Approximately 1,800 people attended the free event. After analyzing environmental samples as well as food and water served at the party, Health Department officials have traced the source of the outbreak to beef served at the party.

Battle Ground Lake, Washington:

This outbreak occurred in Clark County, Washington, and has been connected with swimming at Battle Ground Lake. The outbreak has mainly affected children (median 5 years of age). As of September 9, there were approximately 30 outbreak-related, laboratory-confirmed cases of E. coli O157:H7 infection. Of these, 24 reported swimming in Battle Ground Lake, one reported playing in the sand adjacent to the swimming area, and 5 were in contact with others who had been swimming in the lake. Seven children were hospitalized as a result of the outbreak and three developed Hemolytic Uremic Syndrome. The lake has been closed to all activities (swimming, boating, and fishing) since the outbreak surfaced.

Take Home Message for Organizers of Rural Events:

Although these outbreaks were all caused by the same health-threatening strain of E. coli and took place in rural areas, the medium of contamination was different in each case: well water, food, surface swimming water. The deaths and litigations coming out of the New York county fair outbreak are enough to make any organizer of a community event take pause. Prior to any community event, it is important to have non-public water supplies tested for coliforms and E. coli bacteria. In addition, the Centers for Disease Control and Prevention (CDC) suggests a number of actions that can be taken to prevent E. coli infection:

• Avoid swallowing lake or pool water while swimming.
• Thoroughly cook ground beef. If you are served an undercooked hamburger or other ground beef product in a restaurant, send it back for further cooking. You may want to ask for a new bun and a clean plate, too.
• Make sure that persons with diarrhea, especially children, wash their hands carefully with soap after bowel movements to reduce the risk of spreading infection, and that persons wash hands after changing soiled diapers. Anyone with a diarrheal illness should avoid swimming in public pools or lakes, sharing baths with others, and preparing food for others.
• Avoid spreading harmful bacteria in your kitchen. Keep raw meat separate from ready-to-eat foods. Wash hands, counters, and utensils with hot soapy water after they touch raw meat.
• Drink only pasteurized milk, juice, or cider.
• Wash fruits and vegetables thoroughly, especially those that will not be cooked. Children under 5 years of age, immuno-compromised persons, and the elderly should avoid eating alfalfa sprouts until their safety can be assured. Methods to decontaminate alfalfa seeds and sprouts are being investigated.

Sources: Christina Stark and Donna Scott, Cornell Extension; NY State Health Department press releases, 9/13/99, 9/17/99; MMWR, 9/17/99; E. coli in Drinking Water fact sheet: http://www.epa.gov/safewater/ecoli.html

Updated Monday, August 29, 2011