Florida Officials Seek a Link in 15 Cases of a Kidney Illness

Epidemiologists are trying to triangulate multiple cases of hemolytic uremic syndrome (HUS) that have recently surfaced in Florida to see if they can be associated with a single point source. Along with the 14 confirmed cases, state health officials are investigating seven others around the state, including one involving the death of a girl in Pasco County.
Officials at various Florida hospitals told The Associated Press that they knew of nine children with HUS who had visited petting zoos at the Central Florida Fair in Orlando or the Florida Strawberry Festival in Plant City, but Florida’s secretary of health Dr. John O. Agwunobi said it was “too early to point to one single element, such as a petting zoo.”
The number of cases under investigation has grown to 21, and an etiological agent common to all or most cases has yet to be identified.
There have been previous outbreaks associated with petting zoos, notably one at the North Carolina State Fair last year, in which 180 people were reported sick and 15 developed HUS. The virulent bacteria strain that causes HUS, known as E. coli 0157:H7, lives in the guts of cattle, sheep, goats and other ruminants, and can be picked up by petting or nuzzling the animals, or simply touching one’s shoes after walking through manure. The disease is most dangerous to children under 5 and the elderly, and can be transmitted in many settings, Dr. Agwunobi said, including pony rides, rodeos, livestock displays, milking demonstrations, hayrides and pig races.
Many other dangerous bacteria are found on petting animals and poultry. Snakes, for example, often have salmonella on their skins, and animal feces may contain campylobacter, shigella, giardia and cryptosporidium. Young animals and birds are the most likely to transmit infections.
The petting zoos at the two festivals remain the focus of the investigation, but under cooked foods or other sources linked to the animals at the petting zoos are still being investigated.
HUS can cause bloody diarrhea and can lead to the kidneys, overwhelmed by toxins, shutting down. In rare cases, it can require dialysis or a kidney transplant. Three percent to 5 percent of cases are fatal. There were about 73,000 infections nationally with the E. coli strain last year; of those, 61, or less than one-tenth of 1 percent, were fatal.