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Outbreak News

Durham, Chatham children get E. coli

BY JIM SHAMP : The Herald-Sun

Nov 2, 2004

DURHAM -- Durham County Health Director Brian Letourneau confirmed Tuesday that the 2½-year-old Durham child was infected with a virulent strain of the common Escherichia coli (E. coli) bacterium. There are various forms of the bacteria, often found in feces and the digestive tracts of mammals, including humans.

Letourneau said the "0157" strain, which has caused diarrhea, vomiting and stomach cramps in the most recent outbreak, appears similar to the 1993 strain that sickened patrons of the Jack in the Box hamburger restaurant chain. More than 600 people, most of them children, became sick in Washington state that year after eating contaminated hamburgers from the chain.

State and county health officials, however, are still trying to pinpoint the cause of the recent outbreak. A children's petting zoo at the N.C. State Fair is suspected in some cases, but Letourneau said it's possible there might be more than one source.

"One of the risk criteria for the investigation is petting zoos, especially for this outbreak," Letourneau said. "People have postulated that the animals will step on their own feces contaminated with this type of E. coli, then come into contact with the child."

The fair, which was held Oct. 15-24, was attended by more than 800,000 people, according to its Web site.

Health officials, who were notified about the Chatham County E. coli case Monday, are looking into whether it's related to the fair, which that child attended Oct. 20. People who have had contact with the child also are being notified, said Vanessa Jeffries, health education supervisor with the Chatham County health department.

Officials have not released any additional information about the children, including where they live.

Besides the Durham and Chatham cases, others have been confirmed in the following counties: five in Wake, four in Mecklenburg, two in Union, and one each in Wilson, Lee, Cleveland, Forsyth and Nash.

But epidemiologists say they have not connected all the identified E. coli cases with the fair.

"It's actually not so uncommon for this type of situation to occur," Letourneau said. "It's not an annual thing for us here in Durham County, but it's been documented before. We have some 42 cases of E. coli problems every year in North Carolina."

State epidemiologist Jeffrey Engel said people should call a doctor immediately if they develop the symptoms associated with E. coli, including diarrhea, bloody diarrhea, severe abdominal cramping, nausea and dehydration. The infection may or may not be accompanied by a low-grade fever, and seizures may accompany such complications as hemolytic uremic syndrome -- a serious concern for high-risk people such as children.

Severe cases of the bacterial infection also can cause kidney failure and even death.

"The best way to reduce the risk of getting E. coli, especially if a friend or family member is sick with the disease, is careful and diligent hand-washing," Engel said Tuesday in a news release. And people also are warned to thoroughly cook meats, wash all fruits and vegetables and clean cutting boards and utensils well.

"Teachers and school officials will want to make sure they have plenty of soap and paper towels for their students," Engel said. "If teachers notice a student who appears to have any of the symptoms associated with E. coli, they should contact the parents as soon as possible."

More on this outbreak: Crossroads Farm (N.C. State Fair) E. coli Outbreak

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