With the National Western Stock Show opening in Denver on Saturday, and the start-up of county fair season just ahead in Florida, planners of similar events featuring animals and children might look across the pond for some safety pointers.

The United Kingdom’s Heath Protection Agency (HPA) has recently analyzed 55 outbreaks of gastrointestinal diseases linked to petting farms in England and Wales between 1992 and 2009.

According to the report in Emerging Infectious Diseases, pet-farm animal visits during those 17 years in the UK led to 1,328 people being infected with illnesses ranging from severe diarrhea to more serious conditions. One hundred thirteen required hospitalization.

The HPA study is the first of its kind since the UK’s 2009 outbreak at Godstone Farm, when 100 people, mostly children, were infected with E. coli O157:H7.  That outbreak was the subject of an independent investigation headed by Professor George Griffin, director of the Infectious Diseases and Medicine unit at St. George’s, University of London.

The Godstone Farm incident was one of several outbreaks that year in which children became sick after contact with farm animals, particularly in petting farms or petting zoos.  In the United States, National Western was blamed for an outbreak of E. coli O157:H7 involving children from Colorado’s Front Range.

Most of the infections in the UK study involved either E. coli O157:H7 (55 percent) or Cryptosporidium (42 percent).

Outbreaks of cryptosporidiosis occurred more often in springtime, whereas outbreaks of E. coli O157 infection occurred more often in mid to late summer, especially in August.

People of all ages became ill in these outbreaks but children under the age of 10 were disproportionally affected because they are more vulnerable to serious illness from these infections, particularly E. coli O157.

Children under the age of five are also more likely to pick up these infections because of poor personal hygiene–for example, at that age they are more prone to sticking fingers, thumbs or toys into their mouths. 

Contributory factors reported in the outbreaks included direct contact with pre-weaned animals–such as lambs, calves and kid goats–or direct contact with the animal feces of animals such as cattle, sheep and goats.  Inadequate hand washing facilities at the farms was another important factor.

Other risk factors recorded in the study included bottle feeding lambs, thumb sucking by children and reliance on sanitizer hand gels instead of hand washing, which are not effective in killing bugs such as E. coli O157 or Cryptosporidium. 

Dr. Fraser Gormley, lead author of the study and an epidemiologist from the Department of Gastrointestinal, Emerging and Zoonotic Infections at the HPA, said: “Visiting a farm is an enjoyable and educational experience for many people, particularly children.  But it’s important to remember that contact with farm animals carries a risk of infection because of the microorganisms–or germs–they naturally carry.

“Avoiding direct contact with animals and their droppings is the surest way of avoiding infection but appropriate awareness of hygiene and supervision of children by parents and teachers will help to ensure that children do not become ill as a result of farm visits.

“Hand washing is the single most important prevention step in reducing transmission of gastrointestinal infections after handling animals and it’s crucial that hand washing in young children should be supervised, especially after touching or petting animals or their surroundings on a visit to a farm. 

Visitors should also be made aware that using sanitizing gels is not a substitute for washing hands with soap and hot water and drying them, as gels may fail to remove contamination in the way that soap and running water can.  However, it is likely that using sanitizing gels following hand washing with soap and water may provide extra benefit.”

Dr. Bob Adak, study co-author and the head of epidemiological services in the Department of Gastrointestinal, Emerging and Zoonotic Infections at the HPA, said: “We know that visits to petting farms have grown exponentially in recent years and while the risk of developing an infection is very low, this research comes as a reminder that it can happen and it’s vitally important that parents are aware that contact with farm animals can lead to illness.”

Cryptosporidium is a protozoan parasite, which can be transmitted through contact with soil, food, water or surfaces that have been contaminated with infected human or animal feces. The most common symptom is watery diarrhea, which can range from mild to severe. Cryptosporidiosis is most common in children aged between one and five years, but it can affect anyone. People with weak immune systems are likely to be most seriously affected.

Escherichia coli (E. coli) are common bacteria that live in the intestines of warm-blooded animals.  There are certain forms, or strains, of E.coli that are normally found in the intestine of healthy people and animals without causing any ill effects.  A number of E. coli strains cause illness but E. coli O157 is associated with more serious illness.  For the majority of people the infection is usually self-limited and clears within seven days, but children under five are vulnerable to more severe illness.  Symptoms can range from mild through to severe diarrhea, to a serious condition called hemolytic uremic syndrome (HUS) that affects the blood, kidneys and in severe cases, the central nervous system.

National Western, which runs Jan. 8-23, will again feature a free petting farm sponsored by the Denver Post.  In its second year since the outbreak, it has beefed up its warnings to parents about E. coli.  Here’s the National Western website statement on E. coli:

“Escherichia Coli, more commonly known as E. Coli, is a commonly found bacteria in our environment.  It can be found in animals as well as people.  Humans may contact these bacteria from flies, touching a contaminated surface or even shaking the hand of another person.

“It is important to use good hygiene whenever a person has been in contact with public facilities, petting animals and interacting with people in public.  Always take the time to wash your hands before eating or touching you hands to your face.  Use soap and warm water if possible and dry your hands well.  Good hygiene will prevent the spread of this bacteria and keep human cases of E. coli infection to a minimum.”

HPA provides advice for the public on avoiding infection on farm visits, and UK’s Health and Safety Executive provides guidance for those running and visiting petting farms.