Two E. coli outbreaks with possible ties to petting zoos expanded Monday. In North Carolina, the number of illnesses linked to the Cleveland County Fair rose from 101 to 106, while a smaller outbreak linked to a Washington state pumpkin patch and petting zoo venue grew from 2 victims to 4. A total of 64 children and 42 are now known to have contracted E. coli infections linked to the Cleveland County Fair, announced the The North Carolina Department of Health and Human Services’ Division of Public Health in a press release Monday. One victim, a two-year-old boy from Gaston County, died due to complications of his infection. Preliminary findings from state and local health department investigations show that animal exposure was a likely source of the bacteria, says the agency. Cases by region are as follows:

Cleveland County – 61

Gaston County – 18

Lincoln County – 14

Catawba County – 1

Mecklenburg – 1

Union County – 3

Rutherford – 4

York County, South Carolina – 2

Cherokee County, South Carolina – 2

Meanwhile, in Washington state, two more E. coli infections were linked to the Willow Grove pumpkin patch and petting zoo in Cowlitz County, adding to the pair of illnesses already tied to the venue. All four victims were children under age 10, Cowlitz County Health Department’s clinical services manager Hilary Gillette-Walch reported to the Longview Daily News. One of the children is known to have been hospitalized for several days but has been released and is recovering, reported the health department. Willow Grove Gardens is an organic farm located in Longview, WA. The affected children visited the establishment between October 10 and  20 and fell ill between October 12 and 22, Gillette-Walch told Longview Daily News. The Cowlitz County Health Department warns anyone visiting a petting zoo to wash their hands thoroughly with soap and water immediately after touching animals. Parents should make sure their children do not touch their eyes, nose or mouth while in an area where animals are housed. “If a hand-washing station is not available, do not have any contact,” advises the department.