The number of E. coli O157:H7 infections in Whatcom County, WA, has been recalculated by federal and state investigators who have been on the scene since last week. As of Monday, May 18, the latest case count is 22 lab-confirmed cases, four cases of hemolytic uremic syndrome (HUS), 10 people hospitalized, and no deaths. Several other potentially related illnesses are also being investigated. for the U.S. Centers for Disease Control and Prevention (CDC), the Washington Department of Health, and the Whatcom County Health Department in Bellingham are calculating these Shiga toxin-producing E. coli (STEC) cases based on lab-confirmed infection and physician-diagnosed HUS cases. The Washington Department of Health is now posting updates on this outbreak each weekday at 3 p.m. PDT. Officials expect that the official case count will be regularly adjusted as the investigation continues. According to DOH, all of those sickened attended the Milk Makers Fest at the fairgrounds in Lynden, WA, between April 21-23, 2015, or were close contacts of them. Most of those sickened were children, including older children who helped set up the event. More than 1,000 children from Whatcom County primary schools attended the fest sponsored by the Whatcom County Dairy Women. Among the featured agricultural exhibits was a farm animal petting zoo. After meeting with CDC officials last week, Milk Makers Fest organizers said they would continue to fully support and participate in the ongoing investigation. DOH and county health officials had asked for CDC’s assistance with the outbreak. The May 15 DOH update stated that a common source (or sources) of the infection is still being investigated through consultation with community health providers to identify cases, interviews with patients and their parents, and results from clinical and environmental laboratory tests. “Health officials expect that it will take several weeks to collect and analyze the information. Even if a common source is not found, potential risk factors will be identified, which will provide information that may reduce the risk of an outbreak in the future,” the update stated. State health officials recommend that anyone who attended the Milk Makers Fest, or has close contact with someone who did, and has signs or symptoms of E. coli infection should see a doctor. It can take 2-8 days after being exposed to E. coli bacteria to develop symptoms. Most people infected with E. coli develop diarrhea (often bloody) and abdominal cramps, and most people recover within a week. However, some illnesses last longer and can be more severe, resulting in HUS, which is a type of kidney failure. HUS can occur in people of any age, but is most common in children younger than five, older adults, and people with weakened immune systems. HUS symptoms can include fever, abdominal pain, pale skin tone, fatigue and irritability, unexplained bruises or bleeding from the nose and mouth, and decreased urination. Anyone with these symptoms should seek emergency care immediately. DOH provided the following precautions for those infected with E. coli or those with a family member infected with E. coli:

  • Wash your hands thoroughly with soap and water immediately after using the restroom or changing a child’s diaper.
  • Wash your hands before and after preparing food for yourself and others.
  • Stay home from school or work while diarrhea persists; most people can return to work or school when they no longer have diarrhea.
  • Special precautions are needed for food handlers, health care workers, and child care providers and attendees. Check with your employer before returning to work, and check with your child’s child care center before resuming child care.

More information from CDC on E. coli O157:H7 is available here.