A number of Shiga toxin-producing E. coli (STEC) illnesses are being investigated following last month’s Washington County Fair in Hillsboro, OR. Public health officials announced Wednesday that potential sources were food items unrelated to the fair, as well as contact with livestock at the fair, which was July 28-31. Anyone who attended the Washington County Fair and has had, or develops, symptoms such as severe stomach cramps, diarrhea, vomiting or fever is being advised to call their health care provider. Some STEC infections can be very mild, but others can be severe or even life-threatening, health officials said. “This type of infection is highly contagious even when symptoms are mild,” says Washington County Deputy Health Officer Dr. Christina Baumann. “To prevent the spread of disease, people with diarrhea should stay home while sick and avoid handling food or preparing food for others.” A potentially life-threatening complication known as HUS (hemolytic uremic syndrome) affects a small number of people infected with E. coli bacteria. Young children and people older than 75 are at highest risk for this complication. Signs that a person is developing HUS include decreased urination, feeling very tired, and losing pink color in cheeks and inside the lower eyelids. HUS, if it occurs, often develops after the earlier symptoms of diarrhea have improved. “The best way to prevent getting STEC infection is by washing hands well with soap and water,” Baumann said. “It’s very important to wash your hands after using the bathroom or changing diapers, before preparing or eating food, and after contact with animals or their environments at farms, petting zoos and fairs.” STEC outbreaks at fairs are not uncommon and have been linked to contact with livestock at petting zoos and contamination in fairground buildings. An E. coli outbreak following a fair in Lynden, WA, last year sickened 25 people and hospitalized 10 of them. Health officials concluded that exposure probably occurred in the dairy barn at the fairgrounds. Fairgoers should take the following precautions to keep themselves and their children healthy:

• Do not put anything in your mouth in the animal areas, including food, beverage, pacifiers, toys or hands.
• Leave any unnecessary items outside the animal areas.
• Be aware that objects such as clothing, shoes and strollers can be contaminated with germs in the animal areas.
• Wash your hands thoroughly and often.
• Supervise children to make sure they are washing their hands well.

For more information about E. coli and STEC infection, see the U.S. Centers for Disease Control and Prevention website.

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