UPI also did an article on the trickling in of lawsuits in the outbreak of kidney failures among children who have visited petting zoos in Florida. Statewide, there are 24 confirmed cases of E.coli infection and 40 suspected cases.
The lawsuits allege Ag-Venture should have done a better job protecting visitors from the bacteria and merely cautioning them to wash their hands was not enough.
"The reality is, trying to keep their hands washed constantly, not just wiping them down with a handy wipe -- it's a very difficult task," said Seattle attorney Bill Marler, who filed one of the suits.
As the Times reported in their article "Seattle lawyer says his client may join other cases against Ag-Venture Farm Shows," Marler Clark filed a suit on behalf of Yvonne Miller, an Orlando mother of three, alleging Ag-Venture should have done a better job protecting fairgoers from exposure to pathogens.
As the number of people who have fallen ill after attending festivals in Orange and Hillsborough counties continues to rise, lawsuits are trickling in. The Times reports that in Orange County, where the majority of the stricken live, at least three lawsuits have been filed against Plant City-based Ag-Venture Farm Shows, the suspected source of the bacteria outbreak. Ag-Venture provided petting zoos at the Florida Strawberry Festival in Plant City, the Florida State Fair in Tampa and the Central Florida Fair in Orlando.
Statewide so far, there are 24 confirmed cases of E. coli infection - 20 of which have been linked to the same source - and 40 suspected cases, Florida Health Secretary John Agwunobi said Monday. Lab tests showed that the strain of E. coli that Miller contracted matched genetically with the 19 others. As I told the Times reporter, I may join lawyers who have also filed lawsuits on behalf of other victims to consolidate the cases.
From the article:
Meanwhile, Marler, the attorney, said petting zoos need to do more to prevent outbreaks, and that it is difficult for parents to keep toddlers' hands out of their mouths.
"They're sitting in ICU with their kids on dialysis and they're hearing it's their fault for not having their kids wash their hands," he said."The reality is, trying to keep their hands washed constantly, not just wiping them down with a handy wipe, it's a very difficult task. In these kinds of scenarios, where it's basically an animal free-for-all, you can't expect hand washing to be perfect."
Marler said in 2002, at the Oregon State Fair, there wasn't a petting zoo, but 85 people who walked through a small animal barn fell ill.
"I represented kids who never got out of their strollers," he said.
Marler added that he wants to see stricter guidelines imposed on petting zoos, like keeping them cleaner, having hand-washing stations with hot water and posting more signs warning parents of the risks.
"We're just not doing enough to protect the kids," he said. "Frankly, the industry isn't doing enough to protect itself."
A seventh child in central Florida has contracted a life-threatening kidney infection after visiting a petting zoo in Orlando. Five of the seven children were hospitalized in critical condition, including one on dialysis, the Orlando Sentinel reported for Thursday editions. Another had been upgraded to stable condition, said Dr. Mehul Dixit, who is treating some of the children at Florida Hospital Orlando.
One child was treated and released from Arnold Palmer Hospital for Children & Women several weeks ago.
The potentially dangerous kidney condition -- hemolytic uremic syndrome, or HUS -- is a rare complication arising from an initial infection most commonly associated with E. coli, a bacterium found in undercooked beef or contaminated food.
Symptoms include bloody diarrhea, lethargy, anemia and decreased urine output are all signs of kidney failure.
The hospitalized children all touched animals recently at area fairs, including the Central Florida Fair in Orlando and the Florida Strawberry Festival in Plant City. They might have been exposed to the bacteria through the animals' feces, officials said.
As the Associated Press reported yesterday, I filed my lawsuit against Crossroads Farm Petting Zoo Friday on behalf of my clients whose young children got HUS from E. coli contamination at the North Carolina State Fair. Some of these families have more than $100,000 in medical bills, so this won't be a cheap lawsuit. Not that HUS cases ever are.
And not that there's any amount of money in the world that could restore what these families have lost. One family had two preschool boys who became severely ill, with one boy hospitalized for 10 days and the other for 17 days. All of the children involved in the lawsuit were 3 or younger.
As the AP reports:
"Twenty-four outbreaks have been linked to fairs and petting zoos since 1995," Marler said after the lawsuit was filed. "At this petting zoo, procedures were woefully inadequate to prevent an outbreak."
North Carolina health officials announced Thursday that the Crossroads Farm Petting Zoo exhibition at the state fair in October. This was a heartbreaking outbreak -- one that caused 15 young children to get HUS. Four out of the 15 are still on kidney dialysis. Half of the 108 people infected with E. coli were 5 years old or younger, and two-thirds were under 18.
As the Associated Press reported yesterday:
Health inspectors found that those infected at the State Fair were most likely to have fallen down in manure, touched manure, stepped on manure or had animals jump on them.
Children who were sucking their thumbs or pacifiers or drinking from a sippy cup while visiting the petting zoo were also more likely to be infected, the report said.
The report said Crossroads Farm Petting Zoo "had implemented guidelines from a national group of public health veterinarians to encourage hand hygiene to protect visitors from illness. Signs and hand sanitizing stations were present."
However, because very few E. coli bacteria can cause infection, those measures were not enough, the report said.
I was featured in the Food Protection Report (December 2004 Vol. 20 No. 12), talking about E. coli O157:H7 and fair outbreaks, specifically regarding the prevention measures taken after the 2002 Lane County outbreak in Oregon... and how kids are still getting sick, even when the fair-runners do everything right.
"I think counties and states may have to reassess whether it is worth having fairs, petting zoos, and other events that bring people in close contact with animals," suggests prominent food litigation lawyer William Marler of the Seattle law firm Marler Clark. "I know it sounds un-American, but we are now having outbreaks of E. coli O157:H7 linked to these events almost on a yearly basis," Marler told Food Protection Report.Infections picked up at events where people and animals mingle can spread throughout the community. Since 1998, at least seven E. coli O157:H7 outbreaks have been traced to fairs. The most recent outbreak occurred in North Carolina, where an investigation is ongoing.
Although the specifics of each E. coli outbreak at fairs differ, Marler says, they all have a common denominator and the pathogen lurks in ways that were not seen decades ago. A 2003 study by USDA found E. coli O157:H7 was not only commonly present at fairs but that levels of the bacteria were similar to those found in commercially reared livestock, which surprised researchers.
The Seattle firm filed suit on behalf of 12 families against lane county, Oregon, where an August 2002 county fair was identified as the source of the state's largest outbreak of E. coli O157:H7, which sickened at least 80 confirmed cases. The lawyer also is representing at least two cases in North Carolina.The Oregon suit was withdrawn in mid-October 2004. "We could not prove the exact form of E. coli transmission," Marler told FPR of the decision to drop the lawsuit. "We could not determine if it was indeed airborne transmission, or whether it was foodborne, caused by having animals in close proximity to people, or a combination of those and other factors." Lane county officials said plaintiffs could not show what the state could have done to prevent the outbreak.
Oregon health officials initially ruled out foods and beverages served at the fair as the cause of the outbreak, and speculated that direct exposure to infected sheep, goats and pigs may have been the culprit. They also suggested dirt and dust may have contaminated dry fecal material infected with the bacteria, which could have been inhaled by visitors. But two years after the event, no one knows exactly how the outbreak occurred.
Short of a ban, counties and states can do several things to protect consumers, Marler suggests. "You can test animals to see if they carry E. coli O157:H7, and if they do, exclude them from human contact," he said. In addition, through sanitation, careful tending of animal bedding to prevent dust, plenty of hand washing stations for visitors and employees, posting signs explaining the importance of hand washing, and not selling or allowing foods close to areas where animals are on display can lessen the risk of disease outbreak.
Following the 2002 Lane County outbreak, Oregon issued recommendations to prevent disease outbreaks at fairs, but it is unclear how many counties have adopted them. "We have 35 fairs in Oregon annually, and some of them have, generally, adopted the recommendations, but it's hard to know how many actually have done so. It's probably been a mixed bag," said William Keane, epidemiologist, Oregon Department of Human Services, told FPR. "We don't have the authority to require fairs to comply with our recommendations," he said. "Oregon doesn't have such authority because the legislature has chosen not to do that," Marler said.
Lane County did adopt measures to better manage human contact with animals, increase public awareness of risks, and improve sanitation, as recommended by the state, and the county has not had any fair-related illnesses since then.
But Marler said that even if all preventive steps are taken, outbreaks can still occur. "We may have to rethink whether fairs and other venues are something we really have to have," he said. Marler Clark has set up a web site www.fair-safety.com to increase awareness of the issue.
As Randi Bjornstad of The Register-Guard reported in the article Back from the Brink: Families of children who contracted E. coli count blessings -- and bills, I've advised my clients to drop their lawsuits regarding the E. coli outbreak at the 2002 Lane County Fair. Not an easy decision, for me or for my clients, but after doing a lot of research and taking dozens of depositions of Lane County officials, family members of those affected by the outbreak and field experts, I saw no other choice.
From the article:
In 2002, when the Lane County outbreak happened, "airborne or dustborne transmission of E. coli was still a novel concept," Marler said. "Whether that's exactly how these people got the infection, we just don't know. Some washed their hands, others didn't. Some touched animals, others didn't. Some of the children walked through the barns, some never got out of their strollers. We just couldn't pinpoint, `This is what the fair didn't do, this is what they should have done.' Without that, we couldn't win a lawsuit."He and the families wanted more than just a financial settlement.
"Most state, county and local entities are either immune from lawsuits or have caps on awards," Marler said. "There's very little economic incentive for them to change. I'm not suggesting that all award caps should be removed, but I think government officials should look at these situations as if it were their grandkids who had the problem."
If they did, Kevin Closson believes, it might cut E. coli outbreaks in the future. Closson's daughter, Madeline, then 3, spent two weeks in Legacy Emanuel Hospital in Portland, undergoing daily dialysis treatments for a week and requiring blood transfusions.
"During dialysis ... they suck the blood out, clean it up, cool it down and put it back in," Closson said. "It takes several hours, which is one thing for an adult but way too much for a little child, so they have to put them under anesthesia to do it. At one point, in one day, Maddy was under three times. The money wasn't as big a thing to us as witnessing what all that did to our 3-year-old's body."
The News-Observer ran an article a few days ago about 3-year-old Matthew Baldwin, who picked up a nearly deadly case of E. coli from a 45-minute visit to the petting zoo in October. Matthew was the first of more than 100 people sickened by E. coli last month after attending the North Carolina State Fair.
From the article:
William D. Marler, a personal injury lawyer in Seattle who specializes in contamination cases, said petting zoos are increasingly being identified as sources of E. coli outbreaks. He said the Centers for Disease Control and Prevention has published suggestions to cut exposure, such as providing hand-washing stations with running water and soap -- an amenity that wasn't offered at the State Fair's petting zoos.Exhibits that fail to take such measures, Marler said, may carry some legal liability, and four North Carolina families have contacted him.
"I don't think we, as the public and people in positions of authority, have taken this seriously," Marler said. "Maybe five years ago nobody really knew about this, and it was novel. But it's far more than novel at this point. There are dozens of outbreaks that have occurred in petting zoos and fairs.
"We have to get past the thought that we're not going to do anything because fairs are part of Americana. If these were Ferris wheel accidents year in and year out, the public would go crazy."
There's nothing more American than the local fair. Countless millions visit them each year for the rides, the delectable goodies, and for some up close and personal -- sometimes even hands on -- time with the farm animals. What fair-goers are finding out though, and often through devastating illness rather than education, is that the irresistible petting zoos and livestock exhibitions, which attract more children than anything, often harbor the lethal bacteria E. coli O157:H7. For the sake of the kids, we must turn our attention to this undeniable health concern.
Most people associate E. Coli O157:H7 only with undercooked hamburgers from fast food restaurants. As a lawyer who has represented thousands of victims of E. coli poisoning, however, I have learned that the problem is not so confined. Infection can occur in a variety of ways, including attendance at a petting zoo or the livestock barn at the county fair, and those most vulnerable are our children..
Any place where people come into contact with farm animals must be considered high risk for exposure to E. coli and other poisons. The track record speaks for itself. Since 1995, fifteen outbreaks of E. coli O157:H7 have been reported at fairs and petting zoos in the United States (see www.fair-safety.com). Hundreds have been sickened. Many escape with a bad case of diarrhea and cramps; but some, mostly kids, suffer permanent kidney damage due to a complication of E. coli infection called Hemolytic Uremic Syndrome (HUS).
Some have even died.
In 2003, 24 people fell ill with E. coli O157:H7 infections after attending the county fair at Fort Bend, Texas. Illness was not linked to food. Investigators found, instead, that all ill individuals had visited animal exhibition areas at the fair. Further investigation revealed that both the rodeo and animal exhibition areas were saturated with E. coli O157:H7.
In 2002, in what is believed to be the largest E. coli outbreak in Oregon state history, at least 82 people became sick after attending the Lane County Fair in Eugene, Oregon. Most were young children, and 22 were hospitalized. Of those who were hospitalized, over half experienced kidney failure. Oregon Health Services eventually traced the infections to the goat and sheep exposition hall, and investigators believe the bacteria were possibly transmitted through the ventilation system.
In 1998, at least 781 people became ill after attending a fair in Washington County near Albany, New York. Of those, 71 were hospitalized and two eventually died from kidney failure. The cause: water contaminated by a neighboring farm.
The list goes on - Pennsylvania, Wisconsin, Ohio - each outbreak beginning with livestock and other farm animals. In 2001, observing the dangerous trend, the CDC warned operators of petting zoos and county fairs to clean up.
The warning, however, has gone unheeded, and lessons from previous outbreaks are unlearned. Now it is North Carolina with over 100 children sickened at a recent livestock exhibition.
Those farm animals may be cute, but they can also carry a deadly pathogen. A recent United States Department of Agriculture study of over 20 County Fairs found E. coli O157:H7 in 13.8 percent of beef cattle, 5.9 percent of dairy cattle, and slightly smaller percentages of sheep, pigs and goats - nearly the same percentages found in animals in feed lots. How many of us would take our kids to visit and pet animals in a feed lot?
Imagine how government would respond if the same number of people had been injured from falling off merry-go-rounds. Those wooden horses would grind to a halt and the lawyers would have a field day. But when people suffer from E. coli O157:H7 poisoning, fair and petting zoo-related outbreaks are ignored. Why?
Ignoring the risks involved with human-animal contact and allowing outbreaks to continue makes good business for lawyers like me. But I'll gladly give up that business if it means not having to see four-year-olds hooked up to kidney dialysis machines. So what do we do? Banish state and county fairs? Eliminate Petting Zoos? Of course not. But fair organizers can take some rather simple and inexpensive precautions.
First, they need to clean up their act. Sanitize walkways and railings, and provide ample hand-washing areas for both employees and visitors.
Second, stop selling or allowing food in close proximity to areas where animals are on display.
Third, increase ventilation of buildings to reduce the risk of airborne contamination. Keep livestock areas damp with an approved disinfectant.
Fourth, test all display animals for E. coli O157:H7 - or require that exhibitors show proof that their animals are pathogen-free.
Finally, educate visitors. Post signs that explain to parents the importance of hand-washing before and after visiting animal exhibition areas and petting zoos. Post warnings at the entrances, emphasizing the risks to small children and of the potential for airborne transmission of disease.
Perhaps these precautions won't eliminate all the risk to public health. But for such a minimal investment, organizers can reduce the risk of sending kids to the hospital - or worse. And at the same time, they can avoid lawsuits and put lawyers like me out of business.
The Charlotte Observer in an article this week said cases of E. coli infection have tripled since last week to 112 as N.C. health officials narrowed their search for the source of bacteria to last month's State Fair.
State epidemiologist Dr. Jeffrey Engel told the media that they're investigating all areas where people have contact with animals, including the fair's two petting zoos and other livestock exhibits, and that contaminated food is also under investigation.
My client Kevin Closson, whose 3-year-old daughter was hospitalized for 16 days and nearly died of kidney failure after visiting the petting zoo at a county fair in August 2002, was quoted in the article. "This is not new," Closson said, "and people are not learning from the mistakes of other people that run these fair venues." Closson's daughter was one of two dozen families Marler Clark represented in the Lane County Fair E. coli outbreak.
In this case, the Charlotte Observer reports that one of the victims is a 21-month-old girl. Several kids have been hospitalized with HUS.
As I told Karen Garloch of the Observer:
"We the public have not kept up with the virulence of E. coli O157:h7 ... If you talk to every one of the parents from the Oregon case, they had no idea that this could happen," Marler said."When I used to take animals to the county fair, when I was a kid, no one ever heard of E. coli."
There's nothing more American than the county fair. From Washington and California to New York and Texas, countless millions of people are visiting their local fairs to ride the rides, feast on cotton candy and hot dogs, and to visit those cute farm animals.
Unfortunately, some of the visitors to fairs will get very sick. And the sickest ones, most of them small children, may be close to death before their doctors identify the cause - a relatively new strain of deadly bacteria known as E. coli O157:H7.
Since 1995, thirteen outbreaks of E. coli O157:H7 have been reported at fairs and petting zoos. Thousands have been sickened. Many escape with a bad case of diarrhea and cramps. But some, mostly kids, have suffered permanent damage to their kidneys.
And some have died.
A year ago, at least 82 people became sick after attending the Lane County Fair in Eugene, Oregon. Most were young children, and 22 of them were hospitalized - twelve with kidney failure.
Oregon Health Services eventually traced the infections to the goat and sheep exposition hall, and investigators believe the bacteria were possibly transmitted through the ventilation system.
In 2000, at least five children were sickened after visiting a petting zoo in Snohomish County, Washington. The cause was not determined, but the children ate their lunches after petting the animals.
In August of 1998, at least 781 people became ill after attending a fair in Washington County, near Albany, New York. Of those, 71 were hospitalized and two eventually died from kidney failure. The cause: water contaminated by a neighboring farm.
The list goes on -- Pennsylvania, Wisconsin, Ohio, each sickening people with a bacterium carried by livestock. In 2001 the CDC warned operators of petting zoos and county fairs to clean up.
So what do we do? Banish the county fair? Of course not. But fair organizers can take some rather simple and inexpensive precautions.
Perhaps these precautions won't eliminate the risk to public health. But, for a minimal investment, organizers can reduce the risk of sending kids to the hospital - or worse. And, at the same time, they can put lawyers like me out of business.
Two dozen families plan to file a lawsuit today against Lane County and the Lane County Fair Board, seeking damages for illnesses caused by the biggest outbreak of E. coli bacteria in state history at last year's county fair. All these folks became ill with a very deadly pathogen through no fault of their own. The fair board and the county could have done more to prevent these people from getting sick in the first place.
The families -- all but two from Lane County -- face a major hurdle even if they win a verdict from a local jury. Oregon law caps the liability of government agencies. Under the law, the most any single family could recover from the Fair Board and the county is $200,000. I will challenge the cap, and I put the county on notice last January that I planned to bring the action.
The suit lists 13 E. coli outbreaks at fairs, petting zoos and farms across the country since 1994, including three at county fairs in the Midwest in summer 2001. County fair officials were negligent if they knew about the earlier outbreaks and didn't take more aggressive steps to protect the public. If fair officials didn't know of the earlier outbreaks, they should have known.
The bottom line is the fair board created a place where people were bound to get ill regardless of what they did. Kids who never got out of their strollers, who never touched a cow, never touched a railing -- all they did was get wheeled through a shed, and they got sick.
Warren Wong, the fair's managing director, said the fair followed appropriate sanitary practices. "I believe what we did and have done are traditional and customary practices that represent the state of the industry," he said.
The fair plans to spend up to $25,000 to reduce the risk of E. coli infection at this year's exhibition by installing hand-washing stations outside animal barns, putting up signs and distributing brochures warning people of the risk.
The county should require that every animal be tested for E. coli. Some animals may slip through such a test, but it would go a long way to reduce risk.
E. coli is most commonly spread through contaminated ground beef and water. But public health investigators traced the fair outbreak to the sheep and goat exposition hall on the south side of the fairgrounds. Investigators never determined exactly how people got infected, but said the bacteria could have spread through straw contaminated with animal feces. Bacteria also were found in the building's rafters, indicating that it became airborne and could have fallen on food, floors, railings or people's skin.
Marler Clark filed a lawsuit today against the Lane County Fair Board on behalf of 29 individuals and families of individuals who were infected with E. coli O157:H7 during an outbreak at the Lane County Fair last summer.
A number of fairs and petting zoos have been implicated in E. coli outbreaks in recent years. The Lane County Fair Board should have been aware of risks to patrons, and taken the necessary precautions to prevent this outbreak. These kids were severely injured, and many may suffer from complications of their E. coli infections later in life. Someone needs to be held responsible for what they went through.
I recommended taking the following steps to prevent outbreaks at future fairs:
Two dozen people sickened by the biggest E. coli outbreak in state history filed a lawsuit Wednesday against the Lane County Fair Board, claiming the board didn't do enough to protect fairgoers given similar outbreaks in other states.
Eighty-two people became sick at the fair -- nearly two-thirds of them younger than age 6. Twelve children were treated at Portland hospitals for hemolytic uremic syndrome, or HUS, a potentially fatal complication of E. coli infection that causes kidney failure.
Tim Outman and Kimberly Kessel took their boys, Makyah and Kyler, to the fair on Aug. 17. The parents pushed the boys through the animal barns in a double stroller. At one point, Makyah got out to inspect a mother pig nursing her piglets and put his hands on the railing of the pen, Kessel said. She wiped off his hands afterward. Kyler, now 2, never got sick. But within days, Makyah, now 4, became violently ill with cramps, abdominal pain, bloody diarrhea, vomiting and fever.
They took Makyah to Doernbecher Children's Hospital in Portland for three days to treat his HUS. The boy avoided dialysis and blood transfusions and today seems to be doing fine, with no sign of permanent damage, Outman said. Outman and Kessel are both artists. They live in Eugene and have a studio in McKenzie Bridge. They don't have health insurance and incurred about $15,000 in medical expenses during their son's illness.
Outman called the fair board after the outbreak and asked it to cover their medical bills. He said he was told to send a copy of the bills to the fair board for coverage. But when he called back after sending in the bills, he was told the county wouldn't cover their expenses. That's why they decided to join the suit.
"The fair board didn't seem to use a reasonable amount of care to prevent this," Outman said. "If someone comes on our property and gets injured, the standard we're held to is warn people or make it safe, and the fairgrounds did neither of those."
While Outman and Kessel hope their son won't have long-term health problems, many children who get HUS develop serious complications later in life and require lifelong medical care.
Carson Walter, the 2-year-old daughter of William and Shelly Walter of Eugene, spent 31 days at Doernbecher and underwent 17 rounds of dialysis, a process that filtered toxins and excess water from her blood.
Today, Carson "seems to be fairly stable," though she's still taking blood pressure medicine, her mother said. The long-term damage to her kidneys won't be known until she's 10 or 12.
Madeleine Closson, 3, is doing well 10 months after she spent 15 days and underwent three surgeries at Doernbecher after she developed HUS, said her father, Kevin Closson of Portland. "That's a hell of a lot to put a kid through," he said. But she often wakes up in the middle of the night, gets headaches and routinely suffers painful stomachaches, he said, though he's not sure whether those are complications of her E. coli-induced illness.
Lane County Commissioner Bill Dwyer said he doesn't think the county or the fair board can be held liable for the outbreak.
"Whenever you're around animals, there's a risk you have to take," he said. "The question is, was it reasonable what the county had done? I'd say it was probably the cleanest fair we ever had. You take some risks when you allow your children to peruse among animals," Dwyer said.
Even with the cap on damages, the Lane County Fair pays about $61,000 a year for a $5 million general liability insurance policy to guard against federal lawsuits, out-of-state claims or contractual liability claims.
I will challenge the constitutionality of the state's "tort caps," as they're known. If I win, I'll ask the jury to award damages that would compensate at least some victims for a lifetime of medical care -- sums that would likely run into millions of dollars and exceed the state cap.
The trial judge would then decide whether the cap applied. Whichever side lost that argument would appeal to the state Court of Appeals and ultimately to the state Supreme Court -- a process that could take years.
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