Community steps up to help Isaiah Peters with E. coli - Summer petting zoo in Brandon may be site of exposure

Isaiah Peters is usually an active little boy. The 3 1/2-year-old red-headed youngster loves to kick his soccer ball around the backyard and play “Guitar Hero.” But instead, Isaiah is lying in a hospital bed in Minneapolis, where he is fighting through a painful illness, H.U.S., a complication of E. coli that can cause kidney failure. Since that time, Isaiah’s little body has withstood dialysis, transfusions, excruciating abdominal pain, IVs, catheters, pneumonia and more at the Children’s Hospitals and Clinics of Minnesota.

“All fingers are pointing to the exotic petting zoo that was in Brandon,” Jon Peters said. “Isaiah rode a camel and fed the goats there. Never would we have imagined we would be here after a silly petting zoo.” It is simply too bad this is happening again, we have seen too many E. coli cases linked to petting zoos and fairs over the years – see www.fair-safety.com.

An account to help the family has been set up at The First National Bank in Brandon. The account is titled “Welcome Home, Isaiah.”

Took a short break from Spinach today


I flew from Seattle to Yakima in the storm and fog to give a presentation to the Washington State Department of Health on how to manage the risk of E. coli O157:H7 infections in petting zoos. I have posted the PowerPoint at www.fair-safety.com.

Avoid zoo fever

I'm quoted by Beacon Journal medical writer Tracy Wheeler's recent article Avoid Zoo Fever, which addresses the issue of fair safety precautions -- like handwashing -- to avoid getting E. coli at petting zoos and fairs. She also addresses the hidden risks, which handwashing won't help.

From the article:

Sometimes, though, the risk is hidden. Consider what happened at the Medina County Fair in 2000, when 27 Northeast Ohioans were sickened by E. coli-contaminated water and ice used by vendors. The problem occurred when water near the cattle barn was siphoned into the water lines by hoses left lying in puddles. Washing their hands after petting the cows wouldn't have helped them at all.

``So what do we do?'' asked Seattle attorney Bill Marler of the Marler Clark firm, which files lawsuits nationwide related to bacterial illness. ``Banish the county fair? Close down petting zoos?''

No, he said. But state legislatures should pass laws requiring hand-washing stations, signs explaining the threat of E. coli and other pathogens and the risk to small children, sanitary walkways and railings, ventilation in buildings to reduce airborne contamination, and a ban of food sales near areas where there is contact with animals.

Only Pennsylvania has passed such legislation.

``Perhaps these laws won't eliminate the risk to public health,'' he said, ``but for a minimal investment, organizers can reduce the risk of sending kids to the hospital -- or worse.''

Praise for North Carolina Petting Zoo Guidelines - But are guidelines enough?

The North Carolina Department of Agriculture has just taken a bold, yet small, step to try and prevent a repeat of last year's outbreak that sickened nearly 100 people, mostly children, who were stricken with E. coli O157:H7 after visiting a petting zoo at the North Carolina State Fair.

The Department of Agriculture announced new guidelines for human-animal interaction at fairs and petting zoos yesterday. It will require the separation of animals and children at petting zoos, as well as the presence of multiple hand washing stations and warnings to the public of the risk of disease spread by animals. These guidelines all make sense, but they are only guidelines.

Although Washington, Oregon, Ohio, Texas, and other states have seen E. coli outbreaks traced to fairs and petting zoos over the last five years, Pennsylvania is the lone state that has put into law measures to protect visitors at fairs and petting zoos. The law, passed by Pennsylvania legislators in 2002, stipulates that animal exhibitions provide hand washing facilities, and post notices on the need for hand washing as well as warnings about the dangers of more than 75 zoonotic diseases. It is the law and applicable to all. But, do North Carolina's guidelines and Pennsylvania law go far enough?

A 2003 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.

Since 1995, at least fifteen outbreaks of E. coli O157:H7 have been reported at fairs and petting zoos. Dozens of children have suffered acute kidney failure, and some will require kidney transplants later in life. In 2001 and in 2005 the CDC warned operators of petting zoos and county fairs to clean up.

Nonetheless, lessons from previous outbreaks are not being learned.

Those farm animals may be cute, but they also can carry a deadly pathogen. We need laws, applicable to all, that focus on prevention. Those laws should implement the following:

Use printed materials - signs, hand-outs, and flyers - to educate petting zoo visitors about the risks of zoonotic diseases.

Petting zoo facility design should minimize exposure risks.

Accepted sanitation protocols to prevent environmental exposures should be used.

All animals should be tested for pathogenic bacteria before they arrive at the petting zoo.

Hand washing stations should be accessible to all visitors.

All visitors should be provided with appropriate protective devices, such as shoe scrubs and gloves.

Prohibit food, drink, and hand-held items in petting zoo areas.

Perhaps putting these recommendations into law won't eliminate the risk to public health. But for a minimal investment, petting zoo organizers can reduce the risk of sending kids to the hospital - or worse.

Praise for North Carolina Petting Zoo Guidelines

There's nothing more American than a State or County Fair. From Washington and North Carolina to New York and Florida, countless numbers of children visit their local Fairs to ride the rides, feast on cotton candy and hot dogs, and visit those cute farm animals at the petting zoos. Unfortunately, some of the children will get very sick from doing a very simple act - petting those animals. And the sickest ones, most of them very 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.

So what do we do? Banish the county fair? Close down petting zoos? Fair organizers and petting zoo owners need to take some rather simple and inexpensive precautions. North Carolina Department of Agriculture has just taken a bold, yet small, step to try a prevent a repeat of last years nearly 100 people, again mostly children, who were stricken with E. coli O157:H7 after visiting a petting zoo at the North Carolina State Fair. Separation of possibly infected animals and children is a positive step. Adding multiple hand washing stations and warning the public of the risk of disease spread by animals all makes sense, but they are only guidelines.

However, Pennsylvania is still the lone state that has put into law measures to protect visitors at fairs and petting zoos from E. coli O157:H7 and other zoonotic diseases. The law passed by Pennsylvania legislators stipulates that animal exhibitions provide hand washing facilities, and post notices on the need for hand washing as well as warning about the dangers of more than 75 zoonotic diseases. It is the law and applicable to all. But, do North Carolina's guidelines and Pennsylvania law go far enough?

Since 1995, at least fifteen outbreaks of E. coli O157:H7 have been reported at fairs and petting zoos. Dozens have suffered acute kidney failure and some of the children will require kidney transplants. Right now kids are still hospitalized with Kidney failure in Florida months after visiting a petting zoo. Three years ago, at 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. In 2000, dozens of children were sickened after visiting petting zoos in Washington and Pennsylvania. The list goes on -- California, Wisconsin, Ohio, each sickening children with a bacterium carried by livestock. In 2001 and in 2005 the CDC warned operators of petting zoos and county fairs to clean up.

Nonetheless, lessons from previous outbreaks are not being learned. Those farm animals may be cute, but they also can 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. So, what do we do to protect the kids? We need laws, applicable to all, that focus on prevention. What should those laws look like:

First, we need to clean up our 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, we should screen all display animals for E. coli O157:H7 - or require that exhibitors show proof their animals are pathogen free.

Finally, educate visitors. Post signs that explain to parents the importance of hand-washing before and after visiting the animals. Post tough warnings at the entrances, emphasizing the risks to small children.

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.

For a complete history of county fair and petting zoo related outbreaks, see www.fair-safety.com.

SERIOUS HUMAN ILLNESSES LINKED TO SOME ANIMAL EXHIBITS

As spring beckons and families begin flocking to petting zoos, fairs, and other animal venues, a few people are coming down with serious illnesses. Some of the latest incidents occurred in Florida, where 60 people in 18 counties have confirmed or suspected cases of E. coli-related illness. The sources were petting zoos in three central Florida counties, and children have been the most vulnerable.

Similar incidents seem to be on the increase, says Jeff Bender, an assistant professor of veterinary public health at the Univ. of Minnesota and co-chair of a March 25, 2005, report published by Centers for Disease Control, prepared by the National Association of State Public Health Veterinarians, and endorsed by the Council of State and Territorial Epidemiologists and the American Veterinary Medical Association.

A list of about two dozen documented incidents in the past decade or so (in IL, MN, OH, NC, NY, OH, OR, PA, TX, WA, WI, the Canadian provinces of British Columbia and Ontario, and a few overseas locations) has been assembled by a Seattle law firm (Marler Clark, William Marler, 206-346-1890). Some of these incidents, which affected a total of more than 1,000 people, are highlighted in the CDC report.

Many venues where people come in contact with animals can pose a risk, says the CDC, including county and state fairs, petting zoos, circuses, carnivals, zoos, farm tours, pet stores, animal swap meets, livestock-birthing exhibits, wildlife exhibits, and schools.

Diseases other than those caused by certain types of E. coli may also pose a threat, including rabies, tuberculosis, salmonella, ringworm, cryptosporidiosis, and monkeypox. Affected animals often show no obvious signs of illness, and testing or antibiotic treatment of animals is of limited value.

In addition, physical injuries such as bites, scratches, stepped-on feet, or broken bones are of concern.

There are few federal regulations covering these situations, and only some states address the problem in any extensive way. However, remedies that can sharply reduce problems are relatively simple, as the CDC report explains, including:

  • hand washing after touching or visiting animals;
  • designing, maintaining, and operating animal exhibits carefully to minimize exposures, including full separation of animal areas from any area where people eat or come in contact with human food;
  • educating operators, staff, exhibitors, and visitors about risks and appropriate protective measures;
  • paying strict attention to those at most risk, including children, the elderly, and those with weakened immune systems; and
  • properly cleaning animal areas, especially since harmful microbes have been proven to linger afterward for months.

Marler Clark Calls for Legislation to Protect Visitors at Petting Zoos

Marler Clark, the Seattle law firm representing several victims of the recent Florida E. coli outbreak, is calling on legislators nation-wide to put into law requirements for the protection of petting zoo visitors.

Proposed requirements include increasing signage and warnings about health risks associated with human-animal contact, providing adequate handwashing facilities at strategic locations throughout petting zoos, and designing petting zoos with the intent of reducing the risks of human contact with animal feces. An outline of proposed requirements is available at the Marler Clark-sponsored Web site www.fair-safety.com.

"I realize the measures we are proposing might seem extreme," said William Marler, managing partner of Marler Clark. "But we're looking at this from the standpoint of having represented dozens of children who visited petting zoos and ended up with kidney failure and life-long medical conditions."

At this time, petting zoos must follow guidelines set out in the Code of Federal Regulations. But those regulations apply primarily to the humane handling and treatment of animals - not to preventing transmission of zoonotic diseases. Few states have laws governing human-animal contact at petting zoos; however, under Pennsylvania law:

(1) An operator shall promote public awareness of the risk of contracting a zoonotic disease at the animal exhibition and of the measures necessary to minimize the risk of contraction by posting appropriate notices at the animal exhibition.

(2) An adequate hand-cleansing facility for adults and children shall be conveniently located on the animal exhibition grounds. The operator shall post appropriate notices which designate the location of the hand-cleansing facility . . . and encourage the cleansing of hands after touching animals, using the restroom, and before eating.

Marler continued, "Pennsylvania has a start. The CDC released its Recommendations for Human-Animal Contact in 2001, but petting zoo operators haven't been paying any attention to those, so it's time the government stepped in and made actual laws that govern this, instead of relying on petting zoo operators to police themselves. Our kids' health is at stake."

Children, the target population for petting zoos, are most susceptible to E. coli O157:H7 infection. Between five and ten percent of children who contract E. coli infection will go on to develop hemolytic uremic syndrome, which can lead to kidney failure and damage to the pancreas, liver, brain, and heart.

"I've represented kids with varying levels of damage after suffering from HUS. Nearly all of them are faced with needing multiple kidney transplants in their lifetime. Most suffer from high blood pressure, and several have become insulin-dependent diabetics," Marler added. "So we can talk about HUS being a rare disease, but these kids will have to live with debilitating medical conditions for the rest of their lives."

Caring for a person with hemolytic uremic syndrome is costly. Marler has represented children with HUS whose medical bills ranged from $15,000 to over $200,000. "And that's just the initial hospital stay and a year of check-ups," Marler continued. "Over their lifetimes, kids with HUS - kids who were healthy before they were exposed to E. coli O157:H7 - will require millions of dollars worth of extra medical treatment."

"The kicker is, for the most part, families must carry the burden of paying those medical bills on their own," Marler said.

Most government entities, including state fairs, are immune to lawsuits or can only be sued for a limited amount of money, and the petting zoo industry is not known for carrying large insurance policies to cover the costs of litigation.

"The longer politicians and the fair industry resist changes, the longer our children's health and the health of the fair industry will be at risk. If we can't make fairs be financially responsible through legislation, at least we can make them morally responsible," Marler concluded.

Lawsuits filed in E. coli outbreak

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."

Lightning Strikes the Same Spot Twice

On Wednesday, the Orlando Sentinel reported that at least five children were in critical condition in Orlando-area hospitals with Hemolytic Uremic Syndrome, a potentially life-threatening cause of kidney failure. All visited a petting zoo the week before they became ill.

There's nothing more American than a petting zoo. Countless numbers of children visit petting zoos to have a hands-on experience with farm animals every year. Unfortunately, some children become ill with E. coli O157:H7 infections - the leading cause of Hemolytic Uremic Syndrome in North America. In fact, it is estimated that five to ten percent of persons who become ill with E. coli infections develop Hemolytic Uremic Syndrome.

Most people identify E. coli with undercooked ground beef, but it's not that simple. E. coli infections are caused by the ingestion of fecal material. So a burger becomes contaminated during the slaughtering process, and children can become infected while playing with livestock that are shedding the bacteria. Just as proper sanitation in slaughterhouses is essential in preventing foodborne illness outbreaks, good hygiene and sanitation in areas where livestock are held are of utmost importance in preventing E. coli outbreaks among petting zoo visitors.

Lightning does strike the same spot twice, or even more often.

Since 1995, at least thirteen outbreaks of E. coli O157:H7 have been reported at fairs and petting zoos in the US. Thousands have been sickened. Many escape with a bad case of diarrhea and cramps. But some, mostly kids, suffer permanent damage to their kidneys after battling Hemolytic Uremic Syndrome. Sadly, the health department, media, and petting zoo industry response has been weak at best. That must change.

Last year, nearly 100 people, again mostly children, were stricken with E. coli after visiting a petting zoo at the North Carolina State Fair. Over a dozen children suffered from Hemolytic Uremic Syndrome, requiring kidney dialysis. Some will likely need transplants in the future. In 2002, 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.

In 2001, the CDC warned operators of petting zoos and county fairs to clean up. The warnings should no longer be ignored.

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.

So what do we do? Close down petting zoos? No. But, fair organizers and petting zoo owners can take some rather simple and inexpensive precautions.

1. Sanitize walkways and railings, and provide ample hand-washing areas for both employees and visitors.

2. Stop selling or allowing food in close proximity to areas where animals are on display.

3. Increase ventilation of buildings to reduce the risk of airborne contamination. Keep livestock areas damp with an approved disinfectant.

4. Screen all display animals for E. coli O157:H7 - or require that exhibitors show proof their animals are pathogen-free.

5. Educate visitors. Post signs that explain to parents the importance of hand-washing before and after visiting animals. Post warnings at fair entrances, emphasizing the risks to small children.

Perhaps these precautions won't eliminate the risk to public health. But, for a minimal investment, organizers can increase awareness and reduce the risk of sending kids to the hospital with Hemolytic Uremic Syndrome - or worse.

For more information and a history of fair and petting zoo-related outbreaks, see http://www.fair-safety.com.

E. coli and the County Fair

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.

Most people identify this pathogen with undercooked hamburgers from fast food restaurants. But as a lawyer who has represented thousands of victims of food-borne illness, I have learned that people, especially children, can be infected in a variety of ways - including attending a local county fair or petting zoo.

Any place where people come into contact with farm animals must be considered high risk. The track record speaks for itself. 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.

Nonetheless, lessons from previous outbreaks are not being learned. Those farm animals may be cute, but they also can 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.

This toxin, in effect, targets small children, burrowing into their intestines and leading eventually to kidney failure. Most adults will recover, but many children won't.

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, the fair-related outbreaks are ignored.

This does make 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 the county fair? 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, they should screen all display animals for E. coli O157:H7 - or require that exhibitors show proof their animals are pathogen free.

Finally, educate visitors. Post signs that explain to parents the importance of hand-washing before and after visiting the animals. Post tough warnings at the entrances, emphasizing the risks to small children.

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.

Petting Zoo Sued Over E. coli Outbreak

NBC17.com also did a story about my Crossroads Farm Petting Zoo lawsuit. From their article:

"Twenty-four outbreaks have been linked to fairs and petting zoos since 1995," said attorney William Marler, of the Seattle law firm Marler Clark. "Any operator of a petting zoo should be well-versed in the ways of preventing E. coli infections among their patrons and should have procedures in place to do just that. At this petting zoo, procedures were woefully inadequate to prevent an outbreak."

Are Fairs, Petting Zoos Just Too Dangerous?

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.

E. coli and the Fair

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.

E. coli and the County Fair

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.


  • They need to clean up their act. Sanitize walkways and railings, and provide ample hand-washing areas for both employees and visitors.

  • Stop selling or allowing food in close proximity to areas where animals are on display.

  • Increase ventilation of buildings to reduce the risk of airborne contamination. Keep livestock areas damp with an approved disinfectant.

  • Screen all display animals for E. coli O157:H7 - or require that exhibitors show proof their animals are pathogen free.

  • Educate visitors. Post signs that explain to parents the importance of hand-washing before and after visiting the animals. Post tough warnings at the entrances, emphasizing the risks to small children.

  • 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.