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The Oregon suit was withdrawn in mid-October 2004.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.
Posted on December 13, 2004 by Marler Lawyer
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Back from the Brink: Families of children who contracted E. coli count blessings - and bills

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."

Posted on December 2, 2004 by Marler Lawyer
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112 cases of E. coli infection suspected

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."

Posted on November 11, 2004 by Marler Lawyer
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Families Ready Lawsuits over E. coli Outbreak at Lane County, Ore., Fair

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.

Posted on June 4, 2003 by Marler Lawyer
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Marler Clark Files E. coli Lawsuit Against Lane County Fair Board

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:

  • Admit only animals that have passed E. coli O157:H7 screening.

  • Limit airborne E. coli by not moving soiled bedding during exhibit hours, keeping stall areas damp with an approved disinfectant, and preventing visitors from entering stall areas.

  • Increase signing that makes clear the need to wash hands when entering and leaving exhibits and to not eat in the exhibit areas.

  • Increase education of the public on the risk of animal contact.

  • Increase ventilation of buildings to improve air flow per approved standards.

  • Sanitize walkways and railings.

  • Ban food from exhibit halls and areas surrounding exhibit halls.

  • Increase the number of hand washing stations and encourage the public to use them.

  • And, add warnings at fair entrances.

    • Posted on June 4, 2003 by Marler Lawyer
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    Families file lawsuit over E. coli outbreak

    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.

    Posted on June 4, 2003 by Marler Lawyer
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