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The Oregon suit was withdrawn in mid-October 2004.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.