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.