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The petting zoo at the Cleveland County Fair is the cause of E. coli outbreak across the region in late September, according to state and county health officials.
State health officials made the announcement an afternoon press conference at the Cleveland County Health Department.
"N.C. Department of Health and Human Services have determined that the petting zoo at the Cleveland County Fair was the initial source of exposure to E. coli," read the statement released on Friday.
More than 100 people were infected from the bacteria, and a 2-year-old died as a result of the infection that spread into neighboring counties in the early weeks of October.
Gage Lefevers, 2, died last month after officials say he contracted the deadly bacteria at the Cleveland County Fair.
The infection spread from Cleveland Co. into Catawba, Gaston, Lincoln, Mecklenburg and Union counties in North Carolina. York and Cherokee counties in South Carolina also have three confirmed case of E. coli.
According to test results, weather may be one of the factors that played a role in widespread contamination of the area surrounding the petting zoo exhibit. Heavy rains during the run of the fair, from 9/29 to 10/8 resulted in runoff that may have spread contamination from petting zoo into nearby areas.
Two specific strains of E. coli on cases from the outbreak were matched to environmental samples taken from fair grounds.
The state made no specific recommendations but is putting together a working group to study what happened.
"Our sincerest sympathies go to those families that have experienced illness and loss in this outbreak," State Health Director Laura Gerald said. "Our goal in this and any other public health investigation is not to assign blame, but to identify how to prevent this kind of event from happening again."
E. coli are naturally occurring bacteria that normally live in the intestines of people and animals. While most E. coli are harmless, the shiga toxin producing E. coli (STEC) type identified in this outbreak is very infectious and can easily cause illness. Ruminant animals, such as sheep, goats and cows, are natural hosts for STEC.
The outbreak follows one at the state fair in Raleigh last year where 25 people were sickened there.
The Cleveland County investigation, which began October 8, involved a case control study of those who became ill as well as an additional 160 individuals who attended the fair but did not become ill.
Local health department personnel conducted 266 extensive interviews in the weeks following the outbreak.
In addition to the case control study, analysis by the State Laboratory of Public Health and United States Department of Agriculture confirmed two specific strains of E. coli in cases from the outbreak that were matched to environmental samples taken from the fairgrounds.
Cleveland County Fair officials say they have cooperated fully in the investigation and as of October 19, announced that all public events at the fairgrounds would be closed pending the completion of the public health investigation.
"An investigation of this size and scope requires a team effort and our local health departments have done outstanding work," Gerald said. "We look forward to working with local and state partners as well as fair officials to identify recommendations to reduce the risk of exposure to future fairgoers."
As a result of recommendations following the public health investigation of an E. coli outbreak at the North Carolina State Fair in 2004, the N.C. General Assembly enacted Aedin's Law, which outlines specific measures governing animal contact exhibits at agricultural fairs to protect public health and safety.
"Those measures, monitored by the N.C. Department of Agriculture and Consumer Services, include fencing and staffing around exhibits, education to inform the public of health and safety issues, and adequate hand washing facilities, health officials told WBTV. "Vigilant hand washing after animal exposure is an effective method to reduce transmission of illness."
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