1 Child Dead in Cluster of E coli Cases Linked to San Diego County Fair

A young child has died after contracting Shiga-toxin producing E coli after coming into contact with animals at a petting zoo while attending the San Diego County Fair. The young boy, who was 2 years-old, was hospitalized for his illness and later died on June 24, 2019, from a complication of the disease.

The County of San Diego Health and Human Services Agency (HHSA) issued a news release on June 28, 2019, announcing that a total of 4 children have been diagnosed with Shiga-toxin producing E coli. The 3 other children did not require hospitalization, but all visited the fair between June 8 and June 15, 2019, and had contact with the petting zoo animals or other animals onsite. The fair officials have closed public access to all animal areas, including the petting zoo, as a precaution.

HHSA is working alongside the County Department of Environmental Health to investigate the cluster of infections. As part of the epidemiological investigation the health officials inspected food facilities that the children visited at the fair but did not find any link to the E coli cluster.

The US Centers for Disease Control and Prevention notes that antibiotics should not be used to treat Shiga-toxin producing E coli, as there is no evidence that antibiotics are helpful in treating this infection. Additionally, antibiotic use may increase the risk of developing hemolytic uremic syndrome (HUS). Patients with HUS should be hospitalized in order to prevent permeant loss of kidney function.

“While most people recover from this illness without complications, 5 to 10% of people diagnosed with [Shiga-toxin producing E coli] develop the life-threatening kidney infection,” Wilma J. Wooten, MD, MPH, San Diego County public health officer said in the press release.

Symptoms of Shiga-toxin producing E coli typically develop 3-4 days following exposure to the pathogen. The symptoms can vary from person-to-person but typically include severe abdominal craps, watery or bloody diarrhea and vomiting.

HHSA reminds the public that the most important step to preventing an E coli infection is to practice good handwashing hygiene. It is important to wash your hands thoroughly following contact with animals or their environments, including farms, petting zoos, fairs, or your backyard. Young children, older individuals, and individuals with weakened immune systems should be mindful to always wash their hands prior to eating or drinking.

Contagion® will continue to provide updates on this cluster as information is made available.