Outbreaks of Escherichia coli O157 infections at multiple county agricultural fairs: a hazard of mixing cattle, concession stands and children.

Journal Article (Journal Article)

Escherichia coli O157 infections cause an estimated 60 deaths and 73 000 illnesses annually in the United States. A marked summer peak in incidence is largely unexplained. We investigated an outbreak of E. coli O157 infections at an agricultural fair in Ohio and implicated consumption of beverages made with fairground water and sold by a geographically localized group of vendors who were all on the same branch of the fairground water distribution system. To examine county fair attendance as a risk factor for infection, we conducted two further epidemiological studies. In the first, we enhanced surveillance for E. coli O157 infections in 15 Northeast Ohio counties during the 2000 agricultural fair season and showed increased risk of E. coli O157 infection among fair attendees. In the second study, we examined Ohio Public Health Laboratory Information Service (PHLIS) data for 1999 using a time-varying covariate proportional hazards model and demonstrated an association between agricultural fairs and E. coli O157 infections, by county. Agricultural fair attendance is a risk factor for E. coli O157 infection in the United States and may contribute to the summer peak in incidence. Measures are needed to reduce transmission of enteric pathogens at agricultural fairs.

Full Text

Duke Authors

Cited Authors

  • Crump, JA; Braden, CR; Dey, ME; Hoekstra, RM; Rickelman-Apisa, JM; Baldwin, DA; De Fijter, SJ; Nowicki, SF; Koch, EM; Bannerman, TL; Smith, FW; Sarisky, JP; Hochberg, N; Mead, PS

Published Date

  • December 2003

Published In

Volume / Issue

  • 131 / 3

Start / End Page

  • 1055 - 1062

PubMed ID

  • 14959770

Pubmed Central ID

  • PMC2870052

International Standard Serial Number (ISSN)

  • 0950-2688

Digital Object Identifier (DOI)

  • 10.1017/s0950268803001237


  • eng

Conference Location

  • England