County health officials announced late Friday night, June 28, that a 2-year-old child has died and three other children between 2 and 13 years old have become ill after having contact with animals at the San Diego County Fair.
The County of San Diego Health and Human Services Agency reported four confirmed pediatric cases of Shig-toxin-producing E. coli — known as STEC — linked to contact with the animals.
Officials from the HHSA’s Epidemiology Program and County Department of Environmental Health are investigating the cluster of four infections, officials said.
The four children who fell ill visited the fair between June 8 and June 15, and began showing symptoms between June 10 and June 16.
“Three of the four cases were not hospitalized,” county authorities said in a statement released at 10:10 p.m. Friday, June 28. “However, one of the four cases, a 2-year-old boy, was hospitalized and unfortunately died on June 24, from a complication of this disease.”
Dr. Wilma Wooten, the county’s public health officer, said in a statement that “our sympathies go out to the family of the child that died from this illness.”
At a news conference late Friday night, June 28, Del Mar Fairgrounds CEO Tim Fennell said fair officials were “heartbroken” and “devastated” by the boy’s death, which he said they only learned of Friday night.
County health officials notified fair officials Friday morning, June 28, of the E. coli outbreak when they arrived to investigate, Fennell said, adding that all animal areas were shut down as soon as county health officials directed the fair to do so.
Fennell said that to his knowledge, this was the first outbreak of E. coli at the San Diego County Fair, previously known as the Del Mar Fair.
“The fair will continue; we hope folks will come out and visit the fair,” Fennell said. “Again, we are devastated by this news, but we’re moving forward; we’re taking every precaution and ... the fair will continue through the Fourth of July.”
Wooten said that while most people recover from the illness without complications, “(five) to 10 percent of people diagnosed with STEC develop the life-threatening kidney infection.”
Officials at the San Diego County Fair closed public access to all animal areas, including the petting zoo, according to the statement issued by the county. The source of the E. coli bacteria remains under investigation, but all the children reportedly visited the animal areas or petting zoo, or had other animal contact at the fair.
Officials with the County Department of Environmental Health re-inspected food facilities that the children visited and found no links there to the outbreak.
According to the statement from county officials, most people infected by this strain of E. coli start feeling sick three to four days after they’re infected, though illnesses can start anywhere from one day to 10 days after exposure. Symptoms vary, but typically include severe stomach cramps, watery or bloody diarrhea and vomiting. Symptoms can occur with or without a fever, but when a fever is present, it is usually less than 101 degrees.
Most infections are very mild, and most people get better within five to seven days, but other infections are severe and potentially life-threatening.
“The public is asked to contact your healthcare provider if you have experienced these symptoms on or after June 8,” county officials said in the statement. “And especially if you have diarrhea that lasts for more than three days or diarrhea that is accompanied by a fever higher than 102 degrees Fahrenheit, or blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine.”
Health officials said good hand-washing is the most important step in preventing E. coli-related illnesses.
“Always wash your hands thoroughly after contact with animals or their environments,” county health officials warned. “Everyone, especially young children, older individuals, and people with weakened immune systems, should wash their hands before eating or drinking.”
-- Alex Riggins is a reporter for The San Diego Union-Tribune