UPDATE: E. coli Outbreak

On Monday afternoon, NC public health officials updated their investigation into an E. coli outbreak that appears to be linked to people who attended the N.C. State Fair in Raleigh earlier this month. A total of 24 cases have been reported, with nine confirmed and 15 under investigation. The total is down slightly from Friday (26) as officials made adjustments following further reviews.

As of 3:00pm Monday, here are the cases and counties reported:

                11                          Wake County

                  7                          Sampson County

                  2                          Wilson County

                   1 each                Cleveland, Durham, Johnston and Warren counties

Of the 24 cases reported, five remain hospitalized, with four of the patients children who are suffering from hemolytic uremic syndrome (HUS), a type of kidney disease associated with E. coli O157.

All nine of the confirmed cases attended the State Fair, according to State Epidemiologist Megan Davies, MD. No new cases were reported over the weekend, as the first incubation period (10 days) ends this week. Dr. Davies says officials typically wait two incubation periods before determining whether an E. Coli O157 outbreak has ended.

Officials are using an exhaustive interview process involving patients and a control group to help pinpoint the source of the outbreak. Dr. Davies said this includes further interviews with the confirmed and suspected cases, and interviews with more than seventy people who attended the fair but did not become ill. The process is designed to find some commonality to lead investigators to the source, but Dr. Davis cautioned that it’s possible they will not learn what the specific exposure was.

People in the control group were selected randomly from about 2,000 fairgoers who had provided emails when purchasing tickets. State Health Director Jeffrey Engel, MD, said media reports had helped the investigation by making people aware of the outbreak and making it easier for investigators to obtain information.

Dr. Davies say she expected the investigation to be completed by early next week. Working closely with the Division of Public Health are officials from the state Agriculture Department and local health departments.

Updates on the investigation are being posted daily by 4:00 pm at http://epi.publichealth.nc.gov/gcdc/ecoli.html.

State law requires that all suspected shiga toxin-producing E. coli infections and HUS cases be reported within 24 hours to the local health department. Physicians may call their local health department or the epidemiologist on call at 919-733-3419 to report suspected cases, which do not require laboratory confirmation to be reported.


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