You can never be too careful when children are around livestock. And an unfortunate story from Washington State shows the value of hand-washing, and sanitation in general, in relation to disease risk when humans interact with animals.
From April 21 to 23 the Whatcom County Dairy Women held their 23rd annual Milk Makers Fest at the Northwest Washington Fair in Lynden, Washington. The group invited 1,325 first graders, plus teachers and parents to enjoy a hay maze, scavenger hunt, petting zoo, and learn about raising calves and milking cows.
Unfortunately, 25 confirmed cases of E. coli 0157:H7 were connected with the event shortly after it ended, according to a release made public Wednesday afternoon. Of those 25, nine did not attend the event, but did come in contact with people who had attended. Six developed physician-diagnosed hemolytic uremic syndrome (HUS), a type of kidney failure. Some of those who fell ill were individuals that helped set up the event.
The Whatcom County Health Department (WCHD), Washington State Department of Health, and Centers for Disease Control and Prevention concluded their investigation, stating that environmental contamination was the likely cause, and contamination "most likely occured" before the Milk Makers Fest itself.
In other words, the fairgrounds were not properly sanitized before the event started.
Event attendees who reported not washing or sanitizing their hands and who reported biting their nails often were more likely to become ill.
Should we allow visitors to touch animals?
A call to the Whatcom County Dairy Women late Thursday was not immediately returned, but we will learn whether they decide to host the previously successful event again next year based on the findings. We will also reach out to local health professionals to learn about best practices for hosting children on-farm, and sanitizing facilities.
The WCHD has these recommendations to share:
For event organizers -
- Evaluate and update plans for cleaning and disinfection before, during, and after events, particularly surfaces with high levels of hand contact (such as seats, door or fence handles, and hand railings).
- Evaluate and update measures to restrict access to areas more likely to be contaminated with animal manure.
- This is especially important for people at higher risk for severe illness. These people include young children, pregnant women, adults older than 65, and people with weakened immune systems.
- Ensure access to hand washing facilities with soap, running water, and disposable towels.
- Display signs and use other reminders to attendees to wash hands when leaving animal areas.
- Store, prepare, or serve food and beverages only in non-animal areas.
Recommendations for the Public:
- Consider any environment where animals have been kept, such as barns, to be contaminated with bacteria or viruses that can make people ill.
- Hands should always be washed immediately when exiting animal areas, after removing dirty clothing or shoes, and before eating or drinking.
- Hand washing with soap, running water, and disposable towels is the most effective method.
- Adults should always supervise young children while they wash their hands.
- Food and beverages should be consumed in non-animal areas and only after washing hands first.
- Be aware that objects such as clothing, shoes, and stroller wheels can become soiled and serve as a source of germs after leaving an animal area.
- Nine secondary cases were reported during this outbreak. It's important for people infected with E. coli or those with a family member infected with E. coli to follow these precautions to prevent secondary infection:
- Wash your hands thoroughly with soap and water immediately after using the restroom or changing a child's diaper.
- Wash your hands before and after preparing food for yourself and others.
- Stay home from school or work while diarrhea persists; most people can return to work or school when they no longer have diarrhea. Special precautions are needed for food handlers, health care workers, and child care providers and attendees. Check with your employer before returning to work, and check with your child's child care center before resuming child care.
More information on E. coli is available at the CDC website http://www.cdc.gov/ecoli/general/