The Whatcom County Health Department in Bellingham is investigating an outbreak of Shiga toxin-producing E. coli O157:H7 infections. The Washington State Department of Health and the Centers for Disease Control and Prevention are assisting with the investigation.
Disease investigators are now calculating case counts based on lab-confirmed infection with E. coli 0157:H7 and physician-diagnosed cases of hemolytic uremic syndrome (HUS). The official case count will be adjusted regularly as the investigation proceeds.
Twenty-five people are confirmed cases. Nine of these confirmed cases are considered secondary cases (the ill person didn’t go to the event but had close contact with someone who did attend).
- No one has died.
- Ten people have been hospitalized.
- Four people have developed hemolytic uremic syndrome (HUS).
- Illnesses in several other people are under investigation.
- Four of 10 areas sampled produced results that match (indistinguishable from) the E. coli O157:H7 outbreak strain.
All of the ill people attended the Milk Makers Fest between April 21 and 23 at the Northwest Fairgrounds in Lynden; helped with the event between April 20 and 24; or were close contacts of ill people associated with the event. Most of the ill people are children, including older children who helped with the event. More than 1,000 primary school children from all school districts in Whatcom County attended the event on these days.
Whatcom County Health Department is working with community health care providers to identify cases, and interviewing patients and their parents to investigate the source of the outbreak. The source investigation involves collecting information from interviews as well as from clinical and environmental laboratory tests. A common source or sources has not been determined. Health officials expect that it will take several weeks to collect and analyze the information. Even if a common source is not found, potential risk factors will be identified, which will provide information that may reduce the risk of an outbreak in the future.
Advice to the Public:
People who attended the Milk Makers Fest, or have close contact with someone ill who did, and have signs or symptoms of E. coli infection should see a doctor. People usually get sick from E. coli 2-8 days (average of 3-4 days) after swallowing the germ (organism). Only people who have symptoms should see a doctor in relation to this outbreak.
Most people infected with E. coli develop diarrhea (often bloody) and abdominal cramps, and most people recover within a week.
Some illnesses last longer and can be more severe, resulting in a type of kidney failure called hemolytic uremic syndrome (HUS).
HUS can occur in people of any age, but is most common in young children under five, older adults, and people with weakened immune systems.Symptoms of HUS can include fever; abdominal pain; pale skin tone; fatigue and irritability; small, unexplained bruises or bleeding from the nose and mouth; and decreased urination. People who have these symptoms should seek emergency medical care immediately. o Antibiotics and antidiarrheal medicines should not be given unless E. coli is ruled out, since they may increase the risk of HUS in people with E. coli infections.
The outbreak appears to be over; however, the investigation into the source of the infections is ongoing. Secondary cases (people who become ill after contact with a person with E. coli infection) may be reported.