North Carolina
• 108 people came down with E.coli infection, after visiting the North Carolina State Fair’s petting zoos. Twenty patients were hospitalized, and 15 had hemolytic uremic syndrome diagnosed.
• One of the petting zoos contained approximately 100 goats and sheep in an area where visitors could have extensive contact with animals and their bedding, which contributed to the outbreak, since visitors had access to potentially contaminated animal waste.

• For children who visited another petting zoo at the Fair, playing and petting the animals also included touching or stepping in manure, falling or sitting on the ground, and use of a pacifier or “sippy” cup, or sucking on one’s thumb while in the petting zoo also are thought to also have been contributing factors to the outbreak.
• A outbreak of E.coli O157:H7 was found at three Florida Fairs and Festivals.
• Seventeen patients were hospitalized, and seven had diagnoses of HUS.
• The three fairs had one common animal vendor -a farm animal petting zoo. The petting zoo owner was contacted and the animals were placed under voluntary quarantine. After additional testing, any farm animals that tested positive for E.coli O157:H7 were put under state quarantine by the Florida Department of Agriculture and Consumer Services.
• Two children hospitalized with E. coli O157:H7 infection had visited a zoo in Arizona that contained a petting zoo.
• One child had direct contact with petting zoo animals; the second child only had possible contact with exterior railings at the petting zoo. Both children had played in an area immediately adjacent to and downhill from the petting zoo facility.
• Upon notification of test results that confirmed E.coli contamination, zoo officials immediately closed the petting zoo and adjacent play area.
In all of the cases, the victims contracted the bacteria from extensive direct animal contact at petting zoos that were contaminated with manure.
E. coli O157:H7 causes approximately 73,000 illnesses in the United States annually, leading to an estimated 2,168 hospitalizations and 61 deaths.
Recommendations to minimize contamination and bacterial exposure include keeping visitors, especialy young children, from directly entering open-interaction areas of petting zoos. In addition, the National Association of State Public Health Veterinarians has published recommendations on hand washing, venue design, animal care and management, and risk communication regarding disease transmission for staff and visitors.