State health officials today announced that they have collected enough information from the ongoing E. coli disease investigation to identify the state fair as the source of the outbreak. Health officials stressed that while a specific exhibit or concession within the state fair cannot yet be identified, the disease investigation can now focus on the most likely sources. In addition, state agriculture officials continue to assist with public health efforts.
“More than 90 percent of the E. coli cases we’ve investigated during this outbreak were contracted during the time period of the state fair,” State Epidemiologist Jeffery Engel said. “We have also determined that a large majority of the people who tested positive for E. coli during this time period indicated that they had attended the state fair. As our investigation continues we will attempt to determine the exact source or sources of the outbreak.”
At the time this news release was written, health officials were investigating 112 cases. A number of cases reported earlier have been dropped from the investigation because genetic testing conducted by the State Laboratory of Public Health determined that those cases are not associated with this specific outbreak.

“Typically, North Carolina will experience about 50 cases of E. coli each year, most of them in the warmer months,” Dr. Engel said. “Increasing public awareness and case reporting efforts will almost always lead to finding such background cases. Fortunately, we now have the technology to differentiate between strains of the bacteria, allowing us to better target our efforts to contain an outbreak.”
In addition to continuing the investigation, state health officials have focused efforts on communicating disease control measures, particularly in regard to preventing spread of the disease among children and their caregivers. Public health officials have worked with local health departments, hospital emergency departments, the N.C. Pediatric Society and others to make sure all health care providers have the latest information on diagnosis, treatment and prevention of E.coli infections.
“Everyone should be aware of the symptoms associated with E. coli and practicing diligent hand washing measures to prevent spreading E. coli and many other diseases,” Dr. Engel said. “We have worked very hard to make sure child day care operations are receiving this information because small children are the most susceptible to E. coli’s worst symptoms. Children who have been confirmed to have E. coli are not allowed to go back to day care or school until they have had two negative lab tests showing that they no longer carry the disease.”
State health officials will continue to provide updated information as new developments occur.