County Fair, Medina County, Ohio

Crump et al (2000) discussed county fairs as risk factors for E. coli O157:H7 infections. The researchers investigated a cluster of E. coli O157:H7 isolates observed in Medina County, Ohio, in August of 2000. In this case control study 43 culture confirmed E. coli O157:H7 cases were identified. The environmental investigation suggested that contamination of a section of the water distribution system supplying various vendors was most consistent with the localization of the pathogenic exposure. Water samples collected for this study did not indicate any coliforms. However, a Halloween event was arranged on the same fairgrounds where the Medina County Fair was held, during which five children developed E. coli O157:H7 infection. These children consumed water-based products during the party and showed the same PFGE pattern as that observed in the Medina County Fair outbreak.  The researchers concluded that the county fair exposure was significantly associated with the E. coli O157:H7 outbreaks. The report recommended that guidelines be developed for safer interactions between animals, humans, and the environment. These recommendations could include improving public awareness of risk and prevention strategies, identifying high-risk animals, and controlling their contact with humans through identifying interaction activities and groups at greater risk.