1999 Washington County, New York, Fair E. coli and Campylobacter jejuni Outbreak

The New York State Department of Health investigated one of the largest waterborne E. coli O157:H7 outbreaks in United States history.  The outbreak occurred at a fair in Washington County, New York, in August of 1999 (New York State Department of Health, March, 2000).  E. coli O157:H7 and/or Campylobacter jejuni infections were identified among 781 persons.  Of these cases 127 persons were ill with E. coli O157:H7, 71 individuals were hospitalized, 14 persons exhibited hemolytic uremic syndrome (HUS), and 2 people died.  It was suspected that 2,800 people in the community were infected. The environmental and site investigation indicated that unchlorinated water from a well serving the fairgrounds was contaminated with E. coli O157:H7 (DOH News, 1999).  Manure samples collected from a nearby barn and groundwater samples from the well tested negative for E. coli O157:H7.  However, samples from the septic system tested positive for E. coli O157:H7.

This investigation demonstrated the potential for outbreaks to involve more than one pathogen. This is especially true for water-borne outbreaks.