We report an agricultural fair-associated shiga-toxigenic Escherichia coli O157:H7 (STEC O157) outbreak that was unusual in that it affected both livestock exhibitors and visitors. Twenty-five human cases of STEC O157 infection were detected after the Fort Bend County Fair in Rosenberg, Texas, which ran from 9/26/03 to 10/04/03. Seven cases were culture-confirmed. There were four hemolytic uremic syndrome (HUS) cases, and one thrombotic thrombocytopenic purpura (TTP) case. Cases ranged in age from 18 months to 67 years. Twenty-two (88%) cases were female. Analysis of unmatched case-control data linked STEC O157 infection with visiting fair livestock exhibit areas and with multiple fair visits. All outbreak-related isolates were of a single STEC O157 subtype. Fair Ground environmental sampling and culture for STEC O157, conducted 46 days after the end of the Fair, yielded multiple STEC O157 isolates, including the outbreak subtype. Livestock exhibitors and fair visitors should follow guidelines to reduce the risk of transmission of STEC O157 at agricultural fairs.
More than 10 years ago, food-borne pathogens were estimated to cause 76 000 illnesses and 5 000 deaths in the USA alone. Given the under-reporting of food-borne illnesses, the numbers of illnesses and deaths associated with food are actually higher. Food-borne pathogens continue to impact public health through worldwide disease outbreaks as they have many opportunities to enter the food chain - from the pre-harvest environment to the consumer. With over half of all disease-causing micro-organisms having the ability to be transmitted zoonotically, food animal production is a key source of pathogens in the farm-to-fork continuum. The protozoan parasites, Cryptosporidium and Giardia, have both been implicated in food-borne disease, and have the potential to be transmitted zoonotically in the farm environment. Farm management strategies have been developed to minimize the transmission of protozoa (from animals) that may infect farm workers, and contaminate nearby waterways and food crops. Such strategies target protecting the health of the herd, preventing (oo)cyst transmission to surface water and vegetable crops, and providing education to animal husbandry personnel and veterinarians on best management practices. To fully address the challenges associated with food safety, post-harvest control measures should also be implemented.
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