North Dakota health officials are investigating a possible cluster of shiga toxin – producing Escherichia coli (E. coli) (STEC) infections in eastern North Dakota. Three cases have been reported and all are less than 18 years of age and reported attending the Red River Valley Fair in West Fargo. The fair was held July 7 through 12. One of the cases has been diagnosed with hemolytic uremic syndrome, a severe complication of STEC infections.
“We are in the early stages of this investigation and are asking people who became sick with diarrhea or bloody diarrhea for more than 24 hours within ten days of attending the fair to let us know,” said Michelle Feist, an epidemiologist with the Division of Disease Control. “Although the cases reported having contact with animals while at the fair, we are looking into other possible exposures as well.”
STEC is a bacterial infection that can cause abdominal cramping, nausea, vomiting, diarrhea and bloody diarrhea. Symptoms can be severe resulting in dehydration and electrolyte imbalances. A complication called hemolytic uremic syndrome can occur, in which red blood cells are damaged. These damaged red blood cells can cause kidney damage and kidney failure. People usually get sick within 3 to 4 days from the time of infection, but it can take as long as 10 days for symptoms to appear. People who have symptoms of STEC should consult with their health care provider.
STEC is shed in the stool of infected animals and people. STEC infections can result from eating contaminated food, drinking contaminated water, coming into contact with animals that are carrying STEC and can be spread from person to person through inadequate hygiene. Undercooked meats, especially ground beef, contaminated produce or sprouts and attending petting zoos have all been implicated in STEC outbreaks in the United States. Animals may be infected and not have symptoms but can shed the bacteria.