Third known petting zoo fatality since 2011
SAN DIEGO, California––Jedidiah King Cabezuela, age 2, on June 24, 2019 died from hemolytic uremic syndrome, an apparent complication of exposure to shiga toxin-producing e. coli bacteria two weeks earlier at the San Diego County Fair.
“The County of San Diego Health & Human Services Agency said the toddler came into contact with animals while visiting the San Diego County Fair on June 15,” reported Danica McAdam of NBC-7. “He became ill on June 19, 2019.”
Cabezuela was the fourth child under age 13 since June 8, 2019 to contract an e. coli infection after attending the fair, held annually at the Del Mar Fairgrounds. The fairgrounds also hosts the Del Mar Thoroughbred Club, notorious for a string of 27 breakdowns leading to horse deaths that occurred in mid-2016. That losing streak was eclipsed by 30 horse deaths at the Santa Anita Raceway, about two hours’ drive north, during the last days of December 2018 and first five months of 2019.
Fecally contaminated food?
“It appears that these folks [the shiga toxin-producing e. coli bacteria victims] attended the fair between June 8 and June 15 and were involved with contact, possibly, with a livestock animal at the petting zoo,” San Diego County Fair general manager Tim Fennell told media.
Cabezuela and the three other children potentially might have been infected by undercooked hamburgers, pork, or other fecally contaminated food, such as unwashed fresh vegetables and unpasteurized dairy products.
Shiga toxin-producing e. coli infections associated with consumption of ground beef sicken about 96,000 people per year in the U.S., leading to 3,200 hospitalizations and 31 deaths, according to the Centers for Disease Control & Prevention. One recent outbreak linked to ground beef afflicted 156 people in ten states.
Food cleared, petting zoo closed
Victims typically suffer severe stomach cramps and bloody diarrhea, but severe cases, most often occurring in children and people with compromised immune systems, can lead to fatal kidney infections.
However, the County of San Diego Health & Human Services Agency investigation cleared the fairground food services.
“No contamination has to do with food service or food at all,” Fennell reassured potential fair-goers.
But Fennell said that the San Diego County Fair petting zoo is now closed, though the fair itself will remain open through the Fourth of July.
Multiple victims per outbreak
Compared to infected hamburger cases, and other e. coli cases involving contaminated food, shiga toxin-producing e. coli infections contracted from petting zoos are relatively few. But outbreaks associated with petting zoos usually involve multiple young victims, falling ill in clusters.
“Since 2000, petting zoos and organized farm visits around the U.S. have caused at least 32 publicized outbreaks of e. coli, salmonella and cryptosporidium,” wrote James Andrews of Food Safety News in 2012.
ANIMALS 24-7 has logged at least 20 shiga toxin-producing e. coli clusters attributed to exposure to petting zoo animals since 2005, afflicting hundreds of children in all.
Stressed animals, poor sanitation
Two factors tend to be involved in each cluster: highly stressed animals, most often small ruminants such as sheep, goats, and calves, and people, especially small children, who disregard sanitation after touching animals and surfaces with which animals or animal feces have had contact.
The animals have often transported long distances to unfamiliar locations, and in all cases have been exposed to a constant succession of unfamiliar humans.
As for the humans, a team led by veterinary internist and microbiologist Scott Weese, of the Ontario Veterinary College at the University of Guelph, in 2007 published findings in the journal Clinical Infectious Diseases, gathered from observation visits to 36 petting zoos.
You can lead people to sinks, but can’t make them wash
Weese et al found that even though almost all of the petting zoos offered visitors access to some sort of hand-washing facility, fewer than a third of the visitors actually washed their hands after touching animals and surfaces in animal enclosures.
In addition, many parents brought items into proximity to animals, such as baby bottles and toys, which if contaminated could easily transmit e. coli infections to small children.
Petting zoos often featured animals of species known to pose a high risk of transmitting e. coli infections, including newborn calves and baby chicks.
Further, about one animal in three exhibited signs of ill health, including diarrhea and skin lesions.
“You never know when an animal you have touched is contaminated with something particularly bad such as [shiga toxin-producing] e. coli O157. Outbreaks of serious disease have occurred even with apparently well-operated petting zoos,” Weese warned, “so one cannot make assumptions about risk.”
Colton Guay, 20 months
The death of Jedidiah King Cabezuela may have been the first in the U.S. from a shiga toxin-producing e. coli infection believed to have been contracted at a petting zoo since 20-month-old Colton Guay of Poland, Maine, died on October 5, 2015, after handling goats at the Oxford County Fair. A second child, 17-month-old Myles Herschaft of Auburn, Maine, fell seriously ill, but recovered and returned home after an 11-day hospitalization.
The Centers for Disease Control & Prevention published non-binding guidelines for sanitation at traveling animal shows in April 2002, after tracing shiga toxin-producing e-coli outbreaks that occurred in 2000 to a dairy farm in Pennsylvania and a petting zoo in Washington state.
Two years later, animals from the Crossroads Farm petting zoo in Bear Creek, North Carolina, were identified as the source of at least 33 of the e-coli infections that hit 108 visitors to the 2004 North Carolina State Fair.
Recounted James Andrews of Food Safety News, “In 2005, the North Carolina General Assembly passed Aedin’s Law, named after 2-year-old Aedin Grey who developed hemolytic uremic syndrome in the 2004 state fair outbreak. Developed around a Duke University study on reducing animal-to-human disease transfer, Aedin’s Law places a number of mandates on petting zoo exhibits operating in the state, including mandatory soap-and-water hand washing stations, signage warning of the potential risk of animal contact, and fences separating humans from animal pens. The law even bars visitors from bringing in food, drinks, baby bottles or pacifiers.”
Despite new law, another death
But Aeden’s Law did not end the problem.
At least nine confirmed e. coli infections and 15 suspected infections were reportedly traced to petting zoos at the 2011 North Carolina State Fair––the last year that North Carolina State Fair exhibitors were allowed to permit visitors to have direct contact with animals.
While ending petting opportunities ended e. coli infections at the North Carolina State Fair, at least 106 visitors to the 2012 Cleveland County Fair in North Carolina fell ill with e. coli infections.
The North Carolina Department of Health & Human Services linked the outbreak to animal contact, most likely at petting attractions.
Among the victims were 42 adults and 64 children, one of whom, 2-year-old Gage Lefevers of Gastonia, died.