The Shiga-toxin producing Escherichia coli or STEC outbreak associated with the now-closed San Diego County Fairs is still growing.

As of this week, the County of San Diego Health and Human Services Agency (HHSA) was reporting 10 confirmed cases and one probable case have been reported in this outbreak.

On June 28 the HHSA first reported four confirmed or probable pediatric cases of Shiga-toxin-producing Escherichia coli (STEC) that were likely related to contact with animals at the San Diego County Fair.

The fair closed out its run with fireworks on July 4, but the number of outbreak patients has continued to grow. Three victims have been hospitalized, and a 2-year-old boy has died.

The source of the E. coli bacteria is under investigation, but all children were reported to have visited the animal areas, the petting zoo, or had other animal contacts at the San Diego Fair.

County Environmental Health re-inspected food facilities visited by the children and found no link to the cases. For more information,

Symptoms of STEC infection

People with a STEC infection usually start feeling sick 3-4 days after eating or drinking something that contains the bacteria. However, illness can begin anywher from 1-10 days following exposure. Symptoms vary, but often include:

• Severe abdominal cramps
• Watery or bloody diarrhea (3 or more loose stools in 24 hours)
• Vomiting
• Fever, if present, is usually not very high (less than 101˚F/38.5˚C). Most people get better within 5-7 days. However, some infections can be severe or life-threatening.

Preventing STEC infection

One of the best ways to help prevent infection with STEC is frequent and proper handwashing.

Always wash your hands thoroughly after contact with animals or their environments (at farms, petting zoos, fairs, even your own backyard).

Everyone, especially young children, older individuals, and people with weakened immune systems, should wash their hands before eating or drinking. Thorough handwashing means using plenty of soap, warm water, and scrubbing all surfaces of the hands (including between the fingers), for at least 20 seconds.