August 29, 2002
The Johnson family of Monroe Street is playing the E. coli waiting game.
The parents, Donald, a lawyer, and Leslie, a nurse, have both had their blood tested and are waiting to see if they were infected with a nasty strain of the E. coli bacteria when they attended the Lane County Fair.
Their three children - 7-year-old Sam, 4-year-old Maddie and 14-month-old Sophia - each have confirmed cases of E. coli. Now the parents are waiting and hoping and praying the children don't come down with the kidney failure that's afflicted five other youngsters infected with E. coli at the fair.
"I feel like I'm living in a nightmare," Leslie Johnson said Wednesday. "I can't believe this is happening."
The number of E. coli cases linked to the fair grew by five Wednesday to 54, with 45 of those confirmed by laboratory testing, up from 42 confirmed cases the day before, Lane County public health officials said. It's the biggest outbreak in Oregon since E. coli emerged as a public health threat in 1982.
As the numbers come in, it's clear young people such as the Johnson children were hit the hardest. Of the 54 reported cases, 38 were 10 years or younger, said Karen Gillette, the county's public health program manager.
Public health investigators have interviewed nearly 200 sick and healthy fairgoers and have effectively ruled out food or water as sources of the outbreak, said Dr. William Keene, the state epidemiologist leading the inquiry. They suspect the outbreak started in the animal barns, specifically where small animals such as pigs, sheep and goats were kept.
It's possible the outbreak started when children inadvertently touched animal fur, pen railings or barn floors contaminated with manure from animals infected with E. coli O157:H7, he said.
It's also possible the E. coli bacteria in dried manure became airborne in barn dust and was swallowed, he said. That's what investigators concluded caused an outbreak last year in Ohio.
Keene spent Wednesday afternoon taking swabs from the animal barns, hoping to pinpoint the source of the outbreak but said he may not be successful.
Five children remain hospitalized at Doernbecher Children's Hospital in Portland. Carson Walter, a 23-month-old girl from Eugene, was in fair condition Wednesday and has moved out of the pediatric intensive care unit, hospital spokeswoman Cyndi DiMicco said. Another Eugene child, 4-year-old Mary Calhoun, also was in fair condition.
The names of the other three children were not released, at their parents' request. One is in fair condition, one is in serious condition and the condition of the third was not disclosed, DiMicco said.
All five are suffering from hemolytic uremic syndrome, or HUS, the most serious illness associated with the strain of E. coli called O157:H7. The disease causes kidney failure, sometimes requires dialysis and transfusions and in 3 percent to 5 percent of cases, leads to death. About 61 people die each year from HUS, according to the Centers for Disease Control and Prevention.
Leslie Johnson is hoping and praying her children survive their bouts with E. coli without suffering HUS.
"We're living every day by our lab results," she said.
The family went to the fair Aug. 16. It was late, about 8:30 p.m., and they were getting ready to walk home to their house in the Friendly neighborhood.
"We weren't going to go to the barns," she said. "The kids wanted to go, so we breezed through."
Johnson didn't have her children wash their hands afterward because they were heading straight home to take baths before bed. She said she never saw a hand-washing station.
"It's frustrating," she said. "As a nurse, I'm so careful handling meat in the house. I never really thought there was much of a risk touching animals."
Her boy, Sam, got sick five days later and was hospitalized for three days at Sacred Heart Medical Center. He's home now and appears healthy, playing with his Star Wars light sabers and eating solid foods.
But Johnson, a nurse in the neonatal intensive care unit at Sacred Heart Medical Center, knows he's not out of danger. She was told of one child sickened by E. coli at the fair who showed improvement, then developed HUS.
HUS can develop up to two weeks after infection from E. coli, she said, "so we still have another week."
The middle child, Maddie, suffered a milder bout with E. coli and did not require hospitalization. She, too, appears healthy and has learned an important lesson.
"You have to wash your hands after you touch the animals," she said Wednesday.
But it's the youngest, 14-month-old Sophia, that Johnson is most concerned about. Young children are most vulnerable to E. coli bug, and there is no magic bullet to treat or prevent HUS, she said. Nor is there any way to predict which children will develop the syndrome.
"The smaller they are the harder they fall, as far as HUS," she said.
Johnson was so concerned Maddie would get sick that she had her sister-in-law sequester the toddler in a hotel room when Sam was in the hospital. But she still got sick, and it's not yet clear whether she got infected at the fair or from her siblings, Johnson said.
Sophia started getting diarrhea on Sunday, and her lab test came back positive for E. coli on Tuesday. She's been throwing up and acting lethargic. Johnson is trying to keep her hydrated and hoping for the best.
"I'm pretty angry about the whole thing," she said. "This was a major screw-up that could easily have been prevented."
She doesn't remember seeing any signs about washing hands. It turns out the only signs were over the five portable hand-washing stations outside the animal barns. The signs simply said, "Hand-washing stations," said Warren Wong, the fair's managing director.
No signs were posted warning fairgoers to wash their hands with soap and water after petting the animals, he said.
"Next year we will put up more signage," he said.
Fair officials are looking at other steps to make next year's fair safer. In addition to prominent signs about hand-washing, it's likely notices will be printed on fair maps and on the daily schedules, he said.
And the fair will probably bring in more than five portable hand-washing stations, he said.
"I would say that's a good guess," Wong said.
It's unlikely the Johnsons will be back, no matter the precautions taken, Leslie Johnson said.
"The kids want to go, but we're not going," she said. "I don't think food and animals mix very well."