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Florida Officials Search for Source of HUS Cases

florida fair zoo ecoli outbreaksRecent life-threatening cases of hemolytic uremic syndrome (HUS) amongst children and at least one adult have been attributed to contact with livestock at fairs in Orange and Hillsborough counties, and have resulted in inspections of farm animals by a team of veterinarians and inspectors from the State.

The Tampa Tribune reports:

“I think we were a good starting point because we had been mentioned in the news,” said Tom Umiker, who created Ag-Venture in 1996 to educate city kids about farm life. Ag-Venture is based in Plant City and operated petting zoos this month at both the Florida Strawberry Festival and the Central Florida Fair – both places where infected children had been. Ag-Venture is one common factor, but health officials are looking at possible other sources. “They’re talking to the fairs, taking a look at what kind of vendors were there, where the animals were. They’re taking a look at food preparation as well,” said Joann Schulte, an epidemiologist with the state health department.

“It’s tempting to think that there’s a petting zoo at fault, but all we remember are things that are out of the ordinary, whereas you may have forgotten that you drank milk or ate ice cream,” says John Sinnott, director of the division of infectious disease at the University of South Florida.. “This could be an unheard of or unidentified pathogen, and I hope they’re looking carefully at viruses.”

HUS is most commonly associated with a particularly virulous form of E. coli – however, none of the children infected have tested positive for E. coli. The syndrome can also occur with salmonella (from chickens), shigella (from sewage), and some viral agents. Whatever the source, the illness starts with bloody diarrhea and possible fever, followed by lethargy, anemia, and decreased urine output. Even after the diarrhea has stopped, the bacteria emits toxins that destroy red blood cells. Fragmented pieces of those cells can clog vessels in the kidney and impair kidney function.

Florida Hospital had five children with diagnosed cases of HUS. One has been on a ventilator and dialysis for days, and a second child was put on dialysis late Wednesday. On Thursday, Florida Hospital admitted yet another child, increasing the number of children to six. The latest child’s sibling, who also attended the Central Florida Fair, is developing early symptoms of HUS but has yet to be admitted. Their grandparent, who did not attend the fair, is also showing symptoms – a reminder that household contact, especially amongst children and the elderly, can lead to infection if one member of the family has HUS.

There are now two additional cases at Arnold Palmer Hospital for Women in Orlando, although there are currently no cases of HUS in either Hillsborough County or the Tampa Bay area. Of the 15 cases, nine involved people who live in Orange County, which includes Orlando; two of the victims live in Seminole County; two in Volusia; one in Collier County; and one in Pasco County. There is also now a confirmed case of HUS in Wisconsin involving a child who recently had visited the Orlando area.

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