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Florida HUS Investigation Widens to Georgia and Ohio

Recombinomics Commentary
March 31, 2005

>> Investigators continue to look for possible sources of infection, including contaminated food or beverages, the most common source of HUS infections.

Repeated interviews with families of the victims have failed to find a common food source, said Leslie Hodges, a spokeswoman for the state health department. ``So it's more likely an animal source.''

As of Wednesday, health officials had identified 19 children and three adults in six counties as confirmed cases. An additional 24, including nine adults, were classified as suspected cases.

All victims had diarrhea and also attended one of the fairs in Plant City or Orlando. Confirmed cases include a positive test for E. coli 0157:H7 or a diagnosis of HUS.

The federal Centers for Disease Control has identified two suspected cases in Ohio and one in Georgia of tourists who meet the criteria. The agency is investigating several more.

Half of the confirmed cases involve Orange County residents. Volusia County, with six, has the second-highest number.

A mother, father and young child in Hillsborough County represent the only cases in that county. <<

As the hemolytic uremic syndrome (HUS) investigation expands into other states, including Ohio and Georgia, the demographics cited above are beginning to suggest two different diseases associated with the two festivals.  Although both festivals were in central Florida, the Central Florida Fair is near Orange and Volusia counties on the eastern side of the state, near Orlando and Daytona Beach.  The Plant City Florida Srawberry Festival is on the west side of the state, near Tampa/St Petersburg.

The majority of the E. coli 0157:H7 cases are from Orange and Volusia counties (17/22) and are predominantly young (under 10) children (19/22).  In contrast, those that are negative for the bacteria are more commonly adults (9/24).  Included in this second group is the only reported fatality, the 12 year old girl from Wesley Chapel, which is also on the west side of the state.  She had developed a 103 degree fever before she collapsed and died in her home.  The high fever is more commonly associated with viral diseases than bacterial gastro-intestinal infections.

Thus, while all 46 Florida residents attended one of the two central Florida festivals, it is not clear that the same etiological agent was involved, and its not clear if all cases involved the petting zoos.

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