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ARS Home » Plains Area » Lincoln, Nebraska » Agroecosystem Management Research » Research » Publications at this Location » Publication #410995
Research Project: Managing Manure as a Soil Resource for Improved Biosecurity, Nutrient Availability, and Soil Sustainability

Location: Agroecosystem Management Research

Title: Shiga toxin-producing escherichia coli O157:H7 outbreak at an animal exhibit field trip — Tennessee, 2023

Author
item FOSTER, ALLISON - Tennessee Department Of Health
item THOMAS, CHARISTINE - Centers For Disease Control And Prevention (CDC) - United States
item BOOP, SARAH - Tennessee Department Of Health
item MULLINS, HEATHER - Sullivan County Regional Health Department
item MOONEY, HOPELYN - Tennessee Department Of Health
item RIPLEY, DANNY - Tennessee Department Of Health
item TERRELL, ERICA - Tennessee Department Of Health
item Durso, Lisa
item GOLWALKAR, MUGDHA - Tennessee Department Of Health
item OREJUELA, KELLY - Tennessee Department Of Health
item DUNN, JOHN - Tennessee Department Of Health
item MAY, ANDREW - Sullivan County Regional Health Department
item KIRSCHKE, DAVID - Tennessee Department Of Health

Submitted to: Meeting Abstract
Publication Type: Abstract Only
Publication Acceptance Date: 1/22/2024
Publication Date: N/A
Citation: N/A

Interpretive Summary:

Technical Abstract: Shiga Toxin-Producing Escherichia coli O157:H7 Outbreak at an Animal Exhibit Field Trip — Tennessee, 2023 Background: On October 3, 2023, the Tennessee Department of Health identified 2 cases of Shiga toxin-producing Escherichia coli (STEC) O157:H7 infections in 2 elementary students. Both children attended school field trips at the same animal exhibit. To determine STEC source and prevent additional illnesses, we initiated epidemiologic, laboratory, and environmental investigations. Methods: We identified cases using laboratory-based surveillance and by surveying parents and guardians of children who attended the exhibit. We classified cases as probable if an attendee experienced abdominal cramps or diarrhea; and confirmed if an attendee or household contact had laboratory-confirmed STEC infection. We visited the site and interviewed event organizers. Human stool, animal feces, and environmental samples were tested for STEC O157:H7 by polymerase chain reaction (PCR), culture, and whole genome sequencing (WGS). Results: The animal exhibit was attended by approximately 2,300 elementary school students over 2 days. Field trip activities included contact with various farm animal species, drinking milk outside animal enclosures, and eating lunch in a separate building onsite. We received survey responses for 443 persons (19%). We identified 9 confirmed and 55 probable cases with illness onset dates during September 26–October 12. Seven children aged 1–7 years were hospitalized. Four children aged 1–6 years developed hemolytic uremic syndrome. None died. Laboratory testing identified STEC O157:H7 from 8 human stool samples that were highly related (0–1 allele difference by WGS). Three environmental samples had Shiga toxin detected by PCR; culture did not detect E. coli. Three other environmental samples had E. coli O157:H7 culture isolates that were genetically distinct from human isolates. Conclusions: This is the largest reported STEC O157:H7 outbreak associated with an animal exhibit in Tennessee. We identified opportunities for educating school staff, event organizers, and families about risks associated with animal contact and appropriate prevention measures.