A second child sickened by E. coli after visiting the Oxford County Fair was upgraded to fair condition Wednesday, according to a spokeswoman at Maine Medical Center.
Myles Herschaft, a 17-month-old boy from Auburn, developed a dangerous complication from an E. coli infection called hemolytic uremic syndrome, according to a Facebook post by his father, Victor Herschaft. Earlier Wednesday, the boy had been listed in critical condition.
“If your child has symptoms of an illness please don’t take it lightly and please get your children checked out,” he wrote in an earlier post. “Myles initial symptoms appeared as a stomach flu and progressed rapidly.”
Another boy, 20-month-old Colton Guay of Poland, died from the same syndrome a week after visiting the fair, his father, Jon Guay, posted on Facebook.
State public health officials continue to investigate the two cases, which resulted after the boys separately visited the petting zoo at the now-concluded fair. Officials have not confirmed that the boys were infected at the fair.
“Myles is currently in the Pediatric Intensive Care Unit at Maine Medical Center in Portland, Maine and is looking at a long hospitalization,” a family member wrote on a fundraising website. “His parents Victor and Kaitlyn Herschaft are by his side 24/7. His current daily treatment consists of dialysis, blood transfusions and continued critical supportive care.”
State Veterinarian Michele Walsh visited the fairgrounds Wednesday to take samples of animal bedding at the petting zoo. More than two weeks have passed since the livestock, which included goats, sheep, swine, poultry and an alpaca, left on Sept. 19.
Pinning down the source of an E. coli transmission is difficult, because the bacteria commonly live in the digestive systems of humans and other mammals, Walsh explained. Many strains are harmless, but some can lead to illness.
“It’s very challenging to find a smoking gun, if you will,” Walsh said. “So we continue to emphasize the preventative health message. You don’t need to avoid interacting with animals, but you do need to be mindful that those types of interactions come with risks. Washing one’s hands is actually the number one way of preventing infection. You’ve probably heard that since you were four years old, but it’s really true.”
People typically contract the bacteria by coming in contact with animal feces and then eating or touching their mouths with contaminated hands.
“Because most people are interacting directly with animals in a barn, and then have the opportunity to go to the midway and buy a hot dog or grilled cheese, you want to be sure that there is some kind of stopgap measure, like a hand sanitizer,” at all entrance and exit points from barns and petting zoos, she said.
At the Oxford fair, hand sanitizing stations were set up at all three entry and exit points of the petting zoo, along with signs urging fairgoers to use them, Walsh said.
Her staff walks the barns and visually inspects animals at all of Maine’s 26 private agricultural fairs, she said. No sick animals were found at the Oxford fair — though animals carrying E. coli may not appear ill — or at other fairs since then, Walsh said. Officials also check to make sure hand sanitizing stations are fully stocked, she said.
At the Fryeburg Fair, which ends Oct. 11, organizers appointed a “handwashing ambassador” at the petting zoo to ensure parents and children clean their hands before they leave, Walsh said. That step goes above and beyond the recommended precautions, but fair managers have been responsive to protecting attendees’ health, she said.
In previous years, the Maine Center for Disease Control and Prevention issued health alerts and press advisories cautioning fairgoers about health risks at fairs, but the agency released none this year.
Protocols call for testing after someone becomes infected with E. coli, but authorities may not be able to identify the source of the two illnesses, Walsh said. People can also contract E. coli from consuming contaminated food or water at home or in restaurants, which is why public health officials advise fully cooking meat and washing vegetables.
Test results are expected to take at least a week, Walsh said.
Some strains of E. coli produce dangerous toxins. Laboratory tests conducted on Tuesday in connection with the two cases determined the presence of what are known as shiga toxins associated with the bacteria, according to Maine CDC.
People with compromised immune systems, such as young children and the elderly, are more likely than others to develop severe illness and hemolytic uremic syndrome. While most people recover from that complication within a few weeks, some develop kidney failure that leads to permanent damage or death.
Early symptoms of the syndrome include diarrhea, vomiting, abdominal pain, fatigue, pale skin and unexplained bruises or bleeding from the nose and mouth. Neurological problems also may develop, including seizures.
Hemolytic uremic syndrome affects 5 to 10 percent of those diagnosed with E. coli-produced shiga toxin, according to the U.S. CDC.
In Maine, 26 cases of shiga toxin-producing E. coli have been confirmed so far in 2015, according to state health officials. There were 33 cases last year, resulting in one diagnosis of hemolytic uremic syndrome.
Maine CDC has released no information about how many of those E. coli infections originated at agricultural fairs.