On October 29, the North Carolina Division of Public Health (NCDPH) received a report of three cases of hemolytic uremic syndrome (HUS) among children caused by Escherichia coli O157:H7 infection. All three children visited a petting zoo at the North Carolina State Fair during October 15-24. Case finding efforts by NCDPH identified 105 other persons who had become ill with diarrhea after attending the fair. A case-control study was undertaken to identify risk factors for infection with E. coli 0157:H7. Forty-five case-patients and 188 controls who attended the fair and did not get sick were enrolled in the study. A p-value of 0.05 was set as the cutoff for statistical significance. Thirty-six (80%) of 45 case-patients visited the petting zoo, compared with 64 (36%) of 187 controls (odds ratio= 7.7; p<0.0001). In an analysis of case-patients and controls who were aged <6 years who visited the petting zoo, the following results were found: Exposure Touching or stepping in manure Falling or sitting on the ground Use of a pacifier or spill-proof cup or sucking on one's thumb while at the zoo Use of alcohol-based hand sanitizer Awareness of risk of disease from contact with livestock* *among parents who accompanied the children Use of alcohol-based hand sanitizer Odds ratio 6.9 3.2 11.0 1.9 0.1 None of the above Among children who visited the petting zoo, which exposures might be protective factors for infection with E. coli O157:H7? Awareness of risk of disease from contact with livestock (among parents) Use of a pacifier or spill-proof cup or sucking on one's thumb while at the zoo p-value 0.001 0.02 0.001 0.6 0.02

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On October 29, the North Carolina Division of Public Health (NCDPH) received a report
of three cases of hemolytic uremic syndrome (HUS) among children caused by
Escherichia coli O157:H7 infection. All three children visited a petting zoo at the North
Carolina State Fair during October 15-24. Case finding efforts by NCDPH identified 105
other persons who had become ill with diarrhea after attending the fair.
A case-control study was undertaken to identify risk factors for infection with E. coli
0157:H7. Forty-five case-patients and 188 controls who attended the fair and did not
get sick were enrolled in the study. A p-value of 0.05 was set as the cutoff for statistical
significance.
Thirty-six (80%) of 45 case-patients visited the petting zoo, compared with 64 (36%) of
187 controls (odds ratio= 7.7; p<0.0001). In an analysis of case-patients and controls
who were aged <6 years who visited the petting zoo, the following results were found:
Exposure
Touching or stepping in manure
Falling or sitting on the ground
Use of a pacifier or spill-proof cup or sucking on
one's thumb while at the zoo
Use of alcohol-based hand sanitizer
Awareness of risk of disease from contact with
livestock*
*among parents who accompanied the children
Use of alcohol-based hand sanitizer
Odds ratio
6.9
3.2
11.0
1.9
0.1
O None of the above
Among children who visited the petting zoo, which exposures might be protective
factors for
infection with E. coli O157:H7?
Awareness of risk of disease from contact with livestock (among parents)
Use of a pacifier or spill-proof cup or sucking on one's thumb while at the zoo
p-value
0.001
0.02
0.001
0.6
0.02
Transcribed Image Text:On October 29, the North Carolina Division of Public Health (NCDPH) received a report of three cases of hemolytic uremic syndrome (HUS) among children caused by Escherichia coli O157:H7 infection. All three children visited a petting zoo at the North Carolina State Fair during October 15-24. Case finding efforts by NCDPH identified 105 other persons who had become ill with diarrhea after attending the fair. A case-control study was undertaken to identify risk factors for infection with E. coli 0157:H7. Forty-five case-patients and 188 controls who attended the fair and did not get sick were enrolled in the study. A p-value of 0.05 was set as the cutoff for statistical significance. Thirty-six (80%) of 45 case-patients visited the petting zoo, compared with 64 (36%) of 187 controls (odds ratio= 7.7; p<0.0001). In an analysis of case-patients and controls who were aged <6 years who visited the petting zoo, the following results were found: Exposure Touching or stepping in manure Falling or sitting on the ground Use of a pacifier or spill-proof cup or sucking on one's thumb while at the zoo Use of alcohol-based hand sanitizer Awareness of risk of disease from contact with livestock* *among parents who accompanied the children Use of alcohol-based hand sanitizer Odds ratio 6.9 3.2 11.0 1.9 0.1 O None of the above Among children who visited the petting zoo, which exposures might be protective factors for infection with E. coli O157:H7? Awareness of risk of disease from contact with livestock (among parents) Use of a pacifier or spill-proof cup or sucking on one's thumb while at the zoo p-value 0.001 0.02 0.001 0.6 0.02
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