title: Escherichia coli O157 incident associated with a farm open to members of the public.
abstract: Three children, one who lived on an open farm and two who visited the farm in school parties, developed Vero cytotoxin producing Escherichia coli (VTEC) O157 infection in 1997. All had been in direct contact with animals. All were admitted to hospital with diarrhoea and two developed the haemolytic uraemic syndrome, one of whom developed severe neurological impairment. E.coli O157 phage type 21 that produced Vero cytotoxin 2 were isolated from the three children and from a goat paddock and two cows at the farm. The isolates were indistinguishable by molecular typing. The farm closed voluntarily for six weeks while recommendations to reduce the exposure of visitors to faecal contamination and to improve hygiene procedures (especially handwashing) were implemented. More research is needed into all aspects of VTEC O157 on farms, including the natural history of carriage in animals, the organism prevalence and factors that affect infectivity to humans. Further consideration is needed about the role of open farms in zoonoses, and how open farms can be assisted in reducing risks for visitors. The public need to be educated about the risks and about their responsibilities, which include the need to wash hands thoroughly and to avoid hand to mouth contact when visiting farms.
authors.affiliation: West Hertfordshire Health Authority, St Albans, Herts.
authors.forename: L M
authors.initials: LM
authors.lastname: Milne
authors.forename: A
authors.initials: A
authors.lastname: Plom
authors.forename: I
authors.initials: I
authors.lastname: Strudley
authors.forename: G C
authors.initials: GC
authors.lastname: Pritchard
authors.forename: R
authors.initials: R
authors.lastname: Crooks
authors.forename: M
authors.initials: M
authors.lastname: Hall
authors.forename: G
authors.initials: G
authors.lastname: Duckworth
authors.forename: C
authors.initials: C
authors.lastname: Seng
authors.forename: M D
authors.initials: MD
authors.lastname: Susman
authors.forename: J
authors.initials: J
authors.lastname: Kearney
authors.forename: R J
authors.initials: RJ
authors.lastname: Wiggins
authors.forename: M
authors.initials: M
authors.lastname: Moulsdale
authors.forename: T
authors.initials: T
authors.lastname: Cheasty
authors.forename: G A
authors.initials: GA
authors.lastname: Willshaw
mesh_terms: D000818:Animals; D000829:Animals, Domestic; D002648:Child; D002675:Child, Preschool; D004197:Disease Reservoirs; D004927:Escherichia coli Infections / Q000635:transmission*; D019453:Escherichia coli O157; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000209:etiology*; D006801:Humans; D008297:Male; D011159:Population Surveillance