title: Outbreaks of enteric infections caused by multiple pathogens associated with calves at a farm day camp.
abstract: BACKGROUND
  Transmission of enteric pathogens at venues where the public contacts farm animals is a growing problem, particularly among children. In 2000 and again in 2001, enteric illness outbreaks caused by multiple pathogens occurred at a farm day camp for children in Minnesota.
  
  
  METHODS
  Camp attendees were interviewed about illness history and potential exposures each year. Stool samples from children and calves at the camp were tested for enteric pathogens.
  
  
  RESULTS
  Eighty-four illnesses were documented among camp attendees in the 2 outbreaks; laboratory-confirmed infections included Cryptosporidium parvum (17 cases), Escherichia coli O157:H7 (4), non-O157 Shiga toxin-producing E. coli (STEC) (7) and Salmonella enterica serotype Typhimurium and Campylobacter jejuni (1 each). Kindergarten-fourth grade children provided 1-on-1 care for a bottle-fed calf. Sixty of 83 calves tested carried at least 1 pathogen, including Giardia spp. (26 calves), C. parvum (25), non-O157 STEC (17), Campylobacter spp. (11), 3 serotypes of Salmonella enterica (10) and E. coli O157:H7 (2). Risk factors among children included caring for an ill calf and getting visible manure on their hands. Always washing hands with soap after touching a calf and washing hands before going home were protective. Prevention measures implemented in 2000 failed to prevent the second outbreak.
  
  
  CONCLUSIONS
  Calves were the reservoir of multiple enteric pathogens for children at a farm day camp. Health care providers should consider numerous zoonotic pathogens in patients presenting with gastroenteritis after contact with cattle. Public health officials should help venue operators prospectively implement published guidelines to prevent zoonotic disease transmission.
authors.affiliation: Acute Disease Investigation and Control Section, Minnesota Department of Health, Minneapolis, MN 55014, USA. kirk.smith@health.state.mn.us
authors.forename: Kirk E
authors.initials: KE
authors.lastname: Smith
authors.forename: Sara A
authors.initials: SA
authors.lastname: Stenzel
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Bender
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Wagstrom
authors.forename: Dana
authors.initials: D
authors.lastname: Soderlund
authors.forename: Fe T
authors.initials: FT
authors.lastname: Leano
authors.forename: Charlott M
authors.initials: CM
authors.lastname: Taylor
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Belle-Isle
authors.forename: Richard
authors.initials: R
authors.lastname: Danila
mesh_terms: D000818:Animals; D002167:Campylobacter / Q000302:isolation & purification; D002417:Cattle / Q000382:microbiology*; D002648:Child; D016785:Cryptosporidium parvum / Q000302:isolation & purification; D004196:Disease Outbreaks; D004197:Disease Reservoirs; D004926:Escherichia coli / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology; D006801:Humans