Petting zoos and E. coli. Here we go again. But instead of just reporting the case count, let’s walk through what we actually know, what we don’t, and the questions that public health officials – and parents – should be asking, using the playbook that has existed for two decades.
What We Know
On Friday, October 23, the Will County Health Department announced it is investigating five laboratory-confirmed cases of Shiga toxin-producing E. coli (STEC) that may be connected to visits to Bengtson’s Pumpkin Farm, 13341 W. 151st St. in Homer Glen, Illinois. The department says it is working to determine how the infections occurred and whether there is a common source.
According to owner Scott Bengtson, the health department first contacted the farm on Wednesday, October 21. The farm voluntarily closed its petting zoo and is arranging for animal testing; the rest of the farm remains open. In its statement, the farm said health officials inspected its food service areas and food vendors on October 21 and found no problems, and that a veterinarian will collect samples from the animals. ABC7 Chicago reports that health department personnel will be at the petting zoo Monday to collect samples.
Health officials believe the exposures occurred on or after September 29 and are asking anyone who became ill after visiting the farm since then to fill out a confidential online survey. Anyone who develops symptoms – especially bloody diarrhea or severe stomach cramps – should contact a healthcare provider, and signs of dehydration, decreased urination or unusual tiredness require immediate medical attention.
The farm has described its precautions. It says the petting zoo has staff on-site at all times, handwashing stations at the entrance and exit, and pens that are cleaned daily. Speaking to ABC7, Bengtson emphasized hand sanitizers and signage about the importance of handwashing.
Sean Conners, the department’s Director of Environmental Health, has been careful not to prejudge the source: animals can carry E. coli even when they appear healthy, but animal contact is not the only route – E. coli can also spread through contaminated food, water or surfaces. He also noted that this strain is especially hard on young children.
Kudos to Bengtson’s for closing the petting zoo and cooperating. I wrote about the initial announcement here.
What We Do Not Know
- Who is sick. No ages, hospitalizations or cases of hemolytic uremic syndrome (HUS) have been released.
- What is making them sick. We do not know whether this is E. coli O157:H7 or a non-O157 STEC, or whether whole genome sequencing shows the five cases are genetically linked to each other.
- What the sick people did at the farm. Did all five visit the petting zoo? Did they feed animals, eat at the farm, attend the pig races, or visit on the same days?
- Which animals. We do not know what species are in the petting zoo, how old they are, whether the farm owns them or leases them from an exhibitor, or where else they have been.
- What “handwashing stations” means. Soap, running water and paper towels at child height – or sanitizer dispensers? The farm’s written statement and the owner’s interview leave that open.
- The water source. Municipal water or a well, and whether hoses or water lines near the animals are connected to anything the public uses.
- How big this gets. The survey just launched, STEC symptoms can begin one to ten days after exposure, and secondary (person-to-person) cases are common in households with small children. Five is a starting number, not a final one.
- The sampling results. Animal and environmental results will likely take a week or more, and – as discussed below – a negative animal test does not end the inquiry.
The Questions to Ask – Straight from the Compendium
Since 2005, the National Association of State Public Health Veterinarians (NASPHV), with CDC, has published the Compendium of Measures to Prevent Disease Associated with Animals in Public Settings. The current 2023 edition appeared in the Journal of the American Veterinary Medical Association (also available from CDC Stacks). It applies by name to agritourism venues, farms open to the public and petting zoos. It also says it plainly: there is no federal law addressing these risks, and some states regulate practices like handwashing stations. That makes the Compendium the standard of care investigators will measure Bengtson’s against.
Here is what they should be asking, section by section:
1. Handwashing (Compendium §§ III.A.3.a, IV.D.2.a(2), Appendix 3)
- Was there soap and running water at the petting zoo exit, or only sanitizer? The Compendium says soap and water is preferred because sanitizers do not work equally well on all pathogens or on heavily soiled hands.
- Were the stations accessible to small children and people with disabilities? In a British Columbia pumpkin patch outbreak the Compendium cites, there was no running water, and the sanitizer was mounted too high for some children to reach.
- Was a staff member stationed at the exit to remind visitors to wash? The Compendium cites studies showing staff presence and verbal reminders improve compliance.
- Were paper towels provided? Drying hands on clothing increased the risk of illness in outbreak studies.
- Were there handwashing stations and signs where food was sold and eaten?
2. Education and Signage (§ IV.D.1)
- Were visitors warned before entering that animals can carry pathogens that cause serious illness – and told who is at highest risk, including children under five?
- Did signs tell visitors not to eat, drink, or use bottles or pacifiers in the animal area? Were they in plain language, multiple formats and languages?
- Did school or daycare groups visit, and were the organizers given prevention information before the trip?
3. Layout and Traffic Flow (§ IV.D.2.a)
- Was the farm divided into animal areas, transition areas and non-animal areas, as the Compendium recommends?
- Was there one-way flow with a separate entrance and exit, and was crowding controlled?
- Were food, drinks, strollers, toys, pacifiers and sippy cups kept out of the petting zoo, with stroller parking outside?
- Were children kept from sitting or playing on the ground? Were there double barriers?
- How far is the petting zoo from food service, the pig races and play areas – and was manure or bedding ever carried through areas where visitors walk?
4. Animal Feeding (§ IV.D.2.a(1))
- Online reviews mention buying carrots to feed the goats. How was feed sold and handed out? The Compendium says the public should feed animals only where contact is controlled, such as by barriers, and never from containers people might eat. It also notes that people who fed animals and did not wash before eating were more likely to become ill.
5. Manure, Cleaning and Pests (§ IV.D.2.a–b)
- How quickly was manure removed, where was it stored, and were waste tools kept away from the public?
- What disinfectant was used on railings and surfaces, and for how long? Most compounds need more than ten minutes of contact time, after organic matter is cleaned off.
- Did the farm have a fly and pest control program? The Compendium notes house flies can carry pathogens to surfaces.
6. Water and Unpasteurized Products (§ IV.D.2.c–d)
- Was the drinking water inspected? Were backflow devices installed between livestock water outlets and other lines? Were hoses left on the ground or unlabeled?
- Was any unpasteurized cider, juice or dairy sold? The Compendium says it should not be.
7. The Animals (§ IV.D.3; § III.A.1.a)
- What species and ages? Young animals shed STEC at higher rates than mature animals, and transport, crowding and commingling increase shedding.
- Did the farm retain a licensed veterinarian? Were animals checked daily, and were any from herds with recent diarrhea?
- Are the animals owned or contracted? Are there USDA Animal Welfare Act licenses and current Certificates of Veterinary Inspection? Do records show where the animals came from and where else they have been exhibited?
8. The Investigation Itself (§ IV.C.2)
- Will samples from people, animals and the environment be tested and sequenced? The Compendium calls for exactly that kind of One Health investigation, with reporting to CDC’s National Outbreak Reporting System.
- Will they sample fences, bedding, hay and soil – not just animal feces? STEC can survive in soil for months, and outbreaks have followed exposure to environments after the animals were gone.
- How will negative animal results be read? The Compendium warns that shedding is intermittent, so a negative test does not mean an animal was not shedding earlier.
This Should Not Keep Happening
Pumpkin patches and petting zoos have a long history together: Willow Grove Gardens in Longview, Washington in 2012; Dehn’s Pumpkins in Dayton, Minnesota in 2013; and the fair outbreaks in North Carolina, Florida and Arizona in 2004–2005 and Cleveland County, North Carolina in 2012, which killed a two-year-old boy. Marler Clark tracks these outbreaks at Fair-Safety.com, including a running list of outbreaks linked to fairs and petting zoos. Tips for families are here, and guidance for owners and operators is here.
Prevention is not complicated, and it is not new. The Compendium has laid it out for twenty years. The question in Homer Glen – as always – is whether it was followed.
We will be watching for the animal and environmental test results and whether the case count grows.
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