Twelve more suspected E. coli cases under investigation

Officials have cast a wide net across the state, calling hospitals, doctors and county health departments, asking them to keep an eye out for patients with symptoms that would match an E. coli infection. Symptoms include diarrhea, cramping, fever, nausea and vomiting and usually appear three or four days after exposure.

Half of the suspected cases are in Sampson County, where one child is hospitalized, officials said. Four other suspected cases are in Wake County, while Durham County and Franklin County have one each.

Results of lab tests to confirm whether E. coli caused their illnesses won't be back until next week, said State Epidemiologist Dr. Megan Davies.

A 13th suspected case is in Johnston County. Health officials previously said that case had been confirmed as E. coli, but they backed off of that Thursday without providing details.

Seven children and one adult are confirmed to have been infected with E. coli in recent days. Three children remain in intensive care – one each Cleveland County, at UNC Hospitals in Chapel Hill and at Duke University Hospital in Durham – suffering from serious kidney problems that are often associated with the bacterial infection.

Although officials haven't yet determined the source of the outbreak, Davies said there's no evidence to suggest that the source presents an ongoing threat. Some people could still possibly get sick in the next few days through exposure to someone else with the illness.

Eight of the confirmed victims, who range in age from 2 months to 62 years, attended the North Carolina State Fair, which wrapped up Sunday. Davies said some of the suspected cases also reported attending the fair.

"The only commonality that's shown up so far has been attending the State Fair early," she said. "We have not in these initial interviews been able to determine a common activity that they all had while there."

Hunter Tallent, 2, of Cleveland County, became sick days after visiting the State Fair. His mother said while they were at the fairgrounds they walked through the cow and horse barns, but did not touch the animals. Hunter had a lot to eat at the fair, including hot dogs, pizza and drinks.

Now, he is fighting E. coli at Levine Children's Hospital in Charlotte. Hunter is in fair condition. He has been on dialysis and doctors say he is getting better. 

Seven years ago, a State Fair petting zoo was linked to an E. coli outbreak that sickened more than 100 people.

Lab tests have determined that five of the current cases involve the same strain of E. coli as the 2004 petting zoo illnesses. Officials noted, however, that the strain also has been linked to outbreaks involving hamburger and cheese.

Health officials are "convinced the exposure was in Wake County," Davies said, but they still aren't confident enough to point to the fair as the source of the outbreak.

"It really is not conclusively tied to any common factor right now that we've been able to identify," said Sue Lynn Ledford, Wake County' health director.

Ledford said it would be irresponsible for health officials to make a snap judgment about the source of the outbreak without extensive analysis of people's activities.

Officials plan to conduct more in-depth interviews of those sickened by E. coli this weekend. Technicians in a state lab also are testing manure from the petting zoo and kiddie barn at the State Fair to compare its DNA to the samples from the E. coli victims.

E. coli is a potentially lethal form of food poisoning caused by bacteria found in animal feces, according to the state Department of Health and Human Services. People can become ill after coming in contact with animal feces or infected food or water. It can also be spread from person to person.

Ben Chapman, a food safety researcher at North Carolina State University, said E. coli can also live on surfaces so long as they are wet.

“As that dries out that E. coli will be less viable,” he said.

Outbreaks are under investigation in at least three other states, none of which are believed to be related.

Fourteen people are sick so far in an outbreak in Missouri, and two adults and a child are ill in Michigan. A case that killed one child and left nine more ill in Wisconsin last month was traced this week to an elementary school.