Anyone who has attended a recent event with animal exhibits and has diarrhea with variable severity (from mild to severe and bloody) should contact a health care provider, say Florida officials.

Most of the 22 individuals reportedly infected with the E. coli bacteria are children who attended two state fairs in March: the Central Florida Fair in Orlando or the Strawberry Festival in Plant City. In some of them, the infection has progressed to HUS, a disease of the kidneys that can be life-threatening.

However, at least one person is believed to have contracted E. coli at the Tampa fair in mid-February.

"We have strong indications that the petting zoos at each of the fairs are the likely source of exposure," said John O. Agwunobi, M.D., M.B.A., M.P.H.

Officials are working closely with state and local partners to continue investigating the reported cases.

Case Removed from Listing

Agwunobi told reporters on Thursday that a previously reported suspect case has been removed from the outbreak listing.

"Our hearts go out to the family and classmates of a child who recently succumbed to illness," he said. "After thorough investigation and consultation with the medical examiner's office, we do not believe the child was related to the current outbreak and is no longer classified as a suspect case."

Screening Criteria

Screening criteria are critical to determining if a suspected case of E. coli O157:H7 and/or Hemolytic Uremic Syndrome (HUS) needs further investigation, say Florida officials. Screening criteria fall into the following two categories:

• Suspected case: Individuals with diarrhea with variable severity (from mild to severe and bloody) who have recently attended Florida fairs or festivals.

• Confirmed case: An individual with diarrhea with variable severity (from mild to severe and bloody) that has tested positive for E. coli O157:H7 and/or a diagnosis of HUS, and has recently attended Florida fairs or festivals.

If you or your children attended a recent event with animal exhibits, and have diarrhea with variable severity (from mild to severe and bloody), please contact your health care provider.

To avoid infection and illness, DOH recommends the following safety tips:

• Wash hands often, and immediately after contact with domestic or farm animals.

• Do not eat undercooked meat.

• If you suspect your child may have symptoms of infection, contact your health care provider.

For veterinary or animal-related inquiries, contact the Department of Agriculture and Consumer Services.