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Elk droppings suspect in foothills E. coli outbreak

Across nation, epidemiologists abuzz with news

By Bill Scanlon, Rocky Mountain News (Contact)

Published November 12, 2008 at 12:05 a.m.

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Austin Flynn chases a Frisbee near a pile of elk droppings on Buchanan Field on Tuesday in Evergreen. The E. coli outbreak motivated some coaches to cancel last week's football games in Evergreen on fields close to where elk graze.

Photo by Ken Papaleo / The Rocky

Austin Flynn chases a Frisbee near a pile of elk droppings on Buchanan Field on Tuesday in Evergreen. The E. coli outbreak motivated some coaches to cancel last week's football games in Evergreen on fields close to where elk graze.

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The mystery of the E. coli outbreak southwest of Denver started clearing up when all eight sickened children said they liked playing outdoors - in elk country.

The medical enigma culminated in a decision by some coaches to cancel last week's midget football games in Evergreen - on fields close to where elk graze.

"We track every case of E. coli 0157:H7," said Dr. Gayle Miller, senior epidemiologist with Jefferson County Health and Environment. Usually, the outbreaks are so sporadic that no useful links can be made.

This time, though, she found eight cases of the same strain. All eight kids were between 4 and 12 years old - six from Jefferson County and one each from Park and Clear Creek counties.

"We knew we had a cluster," she said.

Next, she and her staff used a relatively new test, Pulse Field Gel Electrophoresis, and found that not only was the strain the same, but each child's E. coli had almost identical genetic markers.

She and her staff interviewed the kids to see if they could find a pattern.

"All did say they spent some time in the Evergreen area," Miller said.

They all were close to elk country, either through sports teams or spending time in parks.

Trouble is, there has never before been a direct link between a human's E. coli to deer and elk. The closest has been cases in which humans get waterborne E. coli after deer or elk have contaminated streams or lakes.

Still, Miller decided to test the elk feces in Evergreen close to where the kids said they played.

"We were looking for a needle in a haystack," she said.

"Lo and behold, we found it."

The E. coli in the elk had the same genetic markers as the E. coli in the sickened kids.

"That means the kids got the E. coli from the elk," she said.

How? Who knows, but one likely scenario is that their shoes got smeared with elk feces. Later at home, they took off their shoes, then, say, ate an apple before washing their hands.

E. coli is a bacterium that is a leading cause of bloody diarrhea, and kids tend to get sicker than adults. Typical outbreaks are traced to poorly cooked hamburger or unwashed vegetables such as lettuce, or to contaminated water.

"This is the first time all the pieces have been put together - showing the epidemiology, correlating it with an infection and finding the same organism in the elk," she said.

Miller's office didn't insist that the sports teams cancel their games. But since it was toward the end of the season, the coaches decided to cancel last weekend's games as a precaution, she said.

Jefferson County Health and Environment will continue to preach the sermon of frequent hand-washing and speak of the extra risk for those in elk or deer country.

Meanwhile, the Evergreen case has generated a lot of interest among epidemiologists nationwide. It's a favorite topic among members of the Program for Monitoring Emerging Diseases, also known as ProMED-mail, an organization of epidemiologists.

"Today's lab results tell us it is very likely the children acquired the E. coli infection from exposure to elk droppings in the environment," Alicia Cronquist, epidemiologist at the Colorado Department of Public Health and Environment, said in a posting to the site. "This is a highly unusual situation, and public health officials are continuing to investigate how the elk in the area may have been exposed."

The kids all have recovered or are recovering.

E. coli FAQ

* What is it?

E. coli is a common type of bacteria that lives in the intestines of animals and people. Most strains are harmless, but one dangerous strain - E. coli O157:H7 - produces a powerful poison. Symptoms include severe bloody diarrhea and abdominal cramps.

* How is it commonly spread?

Outbreaks often are caused by food contaminated with the bacteria or by people who have not washed their hands after going to the toilet.

* Is this the first time that the sickness has been transferred from elk to humans?

Probably not. But it is the first time that epidemiologists documented the direct link "with absolute certainty" that the outbreak was caused by elk droppings.

* How did they get it?

All of the children played in a field that had the elk droppings. They likely got the droppings on their shoes, then transferred it to their hands and ultimately to their mouths.

* Can you get E. coli by breathing dried elk droppings?

No. The bacteria are spread orally, from hand to mouth.

* Do the animals get sick from E. coli?

No. They carry the strain but don't show symptoms.

* What are some precautions?

If you are in elk country, wash your hands after hiking or playing outside and before eating; clean shoes and boots before entering homes.

Comments

  • November 14, 2008

    11:07 a.m.

    Suggest removal

    PABridget writes:

    This story certainly sparked a great deal of interest in me. I live in a small town in PA where elk roam freely through my yard daily.

  • November 19, 2008

    11:34 a.m.

    Suggest removal

    JustSayin writes:

    "What are some precautions?" umm, don't eat elk turds?