Petting zoo illnesses make me sad because the food and ag community has failed

I’m a fan of agritourism, whether that’s touring a bunch of backyard chicken coops or learning about animals, I see value in this stuff. It’s not without risk though – and managing that risk is imperative. A while ago someone asked me about the types of food businesses I like to frequent, from a food safety perspective, and I thought about it a while and came up with this: I like to eat food from places where the people involved in making decisions are constantly worried about making people sick. Like it’s their nightmare. Not places that tell me not to worry about stuff.

My petting zoos/animal interaction wants are the same.

A few years ago my friend (and Carolina Hurricane superfan), Dr. Megan Jacob and I took a couple of visits to animal education/interaction sites to get some ideas about what people do (visitors and organizers). From those visits we saw a lot of stuff that made us think we need to take a different approach. Lots of signs saying to wash hands. Don’t bring food around the animals, don’t bring strollers.

And not a lot of people following the messages. I don’t blame the visitors. I blame us (or at least the collective us) for not doing a better job at saying why it’s important, not having enough people there with reminders and actively helping visitors reduce their risks.

A couple of years ago Gonzalo Erdozian esteemed member of the barfblog team, looked at what was available at a bunch of small petting zoo sites/events in Kansas and Missouri – and came up with some great suggestions after finding lots of risky practices (abstract is below). Reducing risks at fairs and petting zoos isn’t a simple thing – it’s a mix of having the tools, people to point patrons to them, and explaining the risks (without being jerks).

Gonzo found that the reminders really worked.

After those visits, Megan and I, with the help from some others put together a workshop for NC folks who run these events and sites. We learned a whole bunch more from the participants – one of the biggest takeaways for me was that organizers were reluctant to engage in these discussions because although they knew that there was a risk, they didn’t want to alert people who were there that it was risky because maybe they wouldn’t come. I’m not sure what the correct word for that is, but it seems paternalistic or something. One philosophy we’ve followed at barfblog is that people can handle risk discussions and we’re kinda responsible to have them. And let the participants choose.

I home almost daily past the Kelley Building, ground zero for an E. coli O157:H7 outbreak in 2011 linked to 25 illnesses at  the NC State Fair. The building wasn’t considered to be an animal contact area – a petting zoo – but was a spot that was a popular cut-through from an entrance gate to the midway area. Organizers of the fair led a commission to look at what happened, and made changes – having more handwashing stations, passive reminders and actively having actual people reminding; further limiting access to non-petting zoo animal buildings; and, increasing cleaning and sanitation.

People brought food, strollers, and their hands touched a lot of likely contaminated handles and rails.

Over the weekend news broke of another tragic cluster of illness linked to fair/animal interactions. 

A 2-year-old boy died and three others were sickened upon contracting the E. coli virus after coming into contact with farm animals at the San Diego County Fair, according to authorities.

The child was hospitalized after visiting the county fair two weeks ago, and died Monday after complications stemming from the virus, the San Diego County Health and Human Services Agency confirmed on Friday. The other three children did not need medical attention.

A 2-year-old boy died and three others were sickened upon contracting the E. coli virus after coming into contact with farm animals at the San Diego County Fair, according to authorities.

The child was hospitalized after visiting the county fair two weeks ago, and died Monday after complications stemming from the virus, the San Diego County Health and Human Services Agency confirmed on Friday. The other three children did not need medical attention.

The frustrating nexus of these (and all the other illnesses) is that it’s good for folks to learn about agriculture and farming and food by seeing and interacting – and that very situation is risky.

What doesn’t help is when the agricultural community scoffs at these illnesses (I haven’t heard it on this one, but have in the past) essentially saying that handwashing is common sense, so these illnesses happen because people are ignorant. Except that all falls apart because we (the folks in the know) haven’t done our job telling folks how they can manage some of the risk of getting sick, and how organizers are also trying to reduce the risk to patrons. By missing that, we’re not doing everything we can to ensure that the safe behaviors take place. And that makes me sad.

Erdozain G, Kukanich K, Chapman B, Powell D. 2012. Observation of public health risk behaviours, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011. Zoonoses Public Health. 2012 Jul 30. doi: 10.1111/j.1863-2378.2012.01531.x. [Epub ahead of print]

Outbreaks of human illness have been linked to visiting settings with animal contact throughout developed countries. This paper details an observational study of hand hygiene tool availability and recommendations; frequency of risky behavior; and, handwashing attempts by visitors in Kansas (9) and Missouri (4), U.S., petting zoos. Handwashing signs and hand hygiene stations were available at the exit of animal-contact areas in 10/13 and 8/13 petting zoos respectively. Risky behaviors were observed being performed at all petting zoos by at least one visitor. Frequently observed behaviors were: children (10/13 petting zoos) and adults (9/13 petting zoos) touching hands to face within animal-contact areas; animals licking children’s and adults’ hands (7/13 and 4/13 petting zoos, respectively); and children and adults drinking within animal-contact areas (5/13 petting zoos each). Of 574 visitors observed for hand hygiene when exiting animal-contact areas, 37% (n=214) of individuals attempted some type of hand hygiene, with male adults, female adults, and children attempting at similar rates (32%, 40%, and 37% respectively). Visitors were 4.8x more likely to wash their hands when a staff member was present within or at the exit to the animal-contact area (136/231, 59%) than when no staff member was present (78/343, 23%; p<0.001, OR=4.863, 95% C.I.=3.380-6.998). Visitors at zoos with a fence as a partial barrier to human-animal contact were 2.3x more likely to wash their hands (188/460, 40.9%) than visitors allowed to enter the animals’ yard for contact (26/114, 22.8%; p<0.001, OR= 2.339, 95% CI= 1.454-3.763). Inconsistencies existed in tool availability, signage, and supervision of animal-contact. Risk communication was poor, with few petting zoos outlining risks associated with animal-contact, or providing recommendations for precautions to be taken to reduce these risks.



Food safety at fairs and festivals

Tanya Banuelos of the Argus Observer writes:

As the last few weeks of summer vacation dwindle down and families are taking advantage of outdoor food at barbecues, picnics and the county fair, it’s time to talk about warm weather and food safety.
With 100-degree weather expected this week, it’s important to remember how much sooner food can become perishable when it’s out in the heat.
When it comes to food safety, food handlers at the Malheur County Fair must adhere to health guidelines, and an inspector is on site throughout the week. And as with every year at the fair, for those who sell consumable goods, food safety is a priority for vendors, such as Awesome Blossom and Fiesta Guadalajara.
Rely on equipment
One of the key details to remember is the importance of temperature.
Modesto Vega, co-owner of Fiesta Guadalajara, said he is able to keep foods at the appropriate temperature during the fair with commercial equipment.

I have inspected my fair share of temporary events including festivals and fairs and not all vendors are equipped with commercial fridges, freezers, etc. If you got them, all the power to you. I would typically see a lot of residential equipment, some good and some bad. As long as cold/hot holding temperatures are maintained, I’m good.

There have been a myriad of outbreaks associated with outdoor events nationally and internationally. The ethnic nature and diversity of foods prepared coupled with extreme temperatures pose unique problems for public health types. Public health inspections of said facilities rarely assess behavioral practices; rather, they are focused on meeting Regulatory standards. Time commitment and lack of public health staff have a lot to do with this, I have experienced this personally.

Effective food safety training during these events is critical. A number of operators at fairs and festivals are typically required to take a mandatory 8- hour food safe course or variation thereof prior to the event. I would rather see on-site hands-on training during vendor set-up focusing specifically on their menu items to ensure food safety, a mini HACCP if you will. If a vendor intends on serving hamburgers, well let’s go over what you need to do to ensure that no one barfs from your hamburgers.

Therman Collins, who has been a food vendor at the fair for eight years, said the key to keeping food safe for consumption is to make it fresh and send it right on out, adding that when it comes to food safety, “we know it all.”
Time, temperature equally important
When food is already cooked, especially with warm temperatures, how long people keep their food outside is a cause for concern, according to the Oregon Health Authority.
Most picnic foods will only be safe on the table for two hours; however, if the air temperature is higher than 90 degrees Fahrenheit, then the food is only safe for an hour.
Most importantly, food should be kept out of the danger zone, where cold foods are recommended to be kept below 40 degrees Fahrenheit, and hot foods above 140 degrees Fahrenheit, according to the United States Department of Agriculture.