Date: Mon, 13 Sep 1999
Subject: Glens Falls Poststar Article On E. Coli
Timothy Jensen of Wel-Dun Inc. water systems of Cambridge checks the well at Bordens Apple Orchard in Easton. Jensen has received many calls about wells since an E. Coli breakout occured at the Washington County Fair.
E. coli infection rate slows
Child downgraded to critical
By Judy Bernstein
The number of new cases of suspected E. coli infection appeared to slow Sunday for the first time since people who attended the Washington County Fair began showing up at area hospitals.
The number of suspected or confirmed cases by Sunday afternoon stood at 751, up 19 from Saturday. There was one more confirmed case, bringing the number to 93, and one more hospitalization, bringing that number to 61.
There was both good and bad news Sunday for 10 children being treated at Albany Medical Center for hemolytic uremic syndrome, a complication of E. coli infections that causes kidneys to fail.
One child who had been listed in serious condition was downgraded to critical, while three others who had been serious were upgraded to fair. Five other children remained in serious condition and another remained in fair condition, hospital officials said.
The epidemic, first reported by the state Health Department 10 days ago, already ranks among the most widespread and deadly nationally. Two people, a 3-year-old Clifton Park girl and a 79-year-old Gansevoort man, have died from the infection.
All of those who've fallen ill attended the Washington County Fair on either Aug. 28 or 29, and health officials believe a believe a rainstorm on Aug. 26 may have washed infected cow manure into a well that supplied water to a portion of the fairgrounds. The contaminated water was used to make beverages and to prepare food sold to fairgoers.
Children and the elderly face the greatest risk from E. coli, which causes diarrhea and abdominal pain.
One of the children in fair condition Sunday at Albany Medical Center was 2-year-old Kaylea Aldrich, whose 3-year-old sister, Rachel, died Sept. 4 from the infection.
The state Health Department said that the number of secondary infections -- cases in which someone exposed to E. coli at the fair spread the illness to someone else -- continued to remain at " about 10," largely unchanged from Thursday.
That news in particular cheered health officials, who had appealed to the public all week, and particularly to schools and day care centers, to instruct children on hand washing and other sanitary practices to prevent the spread of infection.
" I think that's indicative to us that we got the message out to people ... That's really what we were worried about," state Health Department spokesman John F. Signor said.
Most people who attended the fair, which ended Aug. 29, would have developed primary infections by early last week, because the infection incubation period usually lasts up to nine days after exposure, health officials have said.
The number of suspected cases had been rising by the hundreds every day for much of last week, although Health Department officials had said they believed the increases were due to a lag time in reporting cases.
" The numbers do appeared to be leveling off, but it's a fluid number and it could change at any time," Signor said. " We're hoping that it's leveling off."
Homeowners testing well water
By Suzanne Seay
The phone at Wel-Dun Inc. began ringing off the hook the day the news broke about possible E. coli poisoning from well water at the Washington County Fair.
The Cambridge company installs water treatment systems at homes and businesses, and area residents, spurred by the outbreak of illness from the fair, started worrying about their own drinking water.
" People who didn't want to do anything (about their water) for years called back and said they were ready to do something," said Timothy Jansen, the owner of Wel-Dun.
However, E. coli contamination is uncommon in wells, Jansen said, particularly deep drilled wells that tend not to be influenced by surface water.
Today, more than half of the wells in Washington County likely are the deep type, drilled through clay or rock barriers to reach underground water supplies. But many older farmhouses still have shallower dug wells, which are more prone to contamination, Jansen said.
Jansen said he's been busy for the past week giving estimates on installing water treatment systems. He also has picked up extra business testing water samples.
Jansen said he hates the idea of profiting from a public tragedy that already has taken the life of a 3-year-old girl and an elderly man who were infected with a particularly deadly strain of E. coli. The two who died, and more than 700 people who have developed symptoms of E. coli poisoning, attended the Washington County Fair on Aug. 28 or 29.
Jansen said he believes people should be concerned about making sure their drinking water is safe, however.
All of the recent water tests he had performed came back negative for E. coli, as is typical, Jansen said.
What You Can't See
In normal times, when there's no water-related catastrophe in the headlines, people mostly ask for solutions to annoying water problems, such as the smell of sulphur, or the presence of iron that stains clothes in the washing machine.
" If people can see it, smell it or taste it, they're concerned with it," Jansen said. " But it's usually the things you can't see or taste or smell that can hurt you."
E. coli bacteria cannot be detected by the senses, and microscopic quantities of the bacteria can sicken people, according to the state Health Department.
It's believed that the E. coli outbreak at the fair started when rainwater carried manure from a cattle barn at the fair into a shallow well that supplied drinking water to a portion of the fairgrounds, health officials have said. Several food vendors used the contaminated water to prepare food and to make coffee, lemonade and fountain soda.
But if cow manure can contaminate well water, and lots of Washington County homes have shallow wells, why is it rare for the county's many dairy farmers to be stricken with E. coli?
Experts aren't sure, according to Dr. Richard Leach, a specialist in infectious diseases at Glens Falls Hospital.
Before the outbreak linked to the fair, there had been about a half-dozen patients treated this year at Glens Falls hospital for E. coli 0157:H7, the virulent strain responsible for the current epidemic.
People have different responses to the bacteria, Leach said. Some people will have no symptoms, and the toxic bacteria simply passes through their systems. Some get diarrhea and recover. Some get extremely ill and develop hemolytic uremic syndrome, which can destroy the kidneys. A very few die.
The disease becomes a public health problem when a pattern emerges.
An observant doctor in the Albany area apparently treated two people with hemolytic uremic syndrome, investigated the coincidence and figured out that the common factor was attendance at the fair, Leach said.
In general, good hygiene keeps the dangerous E. coli out of people's system.
Leach recommends washing hands with regular soap for at least 8 seconds, almost exactly the amount of time it takes to sing " Row, Row, Row Your Boat."
Science hasn't determined whether people become resistant to E. coli with exposure, although there is some suspicion that they do.
Part of Leach's local medical practice as an internist is a speciality in travel medicine.
Travelers diarrhea is a common ailment, often caused by encountering unfamiliar strains of E. coli, he said. People in the Peace Corps will often develop the problem for four to six weeks, then recover completely. But when they return to a country after having been away for a length of time, the cycle happens again. This could indicate that people don't become immune indefinitely, he said.
In developing countries, there also is an alarming rate of death among children with diarrhea, Leach pointed out.
There is no data indicating that dairy waste is a pervasive problem in farming communities, said Dr. John May, the director of the New York Center for Agricultural Medicine and Health. The center, affiliated with Columbia University, is based at Bassett Health Care in Cooperstown.
The center recently launched a study in central New York to look at the rates of diarrheal disease in dairy farmers, comparing the incidence of such illnesses to the number of sick cows. The occupational study is focusing on whether people pick up diseases from the animals they work with, May said.
When animals make humans sick, it's called zoonotic spread of disease. However, E. coli 0157:H7 lives inside perfectly healthy cows, much like other forms of E. coli live inside humans with no ill effects.
In the past, May's agricultural center has studied the contamination of wells with nitrates, which also come from cow manure. This type of contamination has been a problem in the Midwest, where manure is used heavily as a fertilizer and the water table is higher, making it easier for the nitrates to leach into wells. It was not found to be a problem in central New York, May said.
Banks and Water
Another group concerned about good well water is money lenders.
Banks and other lenders won't provide a mortgage on a house unless its well tests clean, although standards vary.
The minimal test is for coliform, which includes E. coli, according to Michael Hough, the lab director at Hudson Environmental Services in Moreau.
Hudson's analytic testing laboratory routinely checks water for home buyers, as well as for municipalities and businesses required by the state Health Department to have periodic tests.
Any presence of coliform is enough for a home well to be deemed unsafe, Hough said.
But there's a cure. In a regular well on private property, a solution for water contaminated with coliform is simple: Add store-bought chlorine bleach.
The process involves adding a specific amount of bleach, depending on the depth of the well. Run all the taps in the house until the water coming out smells like chlorine, then shut them and let the chlorine sit in the water for a specified period of time. Then run all the taps again until you can't smell chlorine anymore.
This usually works like a charm, and the next test for coliform is clean, said Scott Newell, an area real estate broker and developer.
The chlorine cure is only temporary, of course, if the source of the contamination is not also eliminated.
If you pay cash for a house, no well tests are required, but Newell said he always recommends that his clients test the water.
Jansen's Wel-Dun company sells three types of water-treatment systems that kill E. coli and other bacteria after the water comes out of the well, but before it goes through the tap.
The household systems include: ultraviolet light, which destroys reproductive capabilities of bacteria; chlorinators, which are generally also outfitted with filters that take out the chlorine taste and smell; and ozone, which oxidizes the water.
Prices range from $500 to $1,500 for an ultraviolet system, about $2,000 for a chlorinator and about $5,000 for the ozone system, Jansen said.
Timothy Jensen - Wel-Dun Inc. water systems