San Luis Obispo County Closes Brookshire Farms E. Coli Probe With No Source Found: 15 Sick, 3 Children With HUS

The County of San Luis Obispo Department of Public Health wrapped up its investigation into the Brookshire Farms E. coli outbreak on Friday, Nov. 6. It did so without finding where the bacteria came from.

The farm reopened its pumpkin patch that same day after a 10-day voluntary shutdown. The county's announcement that there was "no longer an ongoing public health threat" came roughly five hours later.

The numbers

Fifteen people are counted in the outbreak. Five have laboratory-confirmed E. coli O157 infections. Ten more are suspect cases with matching symptoms. The county had reported 13 cases on Oct. 30.

The confirmed patients visited the farm on Oct. 17 or 18. The other ten visited between Oct. 16 and Oct. 26.

Three children developed hemolytic uremic syndrome, or HUS, a complication that can cause kidney failure and sometimes organ failure and brain damage. All three required pediatric intensive care.

Camden Foy, 6

One of them is Camden Foy of Nipomo, who visited the farm on Oct. 17. He was admitted to a Santa Maria hospital and diagnosed with HUS on Oct. 27, then transferred by ambulance to Lucile Packard Children's Hospital at Stanford.

His condition escalated to severe neurological complications. He was intubated and received multiple rounds of blood and platelet transfusions on Oct. 29 and 30, according to his grandmother, Linda Strong-Foy, who has posted regular updates on Facebook.

In her latest post, she said he was on five blood pressure medications: an IV drip, three oral drugs and a patch. He remains in critical condition.

The county's Nov. 6 release refers only to "the families affected." The county has not said publicly whether the other two children have left the hospital.

What the testing found

County investigators collected water, food and other environmental samples at the farm. None tested positive for E. coli O157.

Other strains of E. coli were found in some samples, but none established the source of the patients' infections, according to the county. Callaway said the bacteria turned up in an old cow pie.

County Health Officer Dr. Christy Mulkerin said the lack of a match was not a surprise. "Although it's frustrating to not be able to pinpoint the exact source of the infection through environmental lab testing, this is not unexpected, and bacterial contamination is often temporary and difficult to detect through available sampling methods," she said.

Mulkerin added that "clinical and epidemiological information continues to point to a short-lived shared exposure." She said the county believes the risk of additional exposure has passed.

The county's list of possible exposure routes, none of them confirmed and none ranked, covered produce, hay, food served in an edible cup, and water not meant for drinking. Brookshire advertises hayrides, a hay climb, a hay maze and duck races.

The farm's position

Co-owner Shawn Callaway, a firefighter for 36 years, told The Tribune of San Luis Obispo on Nov. 6 that he and his wife are "destroyed." They started the farm 14 years ago on Los Osos Valley Road.

"We've gone through about 11 days now of numbness," he said. "Our hearts go out to the families, the kids, the adults."

Callaway said the farm has 17 restrooms, pumped and cleaned twice a week, plus 17 handwashing stations and eight sanitizing stations. He said tables and chairs are cleaned several times a day. The farm can draw more than a thousand visitors a day before Halloween.

He also said Brookshire has no petting zoo, which he called a major culprit in other E. coli outbreaks. Callaway said the only known link among the confirmed cases was that they visited the farm.

The county says no animal area was open to the public during this outbreak. A typical farm O157 investigation centers on animal contact, as in the other fall-attraction outbreaks at an Illinois pumpkin farm and the State Fair of Texas petting zoo.

What remains open

Food-safety writer Bill Marler, who tracks outbreaks, noted that finding generic E. coli does not show what carried O157. It does show detectable fecal contamination somewhere on the property when samples were taken, he wrote. The county's account was similar: sampling could not take the next step.

Marler's blog also pointed out that the county closed its file with no identified source and no ranking of the possible routes. The farm, for its part, has said it is still trying to learn what went wrong.

No charges, citations or enforcement actions have been announced. The county has described the case as a closed public health investigation, not a regulatory one.

Three weeks after the exposures, the open questions are specific. The county has not said where the two other hospitalized children stand. The source of the contamination is still unknown. Camden Foy's family says he remains critical at Stanford.