Death Came in the Water

E. coli breaks out at a N.Y. county fair

BY AMANDA SPAKE

At first, the illness was a mystery. The Washington County Fair in Greenwich, N.Y., was great fun, but two days later, the Aldrich girls had become feverish, irritable, and lethargic. Their doctor sent them to a local hospital and Kaylea, 2, seemed to improve. But 3-year-old Rachel grew sicker. On Friday, September 3, she was rushed to the pediatric intensive care unit at Albany Medical Center Hospital, where she and her sister were found to be infected with the deadly E. coli 0157:H7 bacterium from drinking water at the fair.

At Albany, Wayne and Lori Aldrich watched helplessly as Rachel's heart stopped, cutting off oxygen to her brain. Her kidneys failed and she was not able to breathe on her own. Late Saturday afternoon, September 4, on the day she was to celebrate her fourth birthday, Rachel died in her parents' arms.

Now, the Aldriches sit by Kaylea's bedside as she remains in serious condition, on kidney dialysis like 10 other children who went to the fair. They are among over 600 people thought to be infected with the bacterium. If confirmed, this would be one of the largest E. coli 0157:H7 outbreaks on record. The great risk now, according to the New York State Department of Health, is further person-to-person spread of the organism.

How did a supposedly safe drinking-water system become the source of a major outbreak? The health department's theory is that a torrential rainstorm in late August washed manure-laden water from cattle exhibits into loose soil around an auxiliary well at the fairgrounds. This contaminated surface water mixed with the well's usual source, a ground-water aquifer, which had fallen low because of this summer's drought. Unlike other wells supplying the fair, the auxiliary well was not chlorinated. Once the well was in use, contaminated water was pumped to food and drink vendors. Two vendors, one of whom has developed symptoms of infection, may have taken water to another New York fair.

But the Greenwich fiasco points up a greater problem: Treatment and monitoring of drinking water cannot be taken for granted. Kristine Smith, spokesperson for the New York Department of Health, says that since the fairgrounds' water system was considered private, only limited treatment and testing was mandated by the state, and the system was not subject to U.S. Environmental Protection Agency regulations.

But J. Charles Fox, assistant administrator for the Office of Water at the EPA, is not so sure. "This seems to be what we call a transient noncommunity water system," says Fox: It is a system that serves the public on an intermittent basis. Smith says the EPA is wrong because the system "does not operate for 60 days a year"–though, as the Washington County Fair office confirms, it serves thousands of people at different events throughout the year.

Higher standards. Upcoming EPA rules will probably require disinfection of ground-water systems like this one, Fox says. And the EPA has been tightening standards for all water systems since renewal of the Safe Drinking Water Act in 1996.

But states don't always enforce testing requirements, and water-systems managers don't always report violations to the state or the federal government. A recent draft of an EPA audit of 1,800 public water systems and 27 state programs shows monitoring of water quality and reporting of violations are, in Fox's words, "exceptionally weak." While many of the infractions identified in the audit are inconsequential, about one third involve failure to report excessive coliform bacteria, such as E. coli, or failure to treat water for bacterial contaminates. Fox says that "there is nothing in this that should make people feel less confident about their water." Yet EPA studies show that the U.S. drinking water system "suffers from long-term neglect and serious deterioration." The cost for fixing the problem is an estimated $12.1 billion–just to meet existing EPA standards, not the more stringent upcoming regulations.

Within the next month, everyone on a water system with more than 25 customers should receive in the mail his first "Consumer Confidence Report." The reports are now required by law to inform consumers about microbial and chemical contaminants and any violations of EPA regulations by the water supplier–at least those that have been reported. But as the outbreak at the Washington County Fairgrounds shows, it is not what we know about our water that may be most significant, but what we don't know!