{"id":11327,"date":"2024-06-14T13:46:01","date_gmt":"2024-06-14T17:46:01","guid":{"rendered":"https:\/\/www.vdh.virginia.gov\/surveillance-and-investigation\/?page_id=11327"},"modified":"2024-07-30T08:32:51","modified_gmt":"2024-07-30T12:32:51","slug":"escherichia-coli-stec-outbreak-in-virginia","status":"publish","type":"page","link":"https:\/\/www.vdh.virginia.gov\/surveillance-and-investigation\/escherichia-coli-stec-outbreak-in-virginia\/","title":{"rendered":"2024 Shiga toxin-producing Escherichia coli\u202f(STEC) Outbreak in Virginia"},"content":{"rendered":"<div id=\"pl-11327\"  class=\"panel-layout\" ><div id=\"pg-11327-0\"  class=\"panel-grid panel-no-style\" ><div id=\"pgc-11327-0-0\"  class=\"panel-grid-cell\" ><div id=\"panel-11327-0-0-0\" class=\"so-panel widget widget_sow-headline panel-first-child\" data-index=\"0\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-headline so-widget-sow-headline-default-8abde916dffb-11327\"\n\t\t\t\n\t\t><div class=\"sow-headline-container \">\n\t\t\t\t\t\t\t<h1 class=\"sow-headline\">\n\t\t\t\t\t\t2024 Shiga toxin-producing Escherichia coli (STEC) Outbreak associated with Lake Anna over Memorial Day Weekend  \t\t\t\t\t\t<\/h1>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"decoration\">\n\t\t\t\t\t\t<div class=\"decoration-inside\"><\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n<\/div><\/div><div id=\"panel-11327-0-0-1\" class=\"so-panel widget widget_sow-editor\" data-index=\"1\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<ul>\n<li>Updated Outbreak Investigation Summary and Environmental Testing sections and multiple FAQs with STEC water testing results for samples collected on June 25.<\/li>\n<li>Added a new FAQ: What is non-O157 STEC?<\/li>\n<li>VDH is not planning future updates to this website.<\/li>\n<\/ul>\n<\/div>\n<\/div><\/div><div id=\"panel-11327-0-0-2\" class=\"so-panel widget widget_nav_menu\" data-index=\"2\" ><div id=\"menu-outbreak\" class=\"panel-widget-style panel-widget-style-for-11327-0-0-2\" ><div class=\"menu-ecoli-outbreak-on-this-page-menu-container\"><ul id=\"menu-ecoli-outbreak-on-this-page-menu\" class=\"menu\"><li id=\"menu-item-11358\" class=\"monkeypox-menu-item-first menu-item menu-item-type-custom menu-item-object-custom first-menu-item menu-item-11358\"><a href=\"#\">On this page:<\/a><\/li>\n<li id=\"menu-item-11353\" class=\"monkeypox-menu-item menu-item menu-item-type-custom menu-item-object-custom menu-item-11353\"><a href=\"https:\/\/www.vdh.virginia.gov\/surveillance-and-investigation\/escherichia-coli-stec-outbreak-in-virginia\/#outbreak-summary\">Outbreak Investigation Summary<\/a><\/li>\n<li id=\"menu-item-11519\" class=\"monkeypox-menu-item menu-item menu-item-type-custom menu-item-object-custom menu-item-11519\"><a href=\"https:\/\/www.vdh.virginia.gov\/surveillance-and-investigation\/escherichia-coli-stec-outbreak-in-virginia\/#is-it-safe\">Is it Safe to Swim or Recreate in Lake Anna?<\/a><\/li>\n<li id=\"menu-item-11366\" class=\"monkeypox-menu-item menu-item menu-item-type-custom menu-item-object-custom menu-item-11366\"><a href=\"https:\/\/www.vdh.virginia.gov\/surveillance-and-investigation\/escherichia-coli-stec-outbreak-in-virginia\/#outbreak-details\">STEC Case Details<\/a><\/li>\n<li id=\"menu-item-11402\" class=\"monkeypox-menu-item menu-item menu-item-type-custom menu-item-object-custom menu-item-11402\"><a href=\"https:\/\/www.vdh.virginia.gov\/surveillance-and-investigation\/escherichia-coli-stec-outbreak-in-virginia\/#environmental-testing\">Environmental Testing<\/a><\/li>\n<li id=\"menu-item-11436\" class=\"monkeypox-menu-item menu-item menu-item-type-custom menu-item-object-custom last-menu-item menu-item-11436\"><a href=\"https:\/\/www.vdh.virginia.gov\/surveillance-and-investigation\/escherichia-coli-stec-outbreak-in-virginia\/#FAQs-e-coli\">Frequently Asked Questions<\/a><\/li>\n<\/ul><\/div><\/div><\/div><div id=\"panel-11327-0-0-3\" class=\"so-panel widget widget_sow-editor\" data-index=\"3\" ><div id=\"outbreak-summary\" class=\"panel-widget-style panel-widget-style-for-11327-0-0-3\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t><h3 class=\"widget-title\">Outbreak Investigation Summary<\/h3>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<p>VDH worked with local, state, and federal partners to investigate an outbreak of <a href=\"https:\/\/www.vdh.virginia.gov\/epidemiology\/epidemiology-fact-sheets\/shiga-toxin-producing-escherichia-coli-stec\/\">Shiga toxin-producing <i>Escherichia coli<\/i>\u00a0(STEC)<\/a>. People involved in the outbreak were in the Lake Anna area over the Memorial Day weekend, May 24\u201327, 2024 . A total of 25 STEC cases were identified, including 12 caused by STEC O157, the most common type of STEC. Among these 25 cases, 23 were in people who visited the lake and two were in people who had close contact with someone with STEC. All 23 people with STEC who visited the lake were at the lake between May 24 and May 27. Most of these people reported visiting the sandbar.<\/p>\n<p><b>No new STEC cases have been found in people who visited the lake after the Memorial Day weekend. <\/b>This tells us that the exposure period of greatest risk (Memorial Day weekend) for STEC infection has passed. Swimming or other activities in any natural body of water always poses some health risk because the water is not disinfected. VDH encourages people to visit <a href=\"http:\/\/www.swimhealthyva.com\/\">www.swimhealthyva.com<\/a> and CDC\u2019s <a href=\"https:\/\/www.cdc.gov\/healthy-swimming\/safety\/how-to-safely-visit-oceans-lakes-and-rivers.html\">How to Safely Visit Oceans, Lakes, and Rivers website<\/a> for information about how to stay safe during water activities. <strong><a href=\"https:\/\/www.vdh.virginia.gov\/news\/2024-news-releases\/swimming-advisory-issued-for-upper-north-anna-branch-of-lake-anna-in-louisa-county-due-to-harmful-algae-bloom\/\">Some parts of Lake Anna<\/a> <span style=\"color: #a8151f\">remain under a swimming advisory for harmful algal blooms (HABs)<\/span><\/strong>.<\/p>\n<p>The Virginia Department of Environmental Quality (DEQ) collected water samples from Lake Anna on June 25 from similar areas as their previous collections on June 11 and June 17 (Sandbar, Cocktail Cove, and Lake Anna State Park). The Virginia Department of Agriculture and Consumer Services (VDACS) collected water samples for STEC testing, with DEQ\u2019s assistance on June 25 from Lake Anna at the same locations. The Department of Consolidated Laboratory Services (DCLS) tested the water samples.<\/p>\n<ul>\n<li>The fecal bacteria results for water samples collected on June 25 were all below levels of concern.<\/li>\n<li><span class=\"TextRun SCXW31559149 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun CommentStart CommentHighlightPipeRestV2 CommentHighlightRest SCXW31559149 BCX8\">For samples collected on June 25, <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">DCLS <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">used<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\"> a different test to look for strains of STEC that cause disease<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">.<\/span> <span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">STEC O157 was <\/span><\/span><span class=\"TextRun Underlined SCXW31559149 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">not<\/span><\/span><span class=\"TextRun SCXW31559149 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"> <span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">found<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\"> in<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\"> any of the samples<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">. <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">G<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">enetic material from non-O157 STEC bacteria<\/span> <\/span><span class=\"TextRun Underlined SCXW31559149 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">was<\/span><\/span><span class=\"TextRun SCXW31559149 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"> <span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">identified<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\"> in the Sandbar and Cocktail Cove samples. <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">This <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">initial<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\"> test <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">cannot specify if the <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">genetic <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">fragments<\/span> <span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">are <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">from <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">live or dead <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">bacteria. <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">When DCLS <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">did more testing<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">, l<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">ive bacteria<\/span> <span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">could not be found<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">.<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW31559149 BCX8\">\u00a0<\/span><\/span><span class=\"EOP CommentHighlightPipeRestV2 SCXW31559149 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><b>VDH is ending the STEC outbreak investigation on June 28 because:<\/b><\/p>\n<ul>\n<li>We have not identified any new confirmed or probable cases among people who visited Lake Anna on or after the Memorial Day weekend.<\/li>\n<li>At this point, we do not expect to find new cases associated with the Memorial Day weekend exposure.<\/li>\n<\/ul>\n<p><b>It is likely that the STEC infections are a result of exposure to lake water over Memorial Day weekend.<\/b> However, laboratory testing conducted at DCLS was not able to confirm the presence of STEC O157 bacteria in the water samples. It is unlikely that VDH will be able to specifically identify the source of bacteria in the water.<\/p>\n<p>Potential sources include environmental pollution from the following:<\/p>\n<ul>\n<li>Heavy rains<\/li>\n<li>Livestock<\/li>\n<li>Failing septic systems<\/li>\n<li>Boating discharge<\/li>\n<li>Swimmers<\/li>\n<\/ul>\n<p><b>Next Steps<\/b><\/p>\n<ul>\n<li>VDH will conduct enhanced surveillance for STEC through July 17 because of the upcoming 4th of July celebrations. This involves monitoring emergency department and urgent care visits for gastrointestinal illnesses and STEC. VDH will continue to monitor and investigate any STEC illness reports that we receive.<\/li>\n<li>VDH and its local health departments will continue to work with local partners to better understand potential risks in the area and prevention strategies to address those risks.<\/li>\n<li>DEQ will continue their routine monitoring of Lake Anna that occurs each year between April and October. This includes testing for fecal <i>E. coli<\/i> bacteria, but not STEC. <span class=\"ui-provider a b c d e f g h i j k l m n o p q r s t u v w x y z ab ac ae af ag ah ai aj ak\" dir=\"ltr\">DEQ water quality monitoring results are available at\u00a0<a class=\"fui-Link ___1rxvrpe f2hkw1w f3rmtva f1ewtqcl fyind8e f1k6fduh f1w7gpdv fk6fouc fjoy568 figsok6 f1hu3pq6 f11qmguv f19f4twv f1tyq0we f1g0x7ka fhxju0i f1qch9an f1cnd47f fqv5qza f1vmzxwi f1o700av f13mvf36 f1cmlufx f9n3di6 f1ids18y f1tx3yz7 f1deo86v f1eh06m1 f1iescvh fhgqx19 f1olyrje f1p93eir f1nev41a f1h8hb77 f1lqvz6u f10aw75t fsle3fq f17ae5zn\" title=\"https:\/\/www.waterqualitydata.us\/\" href=\"https:\/\/www.waterqualitydata.us\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Link Water Quality Data Home\">Water Quality Data Home<\/a><\/span>.<\/li>\n<\/ul>\n<h3>Fast Facts<\/h3>\n<ul style=\"border: 2px solid #333333\">\n<li><strong>STEC cases:<\/strong> 25 confirmed and probable cases in residents of Virginia and other states.\n<ul>\n<li>12 cases identified as STEC O157 (most common type of <span style=\"text-decoration: underline\"><a href=\"https:\/\/www.vdh.virginia.gov\/epidemiology\/epidemiology-fact-sheets\/shiga-toxin-producing-escherichia-coli-stec\/\">STEC<\/a><\/span>)<\/li>\n<li>1 case identified as STEC non-O157<\/li>\n<\/ul>\n<\/li>\n<li><strong>Hemolytic uremic syndrome (HUS) Cases: <\/strong>7<\/li>\n<li><strong>Deaths:\u00a0<\/strong>0<\/li>\n<li><strong>Results water quality test results:\u00a0<\/strong>indicate that fecal bacteria concentrations were well below a level of public health concern.<\/li>\n<\/ul>\n<p><em>E. coli <\/em>are bacteria that normally live in the intestines of humans and animals, such as cows. Most strains of <em>E. coli <\/em>are harmless. Some strains can produce toxins that make people sick. These harmful strains are called Shiga Toxin-Producing <em>E. coli <\/em>or STEC. The most common type of STEC is <em>E. coli <\/em>O157:H7. STEC infection causes stomach cramps and diarrhea (often watery or bloody). Symptoms can also include vomiting, fever, and chills. In severe cases, the infection can damage organs, such as the kidneys. This can lead to <a href=\"https:\/\/www.vdh.virginia.gov\/epidemiology\/epidemiology-fact-sheets\/hemolytic-uremic-syndrome-hus\/\">hemolytic uremic syndrome (HUS)<\/a>.<\/p>\n<\/div>\n<\/div><\/div><\/div><div id=\"panel-11327-0-0-4\" class=\"so-panel widget widget_sow-editor\" data-index=\"4\" ><div id=\"is-it-safe\" class=\"panel-widget-style panel-widget-style-for-11327-0-0-4\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t><h3 class=\"widget-title\">Is it Safe to Swim or Recreate in Lake Anna and How to Stay Safe<\/h3>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<p>At this point, VDH does not expect to find new cases associated with the STEC outbreak at Lake Anna and the exposure that occurred over the Memorial Day weekend.<\/p>\n<p>Swimming or other activities in any natural bodies of water always pose some health risk because the water is not disinfected. Children under the age of 5 years, older adults, and those with weakened immune systems are at higher risk of contracting illness from natural bodies of water.<\/p>\n<p><strong><span class=\"TextRun SCXW109356188 BCX8\" lang=\"EN-US\" style=\"color: #a8151f\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun CommentStart CommentHighlightPipeRestV2 CommentHighlightRest SCXW109356188 BCX8\">Some parts of Lake Anna<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW109356188 BCX8\"> are not currently safe to swim at due <\/span><\/span><a class=\"Hyperlink SCXW109356188 BCX8\" href=\"https:\/\/www.vdh.virginia.gov\/waterborne-hazards-control\/harmful-algal-blooms\/\" target=\"_blank\" rel=\"noreferrer noopener\"><span class=\"TextRun Underlined SCXW109356188 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun CommentHighlightRest SCXW109356188 BCX8\" data-ccp-charstyle=\"Hyperlink\">to a harmful algal bloom (HAB)<\/span><\/span><\/a><span class=\"TextRun SCXW109356188 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun CommentHighlightRest SCXW109356188 BCX8\">.<\/span> <\/span><span class=\"TextRun Highlight SCXW109356188 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun CommentHighlightRest SCXW109356188 BCX8\"><span style=\"color: #a8151f\">The area to avoid can be seen on an interactive <\/span><\/span><\/span><a class=\"Hyperlink SCXW109356188 BCX8\" href=\"https:\/\/www.vdh.virginia.gov\/waterborne-hazards-control\/algal-bloom-surveillance-map\/\" target=\"_blank\" rel=\"noreferrer noopener\"><span class=\"TextRun Highlight Underlined SCXW109356188 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun CommentHighlightRest SCXW109356188 BCX8\" data-ccp-charstyle=\"Hyperlink\">Harmful Algal Bloom\u202f<\/span><\/span><span class=\"TextRun Underlined SCXW109356188 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun CommentHighlightRest SCXW109356188 BCX8\" data-ccp-charstyle=\"Hyperlink\">map<\/span><\/span><\/a><span class=\"TextRun Highlight SCXW109356188 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun CommentHighlightRest SCXW109356188 BCX8\">.\u202f<\/span><\/span><span class=\"TextRun SCXW109356188 BCX8\" lang=\"EN-US\" style=\"color: #a8151f\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun CommentHighlightRest SCXW109356188 BCX8\">Check the <\/span><\/span><a class=\"Hyperlink SCXW109356188 BCX8\" href=\"https:\/\/www.vdh.virginia.gov\/waterborne-hazards-control\/harmful-algal-blooms\/\" target=\"_blank\" rel=\"noreferrer noopener\"><span class=\"TextRun Underlined SCXW109356188 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun CommentHighlightRest SCXW109356188 BCX8\" data-ccp-charstyle=\"Hyperlink\">HAB website<\/span><\/span><\/a><span class=\"TextRun SCXW109356188 BCX8\" lang=\"EN-US\" style=\"color: #a8151f\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun CommentHighlightRest SCXW109356188 BCX8\"> before you go to the lake, and do not swim in areas that are under a swimming advisory.<\/span><\/span><span class=\"EOP CommentHighlightPipeRestV2 SCXW109356188 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/strong><\/p>\n<p>Some other ways to keep you and your family safe include:<\/p>\n<ul>\n<li>Never swallow untreated water and don\u2019t swim if your skin has cuts or open wounds.<\/li>\n<li>Wash hands frequently, including after swimming, after using the bathroom, and before preparing and eating food.<\/li>\n<li>Shower or bathe after swimming to wash off possible germs and contaminants.<\/li>\n<li>Check the water and the area around it before swimming. Avoid going in water if there is a green film on the water or if the water is cloudier than usual. Avoid swimming near storm drains or livestock.<\/li>\n<li>Avoid swimming if you are vomiting or have diarrhea.<\/li>\n<li>Avoid swimming for three days after a heavy rain. Heavy rain picks up anything it comes in contact with, including germs from overflowing sewage, polluted storm water, and runoff from land.<\/li>\n<\/ul>\n<p>Visit <a href=\"http:\/\/www.swimhealthyva.com\">www.swimhealthyva.com<\/a> and CDC\u2019s <a href=\"https:\/\/www.cdc.gov\/healthy-swimming\/safety\/how-to-safely-visit-oceans-lakes-and-rivers.html\">How to Safely Visit Oceans, Lakes, and Rivers website<\/a> for more information about how to stay safe during water activities.<\/p>\n<\/div>\n<\/div><\/div><\/div><div id=\"panel-11327-0-0-5\" class=\"so-panel widget widget_sow-editor\" data-index=\"5\" ><div id=\"outbreak-details\" class=\"panel-widget-style panel-widget-style-for-11327-0-0-5\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t><h3 class=\"widget-title\">STEC Case Details*<\/h3>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t\n<table id=\"tablepress-1\" class=\"tablepress tablepress-id-1\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Description<\/th><th class=\"column-2\">Information<\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-striping row-hover\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\">Case Type <\/td><td class=\"column-2\">Primary: 23<br \/>\nSecondary: 2<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\">Age<\/td><td class=\"column-2\">Range: 1 to 45 years<br \/>\n<br \/>\nMost cases (76%) are in children under 18 years of age. <\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\">Residency<\/td><td class=\"column-2\">Virginia: 21 <br \/>\n<br \/>\nOther state: 4  <\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<!-- #tablepress-1 from cache -->\n<p>*Data are preliminary and subject to change. VDH counts probable and confirmed cases using the <a href=\"https:\/\/ndc.services.cdc.gov\/conditions\/shiga-toxin-producing-escherichia-coli\/\">national STEC case definition<\/a> and the <a href=\"https:\/\/ndc.services.cdc.gov\/conditions\/hemolytic-uremic-syndrome-post-diarrheal\/\">national HUS case definition<\/a>. For case type, primary cases are infections from direct exposure to the suspected outbreak source. Secondary cases are infections from close contact with someone who was infected.<\/p>\n<\/div>\n<\/div><\/div><\/div><div id=\"panel-11327-0-0-6\" class=\"so-panel widget widget_sow-editor\" data-index=\"6\" ><div id=\"environmental-testing\" class=\"panel-widget-style panel-widget-style-for-11327-0-0-6\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t><h3 class=\"widget-title\">Environmental Testing <\/h3>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<p><strong>Summary of findings: <\/strong><\/p>\n<ul>\n<li>VDACS, DEQ and DCLS worked with VDH in the outbreak investigation. DEQ collected water samples at Lake Anna at three main areas (the Sandbar, Cocktail Cove, and Lake Anna State Park) on three dates (June 11, June 17, and June 25). DCLS testing of the June 25 water samples <u>did not<\/u> identify STEC O157 in any samples. Testing <u>did<\/u> identify genetic material from non-O157 STEC bacteria in samples from the Sandbar and Cocktail Cove. Live bacteria, however, could not be found after additional testing.<\/li>\n<li>All water samples collected on June 11, June 17, and June 25 showed that fecal indicator bacteria concentrations (levels of bacteria associated with human or animal waste) were well below a level of public health concern. Fecal indicator bacteria tests look for fecal coliforms, <em> coli<\/em> (not STEC), and Enterococci.<\/li>\n<li>Water testing has some limitations.\n<ul>\n<li>The results can provide a snapshot about the presence of STEC or level of general fecal contamination at a point in time and location.<\/li>\n<li>The fecal indicator bacteria tests cannot detect all types of bacteria that cause illness.<\/li>\n<li>The samples used for STEC testing were collected on June 25, about four weeks after the Memorial Day Weekend. These samples might not reflect the condition of the water during the holiday weekend.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><span data-contrast=\"none\">DEQ conducts <\/span><b><span data-contrast=\"none\">routine<\/span><\/b><span data-contrast=\"none\"> monthly water quality monitoring on Lake Anna from April to October each year. Water quality testing includes looking for fecal indicator bacteria, specifically <\/span><i><span data-contrast=\"none\">E. coli.<\/span><\/i><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">DEQ collected t<\/span><span data-contrast=\"auto\">he <\/span><b><span data-contrast=\"auto\">routine<\/span><\/b><span data-contrast=\"auto\"> samples for\u202f<\/span><i><span data-contrast=\"auto\">E. coli<\/span><\/i><span data-contrast=\"auto\">\u202f<\/span><span data-contrast=\"auto\">on\u202fJune 4, May 6, and April 2.<\/span><span data-contrast=\"auto\"> The\u202f<\/span><i><span data-contrast=\"auto\">E. coli\u202f<\/span><\/i><span data-contrast=\"auto\">concentrations of each sample were <\/span><span data-contrast=\"auto\">so low that they could not be measured. Samples were taken:<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"36\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"auto\">Near the dam<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"36\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"5\" data-aria-level=\"1\"><span data-contrast=\"auto\">At the Splits (down gradient from the State Park Beach)<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"36\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"6\" data-aria-level=\"1\"><span data-contrast=\"auto\">Mid-lake (just below the Cocktail Creek area)<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"auto\">The <\/span><b><span data-contrast=\"auto\">routine<\/span><\/b><span data-contrast=\"auto\"> samples for\u202f<\/span><i><span data-contrast=\"auto\">E. coli\u202f<\/span><\/i><span data-contrast=\"auto\">collected by DEQ near the Sandbar were taken on<\/span><span data-contrast=\"auto\">:<\/span><span data-contrast=\"auto\">\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"37\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"7\" data-aria-level=\"1\"><span data-contrast=\"auto\">March 12 (816 <\/span><span data-contrast=\"auto\">counts<\/span><span data-contrast=\"auto\">\/100ml)\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"37\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"8\" data-aria-level=\"1\"><span data-contrast=\"auto\">February 20 (173 c<\/span><span data-contrast=\"auto\">ounts<\/span><span data-contrast=\"auto\">\/100ml)\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"37\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"9\" data-aria-level=\"1\"><span data-contrast=\"auto\">November 13, 2023 (10 <\/span><span data-contrast=\"auto\">counts<\/span><span data-contrast=\"auto\">\/100ml)\u202f<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<p>Lake Anna Civic Association (LACA) also conducts routine water quality monitoring. See LACA\u2019s <a href=\"https:\/\/www.lakeannavirginia.org\/Water-Quality-Data\">Water Quality (WQ) and Cyanobacteria Data website<\/a> for more information on their water quality program and test results.<\/p>\n<ul>\n<li>Cyanobacteria are bacteria that may produce toxins. These organisms were <strong>not<\/strong> part of the STEC outbreak at Lake Anna over the Memorial Day weekend. For more information about cyanobacteria, visit <a href=\"https:\/\/www.vdh.virginia.gov\/waterborne-hazards-control\/harmful-algal-blooms\/cyanobacteria\/\">VDH\u2019s Cyanobacteria Fact Sheet<\/a>.<\/li>\n<\/ul>\n<h3>Lake Anna Sampling Sites<\/h3>\n\n<!-- iframe plugin v.6.0 wordpress.org\/plugins\/iframe\/ -->\n<iframe loading=\"lazy\" src=\"https:\/\/www.google.com\/maps\/d\/embed?mid=1N99_Z9bY2lVW4TZCpoBLmepMXa1oHS8&#038;hl=en&#038;ehbc=2E312F\" width=\"640\" height=\"480\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\"><\/iframe>\n\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-11540 size-full\" src=\"https:\/\/www.vdh.virginia.gov\/content\/uploads\/sites\/13\/2024\/07\/legendupdates.png\" alt=\"Lake Anna testing site legend\" width=\"606\" height=\"106\" srcset=\"https:\/\/www.vdh.virginia.gov\/content\/uploads\/sites\/13\/2024\/07\/legendupdates.png 606w, https:\/\/www.vdh.virginia.gov\/content\/uploads\/sites\/13\/2024\/07\/legendupdates-300x52.png 300w\" sizes=\"auto, (max-width: 606px) 100vw, 606px\" \/><\/p>\n<p>Click on the expansion bars on the upper right of the map to make the map larger and see the full legend.<\/p>\n<p>The large green dots show the six sampling locations for June 11 and 17. The small green dots show the four sampling locations for June 25. The green color means fecal indicator bacteria are below levels of public health concern. This type of testing is not specific to all types of bacteria that can cause illness.<\/p>\n<p>The yellow and green pins show the four sampling locations on June 25 for STEC testing. The testing did not detect STEC at Lake Anna State Park. Genetic material from non-O157 STEC bacteria was identified at two Sandbar locations and Cocktail Cove. This initial test cannot tell if the genetic fragments are from live (infectious) or dead (not infectious) bacteria. When further testing was done to try to grow the bacteria, live bacteria could <u>not<\/u> be identified.<\/p>\n<p>Collecting samples on June 25 for STEC testing required time-consuming filtration of large volumes of lake water. Four sites were sampled: 2 locations at the Sandbar, 1 at Cocktail Cove, and 1 at the State Park Beach. These sites were prioritized because they were the locations visited by people who became sick.<\/p>\n<\/div>\n<\/div><\/div><\/div><div id=\"panel-11327-0-0-7\" class=\"so-panel widget widget_sow-accordion panel-last-child\" data-index=\"7\" ><div id=\"FAQs-e-coli\" class=\"panel-widget-style panel-widget-style-for-11327-0-0-7\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-accordion so-widget-sow-accordion-default-d9295f5bfa93-11327\"\n\t\t\t\n\t\t><h3 class=\"widget-title\">Frequently Asked Questions<\/h3><div>\n\t<div class=\"sow-accordion\">\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"is-stec-0157-a-strain-of-e-coli\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-is-stec-0157-a-strain-of-e-coli\" aria-controls=\"accordion-content-is-stec-0157-a-strain-of-e-coli\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tIs STEC 0157 a strain of E. coli?\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-is-stec-0157-a-strain-of-e-coli\"\n\t\t\t\tid=\"accordion-content-is-stec-0157-a-strain-of-e-coli\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>Yes. <em>Escherichia coli<\/em> (abbreviated as <em>E. coli<\/em>) are a large and diverse group of bacteria. Although most strains of <em>E. coli<\/em> are harmless, others can produce toxins that make you sick. These harmful strains are called Shiga Toxin-Producing <em>E. coli<\/em> (STEC). The most common type of STEC is <em>E. coli<\/em> O157:H7. Often when you hear news reports about outbreaks of <em>E. coli<\/em> infections, they are talking about <em>E. coli<\/em> O157:H7.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"what-is-non-o157-stec\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-what-is-non-o157-stec\" aria-controls=\"accordion-content-what-is-non-o157-stec\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tWhat is non-O157 STEC?\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-what-is-non-o157-stec\"\n\t\t\t\tid=\"accordion-content-what-is-non-o157-stec\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>There are many types of Shiga toxin-producing <em>E. coli<\/em> (STEC). STEC O157 is the most common type. Non-O157 STEC includes all STEC types other than STEC O157. Some, but not all, non-O157 STEC cause illness in people. The symptoms of STEC O157 and non-O157 infections are similar (cramps, diarrhea, vomiting). The Centers for Disease Control and Prevention (CDC) estimates that non-O157 STEC causes about 169,000 illnesses and 400 hospitalizations each year in the United States.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"is-the-harmful-algal-bloom-hab-the-same-thing-as-the-stec-outbreak\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-is-the-harmful-algal-bloom-hab-the-same-thing-as-the-stec-outbreak\" aria-controls=\"accordion-content-is-the-harmful-algal-bloom-hab-the-same-thing-as-the-stec-outbreak\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tIs the Harmful Algal Bloom (HAB) the same thing as the STEC outbreak?\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-is-the-harmful-algal-bloom-hab-the-same-thing-as-the-stec-outbreak\"\n\t\t\t\tid=\"accordion-content-is-the-harmful-algal-bloom-hab-the-same-thing-as-the-stec-outbreak\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>No. The Harmful Algal Bloom (HAB) is not the same as the STEC outbreak. They are two separate, unrelated health concerns that happened to be occurring at the same time.<\/p>\n<p>HABs are not uncommon in Lake Anna but can be dangerous to the health of humans and animals in the area. The Virginia Department of Health has issued a <a href=\"https:\/\/www.vdh.virginia.gov\/blog\/2024\/06\/21\/swimming-advisory-issued-for-upper-north-anna-branch-of-lake-anna-in-louisa-county-due-to-harmful-algae-bloom\/\">swim advisory for some parts of Lake Anna as a result of this HAB<\/a>.<\/p>\n<p>Separately, there was an outbreak of Shiga toxin-producing<em> Escherichia coli<\/em> (STEC) in people who were in the Lake Anna area around Memorial Day weekend. At this point, VDH does not expect to find new cases associated with the Memorial Day weekend exposure to Lake Anna.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"what-caused-this-stec-outbreak\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-what-caused-this-stec-outbreak\" aria-controls=\"accordion-content-what-caused-this-stec-outbreak\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tWhat caused this STEC outbreak?\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-what-caused-this-stec-outbreak\"\n\t\t\t\tid=\"accordion-content-what-caused-this-stec-outbreak\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>It is likely that these STEC illnesses are a result of people being exposed to bacteria in the water over Memorial Day weekend. Laboratory testing by DCLS was not able to identify STEC O157 bacteria in water samples from the lake. VDH was not able to specifically identify the source of bacteria in the water.<\/p>\n<p>Potential sources of STEC infections include environmental pollution from any of the following:<\/p>\n<ul>\n<li>Heavy rains<\/li>\n<li>Livestock<\/li>\n<li>Failing septic systems<\/li>\n<li>Boating discharge<\/li>\n<li>Swimmers<\/li>\n<\/ul>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"how-can-i-keep-my-family-safe-when-swimming-or-recreating-in-lake-anna-or-other-natural-bodies-of-water\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-how-can-i-keep-my-family-safe-when-swimming-or-recreating-in-lake-anna-or-other-natural-bodies-of-water\" aria-controls=\"accordion-content-how-can-i-keep-my-family-safe-when-swimming-or-recreating-in-lake-anna-or-other-natural-bodies-of-water\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tHow can I keep my family safe when swimming or recreating in Lake Anna or other natural bodies of water?\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-how-can-i-keep-my-family-safe-when-swimming-or-recreating-in-lake-anna-or-other-natural-bodies-of-water\"\n\t\t\t\tid=\"accordion-content-how-can-i-keep-my-family-safe-when-swimming-or-recreating-in-lake-anna-or-other-natural-bodies-of-water\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>Consider the following steps to prevent getting sick from natural bodies of water, like lakes, rivers, or oceans.<\/p>\n<p><strong>Before<\/strong> visiting natural bodies of water:<\/p>\n<ul>\n<li><strong>Check online before visiting. <\/strong>Check to see if the area is currently monitored, is under advisory, or has been closed for health or safety reasons.See the following for possible advisories:\n<ul>\n<li><a href=\"http:\/\/www.SwimHealthyVA.com\">SwimHealthyVA.com<\/a> for Harmful Algal Bloom (HAB) and coastal beach maps<\/li>\n<li><a href=\"https:\/\/www.theswimguide.org\/find\">The Swim Guide<\/a> for Citizen Monitoring Group results<\/li>\n<li>LACA\u2019s <a href=\"https:\/\/www.lakeannavirginia.org\/Water-Quality-Data\">Water Quality (WQ) and Cyanobacteria Data website<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li><strong>Avoid swimming for three days after a heavy rain<\/strong>. Germs can come from overflowing sewage, polluted storm water and runoff from land.<\/li>\n<\/ul>\n<p><strong>While <\/strong>visiting natural bodies of water:<\/p>\n<ul>\n<li><strong>Avoid swimming <\/strong>\n<ul>\n<li>if you are sick with <strong>vomiting or diarrhea <\/strong>or if you have<strong> skin with cuts<\/strong> or open wounds<\/li>\n<li><strong>near storm drains<\/strong> (pipes that drain polluted water from streets)<\/li>\n<li><strong>in water if there is a green film on the water. Keep pets out as well<\/strong>. This film may mean that an algal bloom and some algae produce toxins are present. These blooms and toxins can make people sick.<\/li>\n<li><strong>near the vicinity of livestock<\/strong><\/li>\n<\/ul>\n<\/li>\n<li><strong>Never <\/strong><strong>swallow untreated water<\/strong>. Natural bodies of water contain germs and contaminants, which can cause illness.<\/li>\n<li><strong>Keep sand away from your mouth and children\u2019s mouths. <\/strong>Sand contains germs that can cause illness if swallowed.<\/li>\n<li><strong>Do not poop in the water.<\/strong>\n<ul>\n<li><strong>Take kids on bathroom breaks and check diapers <\/strong>in bathrooms or diaper-changing areas.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Wash your hands<\/strong> after using the bathroom and before preparing and eating food.This is particularly important if you have been playing in or touching sand.<\/li>\n<li>For people with boats:<strong> Use the proper methods to dispose human waste. <\/strong>Discharge boat sewage at marinas with a pump-out unit or dump station.\n<ul>\n<li>See <a href=\"https:\/\/www.vdh.virginia.gov\/environmental-health\/marina-program\/maps-marina\/\">Pump-out locations around Virginia<\/a>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>After <\/strong>visiting natural bodies of water:<\/p>\n<ul>\n<li><strong>Shower or bathe after swimming<\/strong> to wash off possible germs and contaminants.<\/li>\n<\/ul>\n<p>For recommendations on healthy practices during water activities, see <a href=\"http:\/\/www.swimhealthyva.com\">www.swimhealthyva.com<\/a> and <a href=\"https:\/\/www.cdc.gov\/healthy-swimming\/safety\/how-to-safely-visit-oceans-lakes-and-rivers.html\">CDC\u2019s How to Safely Visit Oceans, Lakes, and Rivers website<\/a>.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"what-should-i-do-if-i-am-sick\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-what-should-i-do-if-i-am-sick\" aria-controls=\"accordion-content-what-should-i-do-if-i-am-sick\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tWhat should I do if I am sick?\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-what-should-i-do-if-i-am-sick\"\n\t\t\t\tid=\"accordion-content-what-should-i-do-if-i-am-sick\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>If you were at Lake Anna and you have gastrointestinal illness (such as stomach cramps and diarrhea), contact your <a href=\"https:\/\/www.vdh.virginia.gov\/health-department-locator\/\"><strong>local health department<\/strong><\/a> and seek medical care if you are still experiencing symptoms.<\/p>\n<p>People with diarrhea should <strong>drink plenty of fluids<\/strong> to prevent dehydration. Dehydration is not having enough water in the body. Talk to your healthcare provider <strong>before<\/strong> taking anti-diarrheal medication, such as Imodium\u00ae. <strong>People with STEC infections should not use anti-diarrheal medication<\/strong>. Using anti-diarrheal medication with STEC infection can increase the chance of hemolytic uremic syndrome (HUS).<\/p>\n<p><strong>It is best to stay home when you have diarrhea<\/strong>. The health department will give advice on each situation in which the person with STEC infection is a food handler, healthcare worker, childcare worker, or childcare attendee. Some people might not be allowed to go back to childcare or work until two stool specimens test negative for the bacteria.<\/p>\n<p>If you are sick with gastrointestinal illness, <strong>be sure to follow safety practices so that you do not pass this on to other members of your household<\/strong>:<\/p>\n<ul>\n<li>Always carefully wash hands before and after preparing foods.<\/li>\n<li>Always carefully wash hands with soap and warm water after using the toilet or changing diapers.<\/li>\n<\/ul>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"did-vdh-test-for-stec-o157-or-e-coli-or-both-at-lake-anna\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-did-vdh-test-for-stec-o157-or-e-coli-or-both-at-lake-anna\" aria-controls=\"accordion-content-did-vdh-test-for-stec-o157-or-e-coli-or-both-at-lake-anna\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tDid VDH test for STEC O157 or E. coli or both at Lake Anna? \t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-did-vdh-test-for-stec-o157-or-e-coli-or-both-at-lake-anna\"\n\t\t\t\tid=\"accordion-content-did-vdh-test-for-stec-o157-or-e-coli-or-both-at-lake-anna\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>For this outbreak, DEQ collected water samples on June 11, June 17, and June 25 for 3 different tests: fecal coliforms, <em>E. coli<\/em>, and enterococci. Fecal coliforms are a broad category. <em>E. coli<\/em> and enterococci are more specific. These routine fecal bacteria tests help tell us if there is human or animal feces (poop) in the water. These tests are not able to identify all strains of <em>E. coli<\/em> or STEC that cause disease, like STEC O157.<\/p>\n<p>On June 25, the Virginia Department of Agriculture and Consumer Services (VDACS) with assistance from DEQ, collected water samples for a different test that can look for strains of STEC that cause disease, like STEC O157. The test results showed that STEC O157 was <u>not<\/u> identified in any of the samples. Genetic material from non-O157 STEC bacteria <u>was<\/u> identified in samples collected at the Sandbar and Cocktail Cove. This initial test cannot tell us if the genetic fragments are live (infectious) or dead (not infectious). After more testing, live non-O157 STEC bacteria could not be found.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"is-stec-o157-included-in-the-routine-testing\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-is-stec-o157-included-in-the-routine-testing\" aria-controls=\"accordion-content-is-stec-o157-included-in-the-routine-testing\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tIs STEC O157 included in the routine testing? \t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-is-stec-o157-included-in-the-routine-testing\"\n\t\t\t\tid=\"accordion-content-is-stec-o157-included-in-the-routine-testing\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>In general, routine fecal indicator bacteria testing is thought to be a good at predicting if someone who is exposed to the water will become sick, but it has limitations. VDH initially understood the routine <em>E. coli<\/em> testing could detect <em>E. coli<\/em> strains that cause disease, like STEC O157. We later learned that it could not. The routine water testing conducted by DEQ and analyzed by DCLS, does not have the capability to test for STEC O157. Collecting water samples and testing for disease-causing <em>E. coli<\/em>, like STEC O157 requires a different type of water sample collection and lab test.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"why-cant-the-routine-water-test-detect-strains-of-e-coli-that-cause-disease-like-stec-o157\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-why-can%e2%80%99t-the-routine-water-test-detect-strains-of-e-coli-that-cause-disease-like-stec-o157\" aria-controls=\"accordion-content-why-can%e2%80%99t-the-routine-water-test-detect-strains-of-e-coli-that-cause-disease-like-stec-o157\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tWhy can\u2019t the routine water test detect strains of E. coli that cause disease, like STEC O157?  \t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-why-can%e2%80%99t-the-routine-water-test-detect-strains-of-e-coli-that-cause-disease-like-stec-o157\"\n\t\t\t\tid=\"accordion-content-why-can%e2%80%99t-the-routine-water-test-detect-strains-of-e-coli-that-cause-disease-like-stec-o157\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>Fecal indicator bacteria tests used in this investigation looked for fecal coliforms, <em>E. coli<\/em>, and Enterococci. They are reliable and widely used for analyses recommended by the Environmental Protection Agency (EPA). They are designed to look for fecal contamination.<\/p>\n<p>In general, the fecal indicator bacteria testing is thought to be a good predictor of if someone is exposed to the water will become sick, but it has limitations. They are not designed to detect all types of bacteria that can cause illness, including STEC O157.<\/p>\n<p>There are many different strains of <em>E. coli<\/em>. To target a specific strain, such as STEC O157, special collection procedures and laboratory testing are needed.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"will-there-be-any-more-testing-at-lake-anna\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-will-there-be-any-more-testing-at-lake-anna\" aria-controls=\"accordion-content-will-there-be-any-more-testing-at-lake-anna\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tWill there be any more testing at Lake Anna?  \t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-will-there-be-any-more-testing-at-lake-anna\"\n\t\t\t\tid=\"accordion-content-will-there-be-any-more-testing-at-lake-anna\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>DEQ will continue its routine monthly monitoring of Lake Anna that occurs during April to October each year. As part of this monitoring, water quality testing includes looking for fecal bacteria, <em>E. coli.<\/em> This DEQ's water quality monitoring data are available to the public through the Water Quality Data Portal: <a href=\"https:\/\/www.waterqualitydata.us\/\">Water Quality Data Home.<\/a><\/p>\n<p>Lake Anna Civic Association (LACA) also conducts routine water quality monitoring on Lake Anna. More information on the water quality program conducted by LACA and their test results can be found at LACA\u2019s <a href=\"https:\/\/www.lakeannavirginia.org\/Water-Quality-Data\">Water Quality (WQ) and Cyanobacteria Data website<\/a>.<\/p>\n<ul>\n<li>Cyanobacteria are bacteria that may produce toxins. These organisms were <strong>not<\/strong> part of the STEC outbreak at Lake Anna over Memorial Day weekend. For more information about cyanobacteria, visit <a href=\"https:\/\/www.vdh.virginia.gov\/waterborne-hazards-control\/harmful-algal-blooms\/cyanobacteria\/\">VDH\u2019s Cyanobacteria Fact Sheet<\/a>.<\/li>\n<\/ul>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"are-deqs-routine-bacteria-water-monitoring-data-for-lake-anna-available-to-the-public\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-are-deqs-routine-bacteria-water-monitoring-data-for-lake-anna-available-to-the-public\" aria-controls=\"accordion-content-are-deqs-routine-bacteria-water-monitoring-data-for-lake-anna-available-to-the-public\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tAre DEQ's routine bacteria water monitoring data for Lake Anna available to the public? \t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-are-deqs-routine-bacteria-water-monitoring-data-for-lake-anna-available-to-the-public\"\n\t\t\t\tid=\"accordion-content-are-deqs-routine-bacteria-water-monitoring-data-for-lake-anna-available-to-the-public\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>Yes. Water quality monitoring data are available at <a class=\"fui-Link ___1rxvrpe f2hkw1w f3rmtva f1ewtqcl fyind8e f1k6fduh f1w7gpdv fk6fouc fjoy568 figsok6 f1hu3pq6 f11qmguv f19f4twv f1tyq0we f1g0x7ka fhxju0i f1qch9an f1cnd47f fqv5qza f1vmzxwi f1o700av f13mvf36 f1cmlufx f9n3di6 f1ids18y f1tx3yz7 f1deo86v f1eh06m1 f1iescvh fhgqx19 f1olyrje f1p93eir f1nev41a f1h8hb77 f1lqvz6u f10aw75t fsle3fq f17ae5zn\" title=\"https:\/\/www.waterqualitydata.us\/\" href=\"https:\/\/www.waterqualitydata.us\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Link WaterQualityData Home\">Water Quality Data Home<\/a>.<\/p>\n<p>DEQ's annual\u00a0<a class=\"fui-Link ___1rxvrpe f2hkw1w f3rmtva f1ewtqcl fyind8e f1k6fduh f1w7gpdv fk6fouc fjoy568 figsok6 f1hu3pq6 f11qmguv f19f4twv f1tyq0we f1g0x7ka fhxju0i f1qch9an f1cnd47f fqv5qza f1vmzxwi f1o700av f13mvf36 f1cmlufx f9n3di6 f1ids18y f1tx3yz7 f1deo86v f1eh06m1 f1iescvh fhgqx19 f1olyrje f1p93eir f1nev41a f1h8hb77 f1lqvz6u f10aw75t fsle3fq f17ae5zn\" title=\"https:\/\/www.deq.virginia.gov\/our-programs\/water\/water-quality\/monitoring\/water-quality-monitoring-plan\" href=\"https:\/\/www.deq.virginia.gov\/our-programs\/water\/water-quality\/monitoring\/water-quality-monitoring-plan\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Link waterquality\u00a0monitoring plan\">water quality monitoring plan<\/a>, including an interactive map with station locations, is available to the public.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"what-is-vdh-doing-to-protect-the-public\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-what-is-vdh-doing-to-protect-the-public\" aria-controls=\"accordion-content-what-is-vdh-doing-to-protect-the-public\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tWhat is VDH doing to protect the public?\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-what-is-vdh-doing-to-protect-the-public\"\n\t\t\t\tid=\"accordion-content-what-is-vdh-doing-to-protect-the-public\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>VDH is taking the steps listed below to protect the public:<\/p>\n<ul>\n<li>Conducting a thorough outbreak investigation to determine who is affected, what is the cause, and how to prevent more illnesses.<\/li>\n<li>Sharing information with the public. VDH launched this website on June 14 and issued news releases on:\n<ul>\n<li><a href=\"https:\/\/www.vdh.virginia.gov\/news\/2024-regional-news-releases\/virginia-department-of-health-is-investigating-a-cluster-of-gastrointestinal-illness-in-the-lake-anna-area-over-the-memorial-day-weekend\/\">June 6<\/a><\/li>\n<li><a href=\"https:\/\/www.vdh.virginia.gov\/news\/virginia-department-of-health-provides-update-about-the-lake-anna-area-outbreak-associated-with-memorial-day-weekend\/\">June 14<\/a><\/li>\n<li><a href=\"https:\/\/www.vdh.virginia.gov\/news\/2024-news-releases\/virginia-department-of-health-provides-update-about-the-lake-anna-area-outbreak-associated-with-memorial-day-weekend\/\">June 21<\/a><\/li>\n<li><a href=\"https:\/\/www.vdh.virginia.gov\/news\/2024-news-releases\/virginia-department-of-health-closes-investigation-of-lake-anna-area-memorial-day-outbreak\/\">July 2<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Asking the public, healthcare providers, and public health partners in other states to rapidly report suspected STEC cases.<\/li>\n<li>Working closely with our state laboratory, the Division of Consolidated Laboratory Services, to test samples from people who are ill and analyze environmental samples.<\/li>\n<li>Collaborating with the Virginia Department of Environmental Quality (DEQ) on the environmental health investigation. This involves reviewing results from routine water testing that DEQ had conducted before the outbreak began and collecting new water samples to see if there are any irregularities.<\/li>\n<li>Collaborating with Virginia Department of Agriculture and Consumer Services to better understand livestock access to Lake Anna and assist with collecting water samples for STEC testing.<\/li>\n<\/ul>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"has-vdh-issued-a-public-health-advisory-why-or-why-not\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-has-vdh-issued-a-public-health-advisory-why-or-why-not\" aria-controls=\"accordion-content-has-vdh-issued-a-public-health-advisory-why-or-why-not\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tHas VDH issued a public health advisory? Why or why not? \t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-has-vdh-issued-a-public-health-advisory-why-or-why-not\"\n\t\t\t\tid=\"accordion-content-has-vdh-issued-a-public-health-advisory-why-or-why-not\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>No, VDH did not issue a public health advisory for Lake Anna. Most of the people with STEC infection reported swimming or other water activities in Lake Anna. These exposures occurred over the Memorial Day weekend (May 24\u201327). VDH did not identify STEC infections in people who visited the lake after that weekend. This tells us that the exposure period of greatest risk (Memorial Day weekend) had passed. Because there is always some risk of getting sick after visiting natural bodies of water, VDH emphasized steps people could take to lower their risk of getting sick.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"why-is-vdh-ending-the-outbreak-investigation\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-why-is-vdh-ending-the-outbreak-investigation\" aria-controls=\"accordion-content-why-is-vdh-ending-the-outbreak-investigation\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tWhy is VDH ending the outbreak investigation?\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-why-is-vdh-ending-the-outbreak-investigation\"\n\t\t\t\tid=\"accordion-content-why-is-vdh-ending-the-outbreak-investigation\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>There are 2 main reasons why VDH is ending the outbreak investigation:<\/p>\n<ul>\n<li>There have been no new cases among people who visited Lake Anna over the Memorial Day weekend. A total of 25 confirmed and probable cases have been reported, including 12 cases caused by STEC O157.<\/li>\n<li>It has been more than 20 days (two 10-day incubation periods) since the last person who visited Lake Anna over the holiday became ill.<\/li>\n<\/ul>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"sow-accordion-panel\n\t\t\t\t\t\"\n\t\t\t\tdata-anchor-id=\"where-can-i-find-more-information-about-this-outbreak-and-how-to-stay-safe\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-where-can-i-find-more-information-about-this-outbreak-and-how-to-stay-safe\" aria-controls=\"accordion-content-where-can-i-find-more-information-about-this-outbreak-and-how-to-stay-safe\" aria-expanded=\"false\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tWhere can I find more information about this outbreak and how to stay safe? \t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-where-can-i-find-more-information-about-this-outbreak-and-how-to-stay-safe\"\n\t\t\t\tid=\"accordion-content-where-can-i-find-more-information-about-this-outbreak-and-how-to-stay-safe\"\n\t\t\t\tstyle=\"display: none;\"\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p>VDH does not plan to provide any more regular updates to this website.<\/p>\n<p>More information is available:<\/p>\n<ul>\n<li>For additional questions about this outbreak, contact VDH\u2019s Call Center at 877-829-4682 (Option 2), The VDH Call Center is available Monday\u2013Friday (except holidays) from 8 a.m. to 5 p.m. This Call Center support is being planned through July 17.<\/li>\n<li>For information about the types of illnesses, see <a href=\"https:\/\/www.vdh.virginia.gov\/epidemiology\/epidemiology-fact-sheets\/shiga-toxin-producing-escherichia-coli-stec\/\">VDH\u2019s Shiga-Toxin Producing E. coli (STEC) Fact Sheet<\/a> and <a href=\"https:\/\/www.vdh.virginia.gov\/epidemiology\/epidemiology-fact-sheets\/hemolytic-uremic-syndrome-hus\/\">Hemolytic Uremic Syndrome Fact Sheet<\/a><\/li>\n<li>For recommendations on healthy practices during water activities, see\u00a0<a href=\"http:\/\/www.swimhealthyva.com\/\">SwimHealthyVA.com<\/a> and <a href=\"https:\/\/www.cdc.gov\/healthy-swimming\/safety\/how-to-safely-visit-oceans-lakes-and-rivers.html\">CDC's How to Safely Visit Oceans, Lakes and Rivers website<\/a>.<\/li>\n<\/ul>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>Updated Outbreak Investigation Summary and Environmental Testing sections and multiple FAQs with STEC water testing results for samples collected on June 25. Added a new FAQ: What is non-O157 STEC? VDH is not planning future updates to this website. VDH worked with local, state, and federal partners to investigate an outbreak of Shiga toxin-producing Escherichia [&hellip;]<\/p>\n","protected":false},"author":464,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"tags":[],"class_list":["post-11327","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>2024 Shiga toxin-producing Escherichia coli\u202f(STEC) Outbreak in Virginia - Surveillance and Investigation<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.vdh.virginia.gov\/surveillance-and-investigation\/escherichia-coli-stec-outbreak-in-virginia\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"2024 Shiga toxin-producing Escherichia coli\u202f(STEC) Outbreak in Virginia - Surveillance and Investigation\" \/>\n<meta property=\"og:description\" content=\"Updated Outbreak Investigation Summary and Environmental Testing sections and multiple FAQs with STEC water testing results for samples collected on June 25. 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