This 12-year-old went to the Arizona State Fair. Then she got hospitalized from E. coli

MARK BRODIE: On the last day of the Arizona State Fair this fall, Jenna Trybus’ 12-year-old daughter, Lucy, and her dad went — they rode some rides and visited the petting zoo.

JENNA TRYBUS: That was on a Sunday. And then on Wednesday, I got a call from her school that she wasn't feeling well. She didn't look well. She just was feeling, had a little bit of nausea and was just really tired and had ended up with a fever that day. So we came home from school. And then the next day, she kind of seemed a little bit better, but then kind of the GI issues started and she couldn't keep anything down.

BRODIE: That weekend, Lucy had blood in her stool, so they went first to her primary care physician, who then sent her to the hospital. 

TRYBUS: We went to the ER Saturday morning. And then it just kind of got worse from there. They were monitoring what we first thought was just for dehydration, right? Because she has now gone days where she couldn't keep anything down. Then we were in the ER for, oh gosh, for eight hours. And they said if she still can't, you know, just a sip of water would kind of trigger all the stomach cramping. And so they said, you know, they want to admit her to monitor her. And then a few days later, her blood work started trending in a direction that they didn't like, and it's called HUS. It was her kidney levels. Her kidneys were failing.

BRODIE: HUS, or hemolytic uremic syndrome, is often triggered by the strain of E. coli that Lucy had picked up. Soon, doctors needed to place a catheter in Lucy's neck and start dialysis. Her mom says she was in temporary renal failure, but she says it then got worse from there. 

TRYBUS: So she had to do six cycles of dialysis. She needed two blood transfusions. She needed two platelet transfusions. She had to have an NG tube placed down her nose for feeding because she couldn't eat, and that was the only thing she could tolerate.

BRODIE: Jenna Trybus says it took 10 days for her daughter to stabilize before they started seeing any improvement. Lucy spent 18 days in the hospital overall. But her mom says she found out Lucy wasn't the only child there who'd recently been to the state fair, and specifically, the petting zoo. 

TRYBUS: Almost right, after we got the, they did the stool sample and figured out the strain of E. coli that it was, once we got up into the room, when she was admitted, the doctors almost immediately came in and asked us, you know, like, where have you been recently? And so we discussed that and they indicated that they are seeing a lot of kids in the hospital at that time with that same strand of E. coli.

BRODIE: At what point did you sense or did the doctors tell you that things were looking like they were going to be OK for your daughter?

TRYBUS: It wasn't ... so from the beginning, they did tell us that with this HUS, that it is slow. It is a very slow process. Things get worse and then they could improve a little and then get worse again. And so that it that it does take time.

So we did know that from the beginning. So they remained positive and hopeful that, you know, everything would be OK. And I personally refrained from looking up any details about HUS just for what that could tell me. But so they said that that what she was going through was typical of this bacteria and what it can do.

BRODIE: And is the expectation that she is really going to be OK, like she's going to make a full recovery? 

TRYBUS: They ... at this time are hopeful that and have no reason to think that she won't make a full recovery. We aren't there yet. We and they said it could take a year for her kidney function to go back to normal.

BRODIE: Wow.

TRYBUS: So we are continuing to do she has to get blood work regularly. We have to go back to the kidney doctor often. And now we're dealing with she has high blood pressure from this. So we've started some medication for that, which has kind of cost. She's having some other issues related to that now. So there's still things that that we're dealing with, but. So we don't know. We don't know because we aren't there yet, but they are hopeful that she will make a full recovery.

BRODIE: How is she doing now? I mean, you're more than a month away from when she first went to the hospital. How's she feeling? How's she doing? 

TRYBUS: Right. She's, yeah, she missed the whole month of November for school. She just went back to school on Monday. She's good. She doesn't have her energy levels aren't quite there. Her strength isn't quite there yet. You know her legs just from walking around. She feels sore just, you know, from being in in the hospital bed for so long that it took.

It took some, it's going to take some time to build her strength back. She still looks, to me, she doesn't look quite right. She's a little pale from, you know, having the blood transfusion, she's, you know, a little bit anemic and. But she's good. It's good to see her back with her friends and just back in school and doing normal 12-year-old girl things.

BRODIE: Yeah. How aware is she of what was going on with her? 

TRYBUS: She was pretty aware only. So at the hospital, they're really, they're really great. They have these child life specialists that come in and will show you diagrams of, you know, things that are going to be done to you and ask you, you know, do you want to know what's going to be happening, what the procedure is? Do you want to know the details? And my daughter did. She wanted to know the details.

So, you know, like with the HD catheter, they would show her what that meant and what it looked like. And so she wanted to be informed of all the things that were happening to her along the way. And so she was aware of what was happening. I don't know if she knew how severe it was or anything like that, but she wanted to know what was wrong with her.

BRODIE: OK. What kind of communication have you had with health officials or public health officials, anyone like that at the state or county level to maybe try to piece together what was going on and maybe try to compare your story with those of other families who are in similar situations? 

TRYBUS: Yeah, I received a call very early on in our stay from the Maricopa County Department of Public Health. Um, she asked me very detailed questions about where Lucy had been, where she'd eaten, where we had been the whole week prior to her getting sick or feeling sick. So I had to provide a lot of detail to them about that. And then I didn't hear anything.

And then on the day that she was discharged, I got another call from the same person asking or verifying if Lucy had been to any other petting zoos other than the one at the state fair within that week time period. So that's it. That's what I've heard from them. I haven't received any follow-up or anything.

BRODIE: Did any of the doctors tell you how common or uncommon this particular strain of E. coli is? Like, how rare is it for, you know, a 12-year-old child to end up with what Lucy ended up with? 

TRYBUS: Yes. So they told us for her to develop, for it to develop into that HUS, the more, you know, the more serious complication from exposure to the E. coli was about 10%, a 10% chance that this could happen.

BRODIE: Jenna Trybus is a mother of two living in Phoenix. We also reached out to the state and county health departments about this story. In a statement, ADHS says it’s working closely with the Maricopa County Department of Public Health and other partners to investigate an increase in this kind of E. coli infections. The statement goes on to say that those investigations are concluding and that the parties involved have cooperated fully. ADHS also points out its October report of diseases finds 44 confirmed and probable cases of this strain of E. coli.

The Maricopa County Department of Public Health says two full incubation periods have passed with no additional linked cases, which indicates transmission has stopped and there is no ongoing public health risk associated with this outbreak.

In a statement, the Arizona State Fair says: “We were made aware of several E. coli cases identified by state and local officials. We are working with them and have provided information to assist with the ongoing investigation. We want to express our concern for the families during this time.”

Full statement from Maricopa County Department of Public Health

"While the investigation is not yet formally closed, we have now passed two full incubation periods — each 10 days, totaling 20 days — for Shiga toxin–producing E. coli (STEC), with no additional linked cases. This indicates that transmission has ceased and there is no ongoing public health risk associated with this outbreak. Additionally, case counts for STEC have declined since early November. We continue to work closely with our state partners to monitor reportable illnesses and ensure timely follow-up on any new concerns.

"As a general reminder, E. coli infections occur year-round, and Public Health encourages residents to reduce their risk by practicing safe food handling, cooking meats thoroughly, washing hands after contact with animals, and avoiding cross-contamination in the kitchen. These everyday steps remain the best way to prevent illness. You can find more info on our website here: maricopa.gov/6282/E-coli-O157H7."

Full statement from Arizona Department of Health Services

"Cases and outbreaks are investigated by local public health departments with support from the Arizona Department of Health Services (ADHS). ADHS is working closely with the Maricopa County Department of Public Health (MCDPH) and other partners to investigate an increase in shiga toxin-producing E. coli (STEC) infections. For up to date information on E. Coli case counts please see a link to our October report, where we indicate 44 probable and confirmed statewide cases that month. We will be posting figures for November on this landing page: azdhs.gov/preparedness/epidemiology-disease-control/index.php#data-stats

"The initial increase in STEC cases was identified through Arizona’s Medical Electronic Disease Surveillance Intelligence System (MEDSIS). A concentration of cases was reported in Maricopa County, which initiated a localized investigation. Please contact Maricopa County for more information related to their investigation.

"County and state investigations are concluding. The parties involved in this case have cooperated fully with inspection and sampling requests. Available data do not indicate continued risk, and case counts have declined since early November."