It was the first weekend in September, and all was not right at the Washington County fairgrounds, 35 miles north of Albany, N.Y. Usually the site of a well-attended arts and crafts show, the fairgrounds was a ghost town. The previous weekend, a convergence of unusual events at the annual county fair created a health nightmare that would take the lives of a 3-year-old and a 79-year-old and sicken more than 1,000. But painful lessons learned may help prevent future outbreaks of infection by Escherichia coli strain O157:H7.

New York State Health Commissioner Antonia Novello summed up the outbreak well: "All the things that could have gone wrong, went wrong." The fair opened on Aug. 23. After a summer-long drought, heavy rains fell on Thursday, Aug. 26. By Saturday, the puddles had dried sufficiently for Wayne and Lori Aldrich and their young daughters Rachel and Kaylea, and hundreds of...

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