LUMBERTON — Health officials say that Robeson County has not reported any cases of the E coli, which has plagued Wake and surrounding counties, but they warn that if residents have visited affected counties since Oct. 6, they should look for signs of the disease.

Health officials suspect the outbreak is linked to food served at the State Fair, but that has not been confirmed.

Symptoms of Escherichia coli infections include severe stomach cramps, diarrhea, bloody stools, and vomiting, although symptoms vary for each person. Anyone with these symptoms should consult a physician.

Most people get better within five to seven days, but some develop life-threatening complications that can cause kidney failure.

Bill Smith, Robeson County’s health director, updated the Board of Health on Thursday at its monthly meeting about the outbreak in Wake County.

Among the 21 cases that have been reported as of Thursday afternoon, eight are confirmed and 13 are suspected cases. All are either residents of or traveled to Wake County within 10 days of becoming ill.

The State Fair ended Sunday.

“The time line is suspect,” Smith said.

Smith said that when investigating an outbreak, officials build a list of everything the sick people ate or everywhere they went and find the most common trait; in this case, it’s the State Fair.

Smith said that the best way to fight the bacteria is to wash your hands frequently or use hand sanitizer.

In 2001, Robeson County suffered an outbreak of E. coli infection in about 200 people. The cases were linked to cattle at a petting zoo, Smith said.

Smith said that with the number of people who attended the State Fair — more than 1 million — and only eight confirmed cases, he didn’t anticipate a large outbreak.

Also on Thursday, the board discussed the improvements at the Robeson County Animal Shelter.

“Things are as good as it’s ever has been,” Smith said.

But he told the board that there have been staffing issues with the Animal Control officers. The department has three, but had not been able to staff all three in months, Smith said, because of illness and other personnel issues.

“At one time, we only had one Animal Control officer covering the entire county,” Smith said.

He also said that a state statute requires the Health Department retrofit the Animal Control trucks with heating and air conditioning to maintain a temperature between 55 and 80 degrees in the pin area. Smith estimated the cost of about $27,000.