COLUMBUS, Ohio - Ohio officials urge people to wash hands and take other hygiene precautions while visiting county fairs this summer.
Several county fairs in Ohio and Indiana were linked to swine flu cases last year, with at least 11 Ohioans hospitalized after contracting the virus.
The Centers for Disease Control said 10 children were hospitalized after visiting Ohio fairs, and a 61-year-old woman from Madison County died after having contact with hogs at the Ross County Fair.
Officials say she had underlying conditions including heart disease and high blood pressure.
The Ohio Departments of Health and Agriculture say they have worked with fairs, youth organizations and veterinarians to increase hand-sanitizing and washing stations.
They say older adults, pregnant women, young children and people with weakened immune systems can be vulnerable.
Health officials also advise leaving strollers outside animal exhibits, and suggest that those considered vulnerable stay out of animal areas.
Ohio's health department director cautioned that some illnesses, such as the flu virus, are commonly carried by livestock and can be directly transmitted between animals and humans in the same way those illnesses are often transmitted between people.
"With fair season upon us, we want to remind folks that some illnesses, such as influenza viruses, are commonly carried by livestock and can be directly transmitted between animals and humans in the same way those illnesses are often transmitted between people," Dr. Ted Wymyslo, Ohio Department of Health director, said in a statement.
CDC officials said most cases associated with the new strain of swine flu last year were relatively mild.
Fair season in Ohio goes from mid-June through October.