(CNN) -- The number of cases of E. coli stemming from a county fair in North Carolina has grown to 38, including one child who died, the state's department of health said Monday.
More than 165,000 people attended the Cleveland County Fair, which ended October 7.
Eight people have been hospitalized for E. coli infections. Two-year-old Gage Lafevers of Bessemer City died Friday, CNN affiliate WBTV reported.
There are more than 700 strains of the bacteria E. coli. Although most of them are harmless, some can cause serious problems by attacking the intestinal tract. Contracting certain forms of E. coli can lead to diarrhea, nausea, dehydration and in some cases, death.
Symptoms of E. coli infection can occur as late as 10 days after exposure, the North Carolina health department said.
"Not much we can say until things are definitely connected and hopefully we can know soon," Cleveland County Fair Manager Calvin Hastings said. "All we can do is hope and pray for the families."
WBTV reported that as many as 75 people who attended the fair have been interviewed by officials, but authorities have yet to discern a possible source of the infection.
Health officials said 22 of the people sickened are children.
The outbreak comes about a year after one at the North Carolina State Fair in Raleigh affected 27 people. The source of that outbreak was a building that housed animals, officials said.
CNN's Joe Sutton contributed to this report.