(CNN)The health department in Pickaway County, Ohio, has reported at least 19 cases of Covid-19 among people who attended the county fair last month.
Additionally, there are three cases among family members of those who attended the fair in Circleville, Pickaway County Public Health said in a report. A death that may be linked to the fair is under investigation.
In its report, the public health department outlined problems observed at the event held June 20-27.
Not all staff and food vendors adhered to guidance from health officials for wearing masks, the report says. The food vendors "allowed condiment bottles to be set out for use by any attendee of the fair," which allowed "for a significant amount of spread of COVID-19 disease from fair attendee to fair attendee," the report said.
"For the Pickaway County Fair Board and people executing the fair planning and event, there was a lack of implementation on the precautions taken to prevent the spread of COVID-19," the health department's report said.
"This failure is shown in the number of concerns people had about having the fair during a global pandemic and it is also reflected in the data showing the spike of cases due to the COVID-19 pandemic."
Organizers of the Pickaway County Fair disputed the health department's statement in a post on Facebook Thursday morning, saying the health department had not directly notified the fair about the coronavirus cases and that fair organizers had not seen the report at that time.
"There was an instance of a food vendor not wearing masks that PCPH brought to our attention and it was addressed with no further incidence," the post said, noting that the state didn't require volunteers to wear masks at that time.
Fair organizers said frequent announcements reminded people to practice social distancing and encouraged mask wearing. Fair organizers noted that a health department representative praised the fair for its planning and collaboration with county agencies in a meeting on Wednesday.
The report is billed as an "After-Action Report/Improvement Plan" aimed at helping officials analyze a "real-world event" at which Covid-19 spread occurred.
According to the health department report, the fair attracts people from surrounding counties and states who participate in animal shows, rides and eating. Circleville is about 25 miles south of Columbus.
The report notes that the health department, along with several other local government organizations, was involved in planning the event but the Pickaway County Fair Board did not implement the safety measures effectively.
Staff from the health department "spent a significant amount of time collaborating for the planning of the 2020 Pickaway County Fair as well as attending the fair consistently to let the Fair Board members know where the failure to implement was occurring," the report says.
Asked Friday about the fair, Ohio Gov. Mike DeWine said, "Clearly Pickaway County did not do what they should have done."
DeWine, speaking on CNN, said he told other fair managers that if they couldn't follow the guidance of health officials, they would need to shut down their fairs.
"Look, we've got good guidelines, we've got good orders. We need to follow them, whether it's a county fair or whether it's in your backyard," DeWine said.