Updated

North Carolina health officials say an E. coli outbreak is responsible for the illness of 21 people who attended the Cleveland County Fair, including a 2-year-old boy who died Friday night.

FOX 8 identified the toddler as Gage Lefevers, from Gaston County. He attended the fair more than a week ago, according to the paper.

State health officials said the illness has affected residents in several counties, the majority of them being children.

Several victims were treated and released from hospitals.

The newspaper said Hannah Roberts, 5, of Gastonia, is suffering from kidney-related problems as a result of E. coli. She has been in the hospital since Tuesday.

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Jordan McNair, 12, a middle school student from Gaston County, is hospitalized at Levine Children’s Hospital in Charlotte because his kidneys are failing, according to WCNC.

He's on dialysis, and WBTV reported he is "improving."

We were deeply saddened to learn there has been a death in our community in connection with the ongoing E. coli outbreak in the region,” said Christopher Dobbins, Gaston County health director.

“This tragic loss underscores the seriousness of this E. coli outbreak, and we want to remind the public that it is critically important to seek medical attention immediately if you have had diarrhea for longer than three days, or bloody diarrhea that began on or after October 1, 2012, and you attended the Cleveland County Fair this year.”

Dobbins said he thinks there are more unidentified cases.

The bacterium is found in the waste of animals such as cattle, sheep and goats. State Health Director Laura Gerald says illness is passed by soiled hands that touched contaminated food or animals.

As of this coming Wednesday, 11 days will have passed since the fair ended, so the incubation period will be over; however, E. coli can be transmitted from one person to another.

Click here for more from FOX 8. 

Click here for more from WCNC.

The Associated Press contributed to this report.