Raw is risky: ‘Not aware this was remotely possible’ Father of toddlers critically sickened by E. coli linked to raw milk in Tenn.

I started the Food Safety Network (the original FSN) as an incoming graduate student in 1993 in the wake of the Jack-in-the-Box outbreak, combining my science and journalism learnings, and because a constant refrain I observed was, I never knew foodborne illness could be so serious.

That’s why I continue to do it as a form of community service (I haven’t been paid since 2016).

There are now at least 15 children sick with E. coli in Tennessee that has now been linked to consumption of raw milk from French Broad Farm.

According to Kristi L Nelson of Knox News, Jordan and Stephanie Schiding wanted to give their children every health advantage.

That’s the reason the Schidings, two months ago, signed up for a local cow-share program after they read about the health benefits of unpasteurized milk.

Instead, 18-month-old Genevieve and 3-year-old Anthony contracted an illness caused by E. coli bacteria and ended up with kidney failure in the pediatric intensive care unit at East Tennessee Children’s Hospital — two of 12 local children hospitalized with E. coli since the end of May.

Knox County Health Department staff told the Schidings the E. coli infection was likely linked to the consumption of raw milk from French Broad Farm. On Thursday, the health department lifted its directive that requested French Broad Farm temporarily cease operations. But health department Director Dr. Martha Buchanan reiterated that consuming raw milk is always risky and health officials recommend the public consume only pasteurized milk and dairy products.

Jordan Schiding said he and his wife knew there was “potential” for food poisoning from unpasteurized milk, which both adults drank with seemingly no serious effects, but “we were definitely not aware that anything like this was remotely possible.”

The Schiding children seem to have turned a corner, he said, with Anthony discharged Friday afternoon and Genevieve still hospitalized but out of intensive care.

But what started as a supposed stomach bug May 31 turned into a terrifying experience that traumatized both the children and their parents, who had to watch them suffer.

Schiding said the family brought Genevieve to the emergency room at Children’s Hospital May 31 after she became seriously dehydrated with diarrhea and vomiting. As she was being admitted, Anthony also began vomiting.

The hospital rehydrated the children and discharged them a few hours later. Schiding believes they were among the first children related to the current cluster of E. coli cases to come to Children’s Hospital.

Two days later, after both children continued to get sicker, the Schidings brought them back to the hospital. This time, hospital staff took a stool sample from Genevieve, which tested positive for E. coli, and then from Anthony, who also tested positive. Both children were admitted, and Knox County Health Department contacted the couple the next day, he said.

The Schidings knew little about E. coli; certain strains produce a toxin, Shiga, that can cause a chain of reactions in the body — hemolytic uremic syndrome — resulting in clots in the small blood vessels in the kidneys that cause kidney failure. The very young, the very old and people whose immune systems are already compromised are more susceptible to HUS.

Four children admitted to Children’s so far have had HUS, including Genevieve and Anthony. Though Anthony wasn’t quite as sick as his sister, both had surgery to implant central lines so they could get fluids, dialysis and blood transfusions, Schiding said. Anthony had three days of dialysis, Genevieve seven.

In addition, Anthony’s central lines became infected with staph, Schiding said, but the antibiotics typically prescribed to treat staph are too hard on the kidneys to give a child with HUS, so doctors had to use a less common medication, which has seemed to work.

“Obviously, we were freaked out a little bit,” Schiding said. “It seemed like he had started turning the corner” until he spiked a fever of 104.9 and tested positive for staph.

Schiding said his family no longer will consume raw milk.

Shiga-toxin E. coli in dairy cattle near Brisbane

Sure it’s almost 20 years old. But a reminder.

Over a 12-month period, 588 cattle faecal samples and 147 farm environmental samples from three dairy farms in southeast Queensland were examined for the presence of Shiga-toxigenic Escherichia coli (STEC). Samples were screened for Shiga toxin gene (stx) using PCR.

Samples positive for stx were filtered onto hydrophobic grid membrane filters and STEC identified and isolated using colony hybridisation with a stx-specific DNA probe. Serotyping was performed to identify serogroups commonly associated with human infection or enterohaemorrhagic Escherichia coli (EHEC). Shiga-toxigenic Escherichia coli were isolated from 16.7% of cattle faecal samples and 4.1% of environmental samples. Of cattle STEC isolates, 10.2% serotyped as E. coli O26:H11 and 11.2% serotyped as E. coli O157:H7, and the E. coli O26:H11 and E. coli O157:H7 prevalences in the cattle samples were 1.7 and 1.9%, respectively.

Prevalences for STEC and EHEC in dairy cattle faeces were similar to those derived in surveys within the northern and southern hemispheres. Calves at weaning were identified as the cattle group most likely to be shedding STEC, E. coli O26 or E. coli O157. In concurrence with previous studies, it appears that cattle, and in particular 1-14-week-old weanling calves, are the primary reservoir for STEC and EHEC on the dairy farm.

A longitudinal study of Shiga-toxigenic Escherichia coli (STEC) prevalence in three Australian diary herds

Veterinary microbiology, Volume 71, Issue 1-2, Pages 125-37, Jan 1, 2000

https://espace.library.uq.edu.au/view/UQ:a5186cb

Raw is risky: Netherlands study finds STEC and Campylobacter in dairy goats and dairy sheep, shows importance of pasteurization

Researchers with the Dutch National Institute for Public Health and the Environment (RIVM) and the Dutch Food and Consumer Product Safety Authority (NVWA) shows that two types of bacteria that can cause diarrhea in humans ( STEC and Campylobacter) are common in dairy goat farms and dairy sheep farms, according to a RIVM press release (computer translated).

According to Outbreak News Today, in the animal study, 181 dairy goat farms and 24 dairy sheep farms were examined. STEC (Shiga-toxin-producing E. coli) and Campylobacter was found on most. STEC appeared on virtually all the farms studied. Campylobacter has been demonstrated in one out of three goat farms (33 percent) and almost all sheep farms (96 percent). These bacteria have found much less among cattle farmers and family members.

Listeria was less common, at about 9 percent of the goat and about 17 percent of the sheep farms. The bacteria was not found in the people studied. People run the risk of becoming infected with the listeria bacteria by eating raw milk soft cheese. The study also looked at Salmonella and ESBL-producing bacteria. These were not very common on the farms surveyed.

The results show that pasteurization of milk and hygiene after visiting a dairy goat farm or dairy sheep farm is important to prevent disease.

The bacteria found are in the intestines of the animals and thus enter the manure. A small amount of manure can contaminate raw milk or raw milk cheese. Contamination can be prevented by drinking only pasteurized milk or using it in other foods. In addition, people at a farm can become infected if they have contact with the animals or their environment. Visitors can reduce the risk of illness by washing their hands after contact with the animals or their environment.

In unrelated but related news, Brandon Macz of the Monroe Monitor reports that St. John Creamery in Monroe, Washington, announced on Thursday it is voluntarily recalling raw goat milk that may be contaminated with Escherichia coli (E.coli) bacteria.

A June 14 news release states the recall was initiated after “the presence of toxin-producing E.coli in retail raw goal milk dated 6/17” was discovered during routine sampling by the Washington State Department of Agriculture.

Included in the recall are half-gallon and one-pint containers of raw goat milk marked best by June 17-21.

HSE investigates highly contagious and dangerous case of e coli in Laois, Ireland

The Health Service Executive is investigating a suspected case of E coli in a baby in Laois.

Sinead Moore of RSVP Live reports the HSE launched an investigation late last week after a potentially serious strain of the bacteria was suspected in the Irish infant.

The strain, called VTEC or verotoxigenic E coli, comes from contact with faeces of healthy farm animals. It can be spread through children’s shared toys or during nappy changing.

The child is understood to have since been diagnosed with the less dangerous E coli bacteria, the Leinster Express reports.

The bacteria can cause vomiting and diahorrea.

As part of the investigation, the creche the baby attends, Sonas Community Childcare Centre in Mountmellick Co Laois was contacted last Friday to raise awareness among staff and parents and to examine if other children attending the creche had any similar symptoms.

Two gorillas at Milwaukee zoo likely died from water contaminated with E. coli

Two gorillas at the Milwaukee County Zoo likely died after ingesting water contaminated with E. coli, according to zookeepers.

Cassius, an adult male, died on April 12, and Naku, a 17-year-old female western lowland gorilla, died on April 29, the zoo said in a press release.

Autopsy results for the gorillas show that they died of gastrointestinal infections believed to have been caused by E. coli in their water supply, according to the zoo.

The water systems in the gorilla and bonobo areas have been disinfected, the zoo said, adding that the water supply available for consumption by the public was never affected.

Zookeepers are also using new protocols to disinfect produce, which can be another source of E. coli, according to the release.

While all animals, including gorillas and even humans, have healthy E.coli in their gut, some variants of E. coli can cause intestinal damage and disease, the zoo said.

Naku had been euthanized after veterinarians found that a portion of her intestine was no longer functioning, ABC affiliate WISN in Milwaukee reported.

Cassius and Nauku’s 8-month-old baby, Zahra, is now an orphan.

Zahra’s diet has consisted mainly of formula in the absence of her mother’s breast milk, zookeepers wrote on Twitter. She is also eating some produce, sweet potato, red pepper, and beans, the zoo said.

‘Close to 10 children hospitalized for E. coli’ in Tennessee: raw milk, farm animals may be sources

Kristi Nelson of Knox News reports East Tennessee Children’s Hospital said Tuesday it’s treated “close to 10” children, all younger than 4, for a “serious outbreak” of E. coli-caused illness over the past 10 days. 

The Knox County Health Department has confirmed two likely sources of the outbreak are unpasteurized milk and farm animals.

Most of the ill children are known to have consumed raw milk from a local cow-share dairy, French Broad Farm in Knox County, the health department said in an alert issued Tuesday evening. The health department recommends consumers dispose of all raw milk or other unpasteurized products they may have from this farm.

“People need to be aware that if they choose to drink raw milk, they’re taking a risk,” said Dr. Martha Buchanan, health department director.

The health department is also investigating whether any of the affected children were exposed to E. coli after interacting with farm animals at a local child care facility. The facility, which officials declined to name, is not currently operating, Buchanan said.

Four of the children are in the Pediatric Intensive Care Unit with kidney failure, said the hospital’s chief medical officer, Dr. Joe Childs, who is director of the PICU. There have been no fatalities related to the outbreak, hospital staff said, but life-threatening infections can occur when the strain of E. coli releases a toxin, shiga, that harms small blood vessels, of which the kidneys have many. Childs said the damage to the blood vessels is usually “temporary,” but children can get very ill, require surgery to place catheters, and may have nonfunctioning kidneys for weeks. 

“We are concerned that some of these cases do have exposure to the consumption of raw milk,” or milk sold unpasteurized, Childs said. “Tennessee is a state where that’s legal, to obtain raw milk. … The FDA and the American Academy of Pediatrics strongly discourage the consumption of raw milk and raw milk products because there’s a lot of things that can be in milk and there’s no real good way to decontaminate it other than pasteurizing it.” 

We let our kids explore the world, they get raw milk and barf

Following a school ski-trip to Austria from 10-18/02/2017, nine of 25 participants of the group from Lower Saxony (Germany) developed gastroenteritis. The students and teachers (17-41 years) shared meals in a hotel. Active case finding revealed further cases among German school groups from North Rhine-Westphalia and Schleswig-Holstein, staying at the same hotel in February 2017.

We conducted two retrospective cohort studies using self-administered questionnaires on clinical symptoms and food consumption. We defined a case as a trip participant in February 2017, staying at the aforementioned hotel and developing diarrhoea, vomiting or abdominal pain during or within ten days after the trip and/or who had a stool sample tested positive for STEC within four weeks after the trip. During the outbreak investigation, Austrian authorities detected that unlabeled raw cow milk delivered by a dairy farm had been offered at the hotel for breakfast during January and February 2017. Stool samples of participants, samples of milk served in the hotel and fecal samples of various animals kept at the milk-delivering farm were examined by culture and polymerase chain reaction. STEC isolates were typed using Pulsed-field Gel Electrophoresis (PFGE) and Whole-Genome Sequencing (WGS).

All 25 participants from Lower Saxony completed the questionnaire on symptoms and milk consumption; 14 were cases (56%). Thirteen of 20 participants who had consumed cold milk fell ill (risk ratio (RR): 3.25; 95%-confidence interval (CI): 0.55-19.32). Of 159 trip participants from North Rhine-Westphalia, 81 completed the questionnaire (51%), 25 were cases (31%); RR for cold milk was 2.11 (CI: 0.89-5.03). The combined RR for cold milk in both groups was 2.49 (CI: 1.16-5.35). Shiga toxin 1a-gene and eaeA-gene positive STEC O103:H2 were detected in nine of 32 patients’ stool samples and in two of 18 dairy farm cattle. Nine isolates from human stool samples and two isolates from cattle fecal samples yielded the same strain with an almost identical PFGE-pattern and WGS-profile.

Microbiological and epidemiological evidence identified raw cow milk as the vehicle. Results may have been compromised by misclassification of cases due to a recall bias and mild symptoms. As a result of this outbreak investigation, the Austrian authorities enforced Austrian law in the hotel, to provide milk only when pasteurized. We recommend re-emphasizing the risk of raw milk consumption to providers.

Shiga toxin-producing Escherichia coli O103:H2 outbreak in Germany after school trip to Austria due to raw cow milk, 2017-The important role of international collaboration for outbreak investigations, 29 May 2018

International Journal of Medical Microbiology

Maren Myliusabc, , Johannes Dreesmana, Matthias PulzaGerhard Pallaschd, Konrad Beyrera, Katja ClaußenaFranz AllerbergereAngelika FruthfChristina LangfRita PragerfAntje FliegerfSabine SchlagereDaniela KalhöfergElke Mertensa

https://doi.org/10.1016/j.ijmm.2018.05.005

https://www.sciencedirect.com/science/article/pii/S1438422118301905

25 sickened Don’t make mousse in a bowl used to prep raw meat: Settlement for kids in Nevada sickened by E. coli

Brian Duggan of the Reno Gazette Journal reports that more than two years after they got sick from eating E. coli-tainted chocolate mousse cake at two Reno restaurants, six children are now awaiting a Washoe judge to approve their financial settlements, according to court records.

The six Reno-area children were all plaintiffs in a lawsuit that followed Washoe County’s worst-ever E. coli outbreak that also sickened two other children and 17 adults.

The outbreak started in October 2015 when the tainted dessert was prepared in a mixing bowl that had been used to process raw meat at Reno Provisions. The cake was later served at Heritage, located inside the Whitney Peak Hotel, and South Reno’s Twisted Fork. 

Owner Mark Estee later closed Reno Provisions. Estee was a consulting chef at Heritage, which was later changed into the Roundabout Grill. Twisted Fork is still in business and has passed all of its restaurant inspections since the 2015 outbreak with no violations, according to Washoe County Health District data.

In all, the children will get $2.5 million — 90 percent of that shared between two boys who had extensive stays at the UC Davis Medical Center to treat their injuries, according to court records.

Estee did not return requests to be interviewed for this story. A representative with Twisted Fork and victims of the outbreak also declined comment. 

Brent L. Ryman, who represented Reno Provisions, said several lawsuits were initially filed by victims of the outbreak in 2015 and 2016. Those lawsuits were later consolidated into one case that ended in financial settlements without the need for a trial. The settlements with the adults who got sick are private and did not require a judge’s approval. 

Two of the boys developed serious kidney complications because of the E.coli infection, said Bill Marler, a Seattle-based attorney who represented nine of the plaintiffs in the case.

1 child dead, 14 sick from E. coli O26 in French ‘Our regions have talent’ raw milk cheese

Outbreak News Today reports on a statement from the French abouthe Escherichia coli ( E. coli ) O26 outbreak linked to the consumption of raw milk reblochons produced at the Cruseilles (Haute-Savoie) site of Chabert. French health officials are now reporting 14 children aged one to five years included in the investigation.

As of May 31, 6 children with HUS were infected with the same strain of E. coli O26, for which the consumption or reblochon incriminated is documented. These six children are domiciled in several regions of metropolitan France (Center-Val de Loire, PACA, Ile-de-France, Auverhne-Rhone-Aples, Pays-de-la-Loire); and for 8 other children, investigations are in progress. Of these, two had signs of gastroenteritis and six had HUS. One of the children with HUS died; the investigation around this case is in progress. To date, it cannot be dismissed or affirmed that these cases of HUS are linked to the consumption of reblochon: non-isolated and characterized strain, or consumption of reblochon incriminated not yet documented.

1 dead, 42 sick: E. coli outbreak linked to pork products in Alberta declared over

On Friday, Alberta Health Services said the E. coli outbreak linked to certain pork products in the province was officially over.

AHS started investigating a number of confirmed cases on March 29.

The outbreak was connected to some pork products sold and distributed by The Meat Shop at Pine Haven. Several other businesses were impacted since they used the affected pork products and the Canadian Food Inspection Agency (CFIA) issued a food recall.

In total, there were 42 lab-confirmed cases of E. coli linked to this outbreak.

Thirteen patients needed medical treatment at the hospital and one person “died likely due to infection with E. coli,” AHS said.

“Our thoughts remain with the family of the patient who died and all of those affected by this,” said Dr. Jasmine Hasselback, medical officer of health for the Edmonton zone. “We would like to thank our federal and provincial partners for their collaboration on this investigation.”