Science or scapegoat’? E. coli outbreak leaves Tennessee: day care owners worried

In May 2018, five children at Pam Walker’s day care in Tenn. were stricken with E. coli O157.

Kristi L Nelson of Knox News reports that science, public health officials said, sleuthed out the source of the E. coli infection: a goat farm across the road.

But for Walker, there’s been no closure — and she may never get the answers to exactly how a microorganism turned her dream of a bucolic child care center in a farm setting to a weeks-long nightmare.

Meanwhile, the health department was already investigating an E. coli outbreak among 10 children who’d consumed raw milk from a nearby dairy, French Broad Farms. Because it would be so unusual for two different E. coli O157 outbreaks to occur in the same area simultaneously, the health department, in the course of extensive interviews, looked for a link between Kids Place and the dairy. Did any children at the day care drink raw milk? Socialize or swim with anyone in the other group of infected children? Did any person or animal go back and forth between the dairy and the day care? The answers, they found, were no.

“Finding a bacteria that is microscopic, not visible to the naked eye, is really, really challenging,” said health department Director Dr. Martha Buchanan. “You have got to get the right sample at the right spot. And environmental cleaning did happen — the environment had changed when they went back” to sample.

With the positive culture from goat feces, the health department’s investigators determined that bacteria from the goats had somehow gotten into the baby house — and probably would have been present there before cleaning. When the specimens were sent back to the Tennessee Department of Health for DNA comparison with stool samples from the sick children, the DNA “fingerprint” from the goat samples and the Kids Place children were an exact match — but different from the DNA “fingerprint” of the cow feces from the dairy and the children who’d consumed raw milk, which matched each other. That meant, though unusual, that Knox County had two separate E. coli outbreaks in young children happening at the same time.

Finding it in goat feces, however, wasn’t a surprise. Goats, cows, sheep and other “ruminant” animals — animals that have a multichambered stomach and regurgitate and rechew food before digesting it — often carry E. coli in their digestive tracts. They can carry the bacteria, and shed it through their feces, but it typically doesn’t make them sick.

“Given that some of these illnesses have been linked to the goats at your facility, I recommend you no longer keep goats or other ruminant animals on your property, or that those who interact with the goats do not have contact with the children in your care,” Buchanan told Walker in a July 6 letter.

After the outbreak, Walker gave the goat herd to a friend. But the week after the health department informed her of the test results, she and her husband contacted the University of Tennessee College of Veterinary Medicine to have the goats tested again for E. coli. Dr. Marc Caldwell, assistant professor in large animal clinical sciences, remembers the test being requested merely to see if the goats were healthy, but Steve Walker said he wanted to see if this second test also would find a DNA fingerprint match between his goats and the children’s stool samples.

Techs from UTVM swabbed the goats themselves for fecal samples, rather than collecting feces from the ground as the health department did, and sent them to the Nebraska lab for culture. None of the goats tested positive for E. coli, but both herd dogs — also swabbed — did, while the health department’s dog feces samples were negative. It’s unusual, but possible, for dogs to carry E. coli, Caldwell said.

Caldwell said the test doesn’t prove the animals didn’t have E. coli O157 when the health department tested the feces. In fact, it doesn’t prove they didn’t have it that week, since the amount of bacteria shed from an infected animal can depend on heat, stress and other factors, and a certain amount has to be present for the antigen test — which is what the lab used — to show positive.

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.

Goats, sheep used for research lived in filth in Washington state, inspector reports

Continuing with the goat theme.

men.goats.apr.16Dozens of goats and sheep used by a Seattle medical research firm backed by a prominent food-safety expert were found in dirty, dilapidated conditions that endangered the animals’ welfare, a federal inspection found.

Many of the 42 goats and four sheep kept at a Redmond farm by Pi Bioscientific Inc., also known as Pi Biologique, suffered from “numerous medical ailments and severe health issues,” according to a March 3 report by the U.S. Animal and Plant Inspection Service (APHIS).

“Lack of adequate staffing, equipment and facilities has adversely affected the care and well-being of the animals, prevented proper biosecurity and has led to the severe discomfort and pain and suffering in these animals,” veterinarian Diane Forbes found.

The animals had little protection from weather and there was no way to remove manure, the report noted.

In addition, staff members couldn’t account for 18 goats and one sheep that apparently went missing since a 2014 inventory that found there were 60 goats and five sheep on the premises.

Mansour Samadpour, the director of IEH Laboratories in Seattle — the firm hired by companies including Chipotle and Costco to improve their food-safety practices — said Tuesday he is a shareholder in Pi Bioscientific and the problems have been corrected.

“We had no idea this was happening,” Samadpour said, adding that staff who had been hired to care for the animals on the farm weren’t doing their jobs properly.

The animals are used for antibody testing for medical research, Samadpour said. Pi Biologique distributes test kits for common food allergies, according to a company website.

Sheep go to heaven, goats go to hell: 41 sick as E. coli at Connecticut petting farm grows

More cases of E. coli have now been confirmed in connection to a dairy farm in Lebanon.

959978c3eb4288a90f1a4f44403753c2The Department of Public Health now says that 41 people have been diagnosed with E. coli after visiting the Oak Leaf Dairy Farm in March. The patients range in age from 9 months to 45 years old, with a median age of five. Of the 41 patients, seven are adults and the other 34 are under the age of 18. Of those under 18, 22 are under the age of five.

Of those who were diagnosed with E. coli, 10 were hospitalized, and one remains in the hospital. Also, three of the hospitalized patients were also determined to have hemolytic uremic syndrome, a rare but serious illness that affects the kidneys and blood clotting. The one child still hospitalized is one of the three who had HUS.

A table of animal contact-linked outbreaks can be found here.

15 sick with E. coli linked to goats at Conn. farm

The Connecticut Department of Public Health (DPH) today issued the following update on the E.coli outbreak linked to the Oak Leaf Farm in Lebanon, CT

aok.leaf.dairyAs of 1:00 p.m. today, DPH is investigating 15 confirmed cases of E. coli O157 infection.  The number of cases could increase in the near future as DPH is actively identifying individuals who were not initially reported. 

 So far, investigators have been able to link 14 of these cases to Oak Leaf Farm.  The patients range in age from 1-44 years old, with a median age of six.  In total, five patients have been hospitalized with three still in the hospital.  Two of the hospitalized patients have been diagnosed with hemolytic uremic syndrome (HUS), as first reported last week.

 Yesterday, the Centers for Disease Control and Prevention (CDC) dispatched a team to Connecticut to assist in the investigation of this outbreak.  Today, officials from DPH, the Connecticut Department of Agriculture, the Uncas Health District, and the CDC team are at the Oak Leaf Farm conducting an onsite investigation.  The Farm remains voluntarily closed to the public, and the owners are cooperating with the investigation.

 The outbreak was first identified on Thursday, March 24th when six of seven individuals sickened with E. coli were confirmed by DPH to have recently visited Oak Leaf Farm and come into contact with goats on the farm. 

From the we’ve-never-made-anyone-sick-before files: Conn. E. coli on goat farm edition

The goat farm in Lebanon that may be linked to an E. coli outbreak has been given two stipulations by the health department, the owner told NBC Connecticut.

oak-leaf-dairy-goat-farm-march-6th-1024x684Oak Leaf Dairy Farm is no longer allowed to have the public visit its goats and may not distribute unpasteurized products, Mark Reynolds, the farm’s owner, said.

Reynolds said the outbreak has already started affecting his wholesale business. He said he had never had E. coli linked to his farm before.

The Department of Health and other agencies began to investigate Oak Leaf Dairy Farm after seven people contracted E. coli.

Six of those people were children who visited the farm and petted the goats.

Connecticut Children’s Medical Center said two patients have been diagnosed with hemolytic uremic syndrome (HUS).

Love of goats is the secret to award winning cheese, NZ farmers say

Australians make fun of New Zealanders and their sheep.

goat.cheese.nzGoat love provides a whole new canvas.

Love is the secret ingredient for John and Jeanne van Kuyk​, who own Aroha Organic Goat Cheese and took home the Milk Test NZ champion cheesemaker award at the New Zealand Champions of Cheese Awards on March 1.

They also took home the 180 degrees champion goat cheese award for the second year in a row for their Aroha Raw Milk Jubilee which achieved a rare score of 100.

“We care so much about the girls and what we do. We know every single one,” Jeanne van Kuyk said.

“We’ve always loved goats. The love for goats has brought it all on.”

It’s the girls that make the cheese so good, she said.

Good on ya: National Zoo temporarily closes kids’ farm due to E. coli

The National Zoo says it’s had to temporarily close its Kids’ Farm exhibit—essentially a petting zoo—because of E. coli.

In a release issued on Monday afternoon, the Smithsonian facility explains that on Feb. 18, a “routine fecal screening process” for goats showed signs of the bacteria. Although the goats were then removed from public view, follow-up tests confirmed E. coli in four goats and one cow last Friday.

“Based on these results, the Kids’ Farm was immediately quarantined and staff started appropriate protective measures, including treating all the farm animals with antibiotics,” the zoo says. The exhibit will reopen after zoo vets get “three consecutive weeks of negative test results.”

“As most people know, E. coli is everywhere in our environment,” Brandie Smith, an associate director at the zoo, explains in the release. “Because it is so common, we routinely test our animals. It’s unfortunate that we have to close the Kids’ Farm temporarily, but we’re taking the right preventative measures for our guests, staff and the animals.”

A table of petting zoo outbreaks is available at https://barfblog.com/wp-content/uploads/2014/04/Petting-Zoo-Outbreaks-Table-4-8-14.xlsx.

Best practices for planning events encouraging human-animal interactions

G. Erdozain , K. KuKanich , B. Chapman  and D. Powell. 2015. Zoonoses and Public Health 62:90-99.

http://onlinelibrary.wiley.com/doi/10.1111/zph.12117/abstract?deniedAccess

Educational events encouraging human–animal interaction include the risk of zoonotic disease transmission. It is estimated that 14% of all disease in the US caused by Campylobacter spp., Cryptosporidium spp., Shiga toxin-producing Escherichia coli (STEC) O157, non-O157 STECs, Listeria monocytogenes, nontyphoidal Salmonella enterica and Yersinia enterocolitica were attributable to animal contact. This article reviews best practices for organizing events where human–animal interactions are encouraged, with the objective of lowering the risk of zoonotic disease transmission.

petting.zoo_.guidelines

Goat ‘arrested’ after refusing to leave Saskatchewan Tim Hortons

You’re not the RCMP (Royal Canadian Mounted Police): Where’s your horse?

This story could not be more Canadian:

goat.tim.hortons.sep.15RCMP in Warman, Sask., were allegedly forced to arrest a “stubborn” goat for refusing to leave a Tim Hortons on Sunday morning.

In a statement, RCMP said that employees initially “asked” the goat to leave – how politely Canadian, eh — and tried to walk him outside, but the rebellious animal turned around and sauntered back through the restaurant’s automatic doors.

Eventually two RCMP members were called to deal with the “disturbance.”

The officers believed that the goat was “cold,” and like many Canadians, was forced to take refuge in a Tim Hortons.

They added that the goat simply wanted to “sleep in the entrance.”

Faced with a noncompliant citizen, the RCMP officers “arrested” the goat and escorted him into their vehicle.

RCMP says the goat was “very unhappy” at his treatment.

“The members decided to take him home instead of holding cells at the detachment,” said the RCMP statement.

At first, they were unable to locate the owners of the goat after knocking on the doors of many local farms.

 

Always the kids: raw goats milk in Idaho sickens at least 2

On August 27, 2014, the Idaho Department of Health and Welfare’s Division of Public Health (DPH) was notified of two cases of cryptosporidiosis in siblings aged <3 years. Idaho’s Southwest District Health (SWDH) investigated and found that both children had consumed raw (unpasteurized) goat milk produced at a dairy licensed by the Idaho State Department of Agriculture (ISDA) and purchased at a retail store. Milk produced before August 18, the date of illness onset, was unavailable for testing from retail stores, the household, or the dairy.

goat.poopSamples of raw goat milk produced on August 18, 21, 25, and 28, taken from one opened container from the siblings’ household, one unopened container from the retailer, and two unopened containers from the dairy, all tested positive for Cryptosporidium by real-time polymerase chain reaction (PCR) at a commercial laboratory. On August 30, ISDA placed a hold order on all raw milk sales from the producer. ISDA and SWDH issued press releases advising persons not to consume the raw milk; SWDH issued a medical alert, and Idaho’s Central District Health Department issued an advisory to health care providers about the outbreak.

All seven of Idaho’s Public Health Districts and DPH continued to monitor cryptosporidiosis reports submitted from Idaho health care providers and laboratories statewide as required by Idaho law. Public Health Districts investigated reports by interviewing ill persons or their parents using a standardized questionnaire. After the hold order, SWDH and the Central District Health Department identified nine ill persons in four households. Four persons who had regularly consumed raw goat milk produced before August 18 experienced symptoms of gastroenteritis, and five household members who had not consumed the milk experienced onsets of symptoms of gastroenteritis 3–8 days after the first household member became ill. No other common exposures were identified. CDC case definitions for cryptosporidiosis were used (1). In total, the 11 ill persons were aged 2 months–76 years (median = 11 years); six were female. One patient was hospitalized. Stool specimens were obtained in three primary cases (i.e., illnesses in those who drank the raw goat milk) and three secondary cases (i.e., illness in contacts of those who drank the raw goat milk); CDC isolated Cryptosporidium parvum subtype IIaA16G3R1 from all six. The last reported outbreak-associated illness was a secondary case with an onset date of September 3.

In addition to the four tested milk samples from containers, five of five milk samples collected along the production line on September 2 tested positive for Cryptosporidium by PCR at the commercial laboratory. Testing of all nine milk samples (four from containers and five from the production line) at CDC for Cryptosporidium by PCR and direct fluorescent antibody test was negative. CDC and the commercial laboratory collaborated to validate the negative result by using sequencing to determine that false-positive results at the commercial laboratory were likely caused by goat DNA amplification during PCR. An inspection of the dairy did not reveal any obvious contamination sources. Water from the producer’s well tested negative at Idaho Bureau of Laboratories for Cryptosporidium by direct fluorescent antibody test after ultrafiltration. Goat stool was unavailable for testing. Negative results led ISDA to release the hold order on September 18.

goat.petting.zooEpidemiologic evidence implicated contaminated raw goat milk as the outbreak source. It was not possible to obtain confirmatory laboratory evidence of milk contamination. Milk consumed before illness onset was unavailable for testing and could have been subjected to a single, undetected contamination event. No other common source was identified, and isolation of the identical Cryptosporidium genotype from ill persons did not disprove a common source. This outbreak highlights an infrequently reported cryptosporidiosis risk from unpasteurized milk (2,3), the value of sequencing to validate PCR protocols, the utility of genotyping Cryptosporidium isolates for strengthening epidemiologic evidence, and the risk for secondary transmission of Cryptosporidium. An increasing number of enteric outbreaks are associated with raw milk consumption (4,5). Resources for consumers, health care providers, and public health officials regarding risks from raw milk consumption are available at http://www.cdc.gov/foodsafety/rawmilk/raw-milk-index.html.

Cryptosporidiosis associated with consumption of unpasteurized goat milk — Idaho, 2014

CDC MMWR 64(07);194-195

Mariana Rosenthal, Randi Pedersen, Scott Leibsle, Vincent Hill, Kris Carter, Dawn M. Roellig

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6407a9.htm?s_cid=mm6407a9_e