E. coli O111:H8: Chaource Lincet and Gaugry raw milk cheeses recalled in France

A few hundred Chaource raw milk cheese brands Lincet and Gaugry, sold throughout France, are subject to a recall procedure after the demonstration of the presence of Escherichia coli. A check has highlighted in these products, manufactured by the Lincet cheese factory in Vaudes in the Aube, the presence of Escherichia coli O111: H8, indicates the cheese Friday in a statement.

This bacterium is likely to cause serious problems in anyone consuming the product, she adds. Nearly 700 Chaource AOP cheeses of 500 grams raw milk, bearing the lot number 227.210 and with a deadline of consumption to 27 September 2019, are concerned, according to the press release.

Lincet brand cheeses have been sold in a variety of supermarket chains, both traditional and fresh, while Gaugry branded cheeses have been distributed in the dairy and market channels.

Raw is risky: 19 children develop HUS in France from E. coli O26 linked to raw milk cheese

Gabrielle Jones, Sophie Lefevre, et al report in Eurosurveillance that from 25 March to 27 April 2019, 19 suspected Shiga toxin-producing Escherichia coli (STEC) associated paediatric haemolytic uraemic syndrome (HUS) cases were notified by French hospital paediatric departments to Santé publique France, compared with 5–10 cases during the same period in previous years [1].

Thirteen cases were confirmed as serogroup O26, with whole genome sequencing (WGS) underway for strain comparison. Initial epidemiological investigations using a trawling questionnaire identified the consumption of raw cow’s milk soft cheeses (Saint-Félicien and Saint-Marcellin) as the common link for eight of these 13 cases. Trace-back investigations using supermarket loyalty cards identified a common producer (producer A) of these cheeses for three cases and on the basis of this information a recall was initiated by French health authorities on 27 April 2019 [2]. As at 27 May 2019, investigations identified 16 outbreak cases including 14 paediatric HUS cases and two cases with uncomplicated diarrhoea (one child and one adult). Investigations are ongoing for one suspected case. The 16 outbreak cases reside in six administrative regions in France. All paediatric cases are under 5 years of age; the median age is 22 months (overall age range: 6 months–63 years). Eight cases are female. Date of symptom onset was between 31 March (week 13) and 29 April (week 18). All HUS cases were hospitalised. Thirteen cases received blood and/or platelet transfusion and seven underwent haemodialysis. Six cases had neurological complications, all of them received transfusions and three also had haemodialysis.

The families of all 16 outbreak cases and the suspected case were interviewed about their at-risk exposures during the 10 days before symptom onset. Families of 16 cases (15 outbreak cases and one suspected case) reported the consumption of Saint-Félicien or Saint-Marcellin raw cow’s milk cheeses by either the case (n = 12) or household members (n = 4). One outbreak case did not report consumption of these cheeses. For the 16 cases with reported consumption of these cheeses, trace-back investigations using loyalty cards and supply data from the different shops where the caretakers reported purchasing the cheeses identified a link with producer A for 13 (all outbreak cases).

Producer A manufactured only Saint-Félicien and Saint-Marcellin cheeses. To date, no positive STEC O26 cheese or milk samples have been identified. Investigations, including sampling of the cheeses and trace-back of the milk supply chains, are ongoing.

Four outbreak cases had not consumed the cheeses themselves but a household member had. This suggests the affected child may have been infected via cross contamination (knives, cutting board, hands, etc.). None of the household members reported symptoms of illness, indicating that the cases were unlikely to have been infected by person-to-person transmission. Investigations are ongoing in an attempt to further document the exposures of these cases (consumption of cheeses or other food items cut by the knives or on the same cutting board as the suspected cheeses). Only one in 16 outbreak cases reported a family member with self-limiting diarrhoea (no stool analysis).

Note: If that many people developed HUS, hundreds could have potentially been sickened.

Raw is risky: 83 now sick with Salmonella from raw milk cheese in France

The number of people sick from Salmonella in reblochons, a type of raw milk cheese specific to the Savoy region of the Alps in France, has risen from 14 to 83.

Public Health France first withdrew the reblochons on Nov. 24, 2018.

Of the 83 people identified so far, 65 were able to be interviewed by the ARS Auvergne-Rhône-Alpes and Public Health France about their symptoms and their food consumption before the onset of symptoms. Symptoms range from 16/09 to 19/11, with a peak in week 40 (from 1st to 07/10/2018). Fifteen people were hospitalized for their salmonellosis: they are now out and are well; no deaths have been reported. Consumption of reblochon with raw milk before the onset of symptoms is reported by 80% of the cases confirmed by the CNR and interviewed.

E. coli alert for sheep milk cheese from Romania

The European Commission has issued an alert over possible Escherichia coli (E. coli) in sheep milk cheese made in Romania.

lactate.bradet.argesAccording to the alert issued in the RASFF – the Rapid Alert System for Food and Feed, the cheese comes from Romania and has been mainly distributed in Italy, France, and Germany.

The Commission decided to issue such an alert after a notification from Italy. The Italian authorities confirmed on Thursday that cheese infected with E. coli caused intestinal infection in a 14-month old Romanian baby admitted to a hospital in Florence, reports local Mediafax. The cheese is believed to have come from Romanian dairy producer Lactate Bradet SRL, headquartered in Arges county.

Referring to this incident, Romanian Agriculture Minister Achim Irimescu said that the contamination of Romanian cheese with E. coli is an accident, and people should still have confidence in Romanian products, local Agerpres reports.

Lactate Bradet has recently been at the core of a media scandal after Romanian authorities said its dairy products caused the E. coli infection that resulted in the illness and even death of several children from Arges county. However, the Cantacuzino research institute in Bucharest later showed that the Bradet cheese was not the source of infection.

The situation escalated on Friday, March 18, when the management of the Sanitary-Veterinary and Food Safety Authority (ANSVSA) announced that over 20 tons of Bradet dairy products have been withdrawn from the Romanian market. A similar decision was also taken in Spain (over 1 ton) and Italy (546 kg), reports local Mediafax.

Authorities have withdrawn from the market all the products Bradet made in February, according to the food safety authority, which also recommended people not to consume these products.

Seek and ye shall find: Salmonella in UK raw milk cheese

The UK Food Standards Agency (FSA) has issued a statement to say that they have advised Barton Farm to stop selling raw drinking milk.

colbert.raw.milkTests carried out by the FSA and the local authority found samples containing levels of microorganisms that breach food safety regulations. The local authority North Devon District Council also found salmonella in a batch of cheese made with raw drinking milk by the company.

The affected batch of cheese has been withdrawn from sale and consumers alerted.

Barton Farm has issued the following notice on its website: “Due to more harassment from the Food Standards Agency, all sales of our raw drinking milk are currently suspended. All our own test results are clear. Online orders will be fulfilled once the licence has been renewed or a refund will be issued. We would like to thank everyone for their patience while we undergo yet another investigation. Someone definitely doesn’t want us to sell our raw milk.”

In response, the FSA has said that it rejects Barton Farm Dairy’s claim that the action is harassment.

Estimating and controlling risk in raw milk cheese

The U.S. Food and Drug Administration announced today that it is requesting comments from the public, including scientific data and information, that would assist the agency in identifying and evaluating measures that might minimize the impact of harmful bacteria in cheeses made from unpasteurized milk.

raw-milk-cheeseThe FDA recognizes that there is broad diversity in cheese manufacturing operations and approaches and that many factors go into ensuring the safety of the food. In issuing this call for data and information, we are interested in learning more about the standards and practices in use by a wide variety of producers, including the growing artisanal cheese manufacturing community.

We are taking this action as part of an ongoing discussion with industry and other stakeholders about potential health risks associated with consumption of cheese made from unpasteurized milk — risks that are greatest for people with weakened immune systems, older adults, pregnant women and children. The FDA is taking this action in part based on findings from a joint FDA/Health Canada Quantitative Risk Assessment also being released today.

The Federal Register notice was published Aug 3/15. Excerpts below:

A 2012 review of outbreaks of foodborne illness that occurred in the United States between 1993 and 2006 that were attributed to dairy products determined that more than 50 percent of the outbreaks reviewed in the study involved cheese, with the remaining outbreaks being attributable to fluid milk (Ref. 1). Forty-two percent of the 65 cheese-associated outbreaks (i.e., 27 outbreaks) were attributable to products manufactured from unpasteurized milk, even though the contribution of unpasteurized dairy products to all dairy product consumption in the United States during the time period under study was estimated at below 1 percent (on a weight or volume base) (Ref. 1). The 65 analyzed outbreaks due to cheese made from unpasteurized milk resulted in 641 associated illnesses with 131 hospitalizations (i.e., a hospitalization rate of more than 20 percent). Pathogens associated with these outbreaks included Listeria monocytogenes, Escherichia coli (E. coli) O157, Salmonella, and others (Ref. 1). All of these pathogens can cause significant illness and even death.

raw.milk.cheeseFDA and Health Canada recently collaborated on the development of a model to evaluate the impact of factors, such as the microbiological status of milk used in cheese production, various cheese manufacturing steps, conditions during distribution and storage, and cross-contamination during processing and handling, on the public health risk of listeriosis from consumption of soft-ripened cheese. Elsewhere in this issue of the Federal Register, we are announcing the release of the “Joint Food and Drug Administration/Health Canada—Santé Canada Quantitative Assessment of the Risk of Listeriosis From Soft-Ripened Cheese Consumption in the United States and Canada” (the FDA/Health Canada QRA) (Ref. 2).

FDA establishes food standards of identity, to promote honesty and fair dealing in the interest of consumers, under the authority set forth in section 401 of the Federal Food, Drug, and Cosmetic Act (the FD&C Act) (21 U.S.C. 341). Some of these standards of identity (e.g., the standard of identity for soft-ripened cheese in § 133.182 (21 CFR 133.182)) permit the manufacture of cheese from unpasteurized milk. These standards of identity specify that the process for cheese manufactured from unpasteurized milk include an aging period. A typical aging period is not less than 60 days at not less than 35 °F (see § 133.182(a) in the standard of identity for soft-ripened cheese).

The aging period for cheese manufactured from unpasteurized milk was presumed to act as a control measure to reduce the risk that pathogens would be present when the cheese was consumed. However, the available data and information raise questions about the safety of cheese manufactured from unpasteurized milk, even when aged. For example, research has demonstrated that pathogens such as E. coli O157:H7 can survive a 60-day aging period in a hard cheese such as Cheddar cheese (Refs. 3 and 4). In addition, a 1997 memorandum from a subcommittee of the National Advisory Committee on Microbiological Criteria for Foods stated that the scientific literature confirms that pathogens can survive the 60-day aging process for cheeses manufactured using unpasteurized milk (Ref. 5). More recently, the results of the FDA/Health Canada QRA suggest that the 60-day aging period for soft-ripened cheese may increase the risk of listeriosis from consumption of soft-ripened cheese by allowing more time for L. monocytogenes, if present, to multiply (rather than decrease) as the soft-ripened cheese ages (Ref. 6).

colbert.raw.milkWe are continuing to evaluate the safety of processes for the manufacture of cheese, particularly processes for the manufacture of cheese from unpasteurized milk. We are requesting comments and scientific data and other information to:

Understand what (if any) aspects of the current regulatory framework for the production of cheese manufactured from unpasteurized milk act as an impediment to efficient and effective control measures to significantly minimize pathogens that may be present in unpasteurized milk.

Understand current practices to reduce the potential for foodborne illness during the manufacture of cheese from unpasteurized milk. To what extent do producers of cheese manufactured from unpasteurized milk solely rely on an aging period to significantly minimize pathogens that may be present in unpasteurized cheese? If such producers rely on control measures other than the aging process, what are those control measures and what is the prevalence of those control measures among such producers? How effective and practical are these control measures?

Understand the availability and feasibility of various treatments (e.g., to achieve bacterial reductions of from 100- to 1,000,000-fold) that could reduce the risk of listeriosis and other foodborne illness from the consumption of all types of cheeses manufactured from unpasteurized milk. We are aware of non-thermal control measures such as added substances (such as bacteriocins, lactoferrins, lysozyme, other enzymes, and salt), bactofugation, carbon dioxide, high hydrostatic pressure, microfiltration, microwave, pulsed electric field, pulsed light, ultrasound, and ultraviolet light. However, we would like to receive additional data regarding the efficacy, on a consistent basis, of such treatments when used to minimize the broad spectrum of pathogens that may be present in unpasteurized milk.

Evaluate the impact of the currently required 60-day minimum aging period for soft-ripened cheese on pathogens other than L. monocytogenes in soft-ripened cheese. For example, how does the minimum aging period affect the safety of the cheese with respect to pathogens other than L. monocytogenes? Are there alternatives to the currently required 60-day aging period for soft-ripened cheese that would ensure the safety of such cheese with respect to these pathogens?

Evaluate the impact on pathogens of a minimum aging period for all those cheeses that are subject to a required minimum aging period through an applicable standard of identity. As discussed in section I, research and a literature review show that pathogens can survive the 60-day aging process for cheeses manufactured using unpasteurized milk. For pathogens other than L. monocytogenes, is a 60-day aging period effective in adequately reducing a broad spectrum of pathogens that could be in cheese manufactured from unpasteurized milk?

Determine whether, consistent with modern international approaches to food safety (Ref. 7), a performance objective (or standard) for L. monocytogenes should be used as a replacement for the 60-day aging requirement and whether a second performance standard for Gram-negative enteric pathogens should also be used. If a second performance standard is used for Gram-negative enteric pathogens, which Gram-negative pathogen should be specified?

Understand the prevalence of testing during manufacture (e.g., testing for pathogens of each lot of cheese manufactured from unpasteurized milk and of bulk shipments of unpasteurized milk). If testing is not currently being used, how practical would such testing be? How much would it cost?

Determine the extent to which consumers understand the risk of foodborne listeriosis or other illness from consumption of cheese manufactured from unpasteurized milk. To what extent are consumers aware that an aging process has had (and may continue to have) a role in food safety as well as a role in the particular type of cheese produced? To what extent do consumers consider whether a cheese is made from pasteurized or unpasteurized milk in making purchase decisions?


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The following references are available electronically at http://www.regulations.gov. (FDA has verified the Web site addresses, but we are not responsible for any subsequent changes to the Web sites after this document publishes in the Federal Register.)

  1. Langer, A. J., T. Ayers, J. Grass, et al., “Nonpasteurized Dairy Products, Disease Outbreaks, and State Laws—United States, 1993-2006,”Emerging Infectious Disease 18(3): 385-391, 2012.
  2. FDA and Health Canada, “Joint Food and Drug Administration/Health Canada—Santé Canada Quantitative Assessment of the Risk of Listeriosis from Soft-Ripened Cheese Consumption in the United States and Canada.” Accessible at http://www.fda.gov/Food/FoodScienceResearch/RiskSafetyAssessment/default.htm and http://www.fda.gov/ScienceResearch/SpecialTopics/PeerReviewofScientificInformationandAssessments/ucm079120.htm (2015).
  3. Reitsma, C.J. and D.R. Henning, “Survival of Enterohemorrhagic Escherichia coli O157:H7 During the Manufacture and Curing of Cheddar Cheese,”Journal of Food Protection, 59(5): 460-464, 1996.
  4. Schlesser, J.E., R, Gerdes, S. Ravishankar, et al, “Survival of a Five-Strain Cocktail of Escherichia coli O157:H7 During the 60-Day Aging Period of Cheddar Cheese Made from Unpasteurized Milk,”Journal of Food Protection, 69(5):990-998, 2006.
  5. Memorandum from Chair, Cheese Subcommittee of the National Advisory Committee on Microbiological Criteria for Foods to Chair, National Advisory Committee on Microbiological Criteria for Foods, “Review of Scientific Literature Regarding the Sixty-Day Aging Process for Hard Cheese,” April 3, 1997.
  6. FDA and Health Canada, “Joint Food and Drug Administration/Health Canada—Santé Canada Quantitative Assessment of the Risk of Listeriosis from Soft-Ripened Cheese Consumption in the United States and Canada: Interpretative Summary.” Accessible at http://www.fda.gov/Food/FoodScienceResearch/RiskSafetyAssessment/default.htm and http://www.fda.gov/ScienceResearch/SpecialTopics/PeerReviewofScientificInformationandAssessments/ucm079120.htm (2015).
  7. Codex Alimentarius Commission, “Principles and Guidelines for the Establishment and Application of Microbiological Criteria Related to Foods, CAC/GL 21-1997,” 1997.

Raw milk cheddar recalled; aged 60+ days?

U.S. FDA announced today the recall of over 1100 lbs of raw milk cheddar cheese. According to a press release, Farm Country Cheese House of, Lakeview Michigan is recalling 1136.53 pounds of Raw Milk Cheddar, because it has the potential to be contaminated with Listeria Monocytogenes.ucm428088

Raw Milk Cheddar was distributed in the state of Michigan. More specific in the Grand Rapids metro area and, Detroit metro area through retail stores and specialty shops.

The Raw Milk Cheddar in question is packaged under two different labels. The first label will have Farm Country Cheese House logo on the far left hand side, and the product name (Raw Milk Cheddar) will be written on top of the label. This product is sold as an 8 oz block. This product has “Use By Date” on the back of the cheese. The dates are between October 28th 2015 and December 5th 2015. This label will also have a Julian Date in the lower right hand corner. These Julian dates are as follows: 14301, 14302, 14308, 14309, 14324, 14325, 14332, 14336, and 14339.

The second label will have Farm Country Cheese House logo on the far left hand side, and the product name (Raw Milk Cheddar) written in white over a light blue banner this label will have the “Use By Date” on the back, it will not have a Julian Date. The “Use By Date” dates are between October 28th 2015 and December 5th 2015. This will be packaged in 8oz blocks and 5 lb. loafs.

The recall was the result of a routine sampling program by the FDA which revealed that the finished products contained the bacteria. Farm Country Cheese House has ceased the production and distribution of the product as FDA and the company continues their investigation as to what caused the problem.

I’m guessing its a hard cheddar, and missing from the info is how long it was aged before sale.

UNC Public health school serves raw milk cheese at welcome reception

Although North Carolina is largely seen as a basketball-first state, college football is definitely king during the fall months. Despite a current top-25 ranking for Carolina, and a less-than-stellar start of the season for N.C. State (a last minute one-point win over Georgia Southern) the two schools are gearing up for the all-important rivalry game in November. The rivalry often spills over into other areas; including public health and food safety.

Liz Rogawski, a student at UNC Chapel Hill’s Gillings School of Public Health writes in a letter to The Daily Tarheel,

raw-milk-cheese-940x626Students, faculty, and staff in the School of Public Health today were welcomed to the fall semester with a large selection of local delicacies as part of the welcome-back social. The spread included raw milk cheese — cheese that is made from unpasteurized milk. The irony of serving raw milk cheese in a school of public health is hard to miss. Pasteurization, which kills harmful bacteria, is one of public health’s finest achievements in disease prevention.

Raw milk is “150 times more likely to cause foodborne illness and results in 13 times more hospitalizations than illnesses involving pasteurized dairy products,” according to the Food and Drug Administration website (this is from a CDC-authored paper -ben).

The serving of raw milk cheese puts our students and staff at unnecessary risk of diseases that have been prevented by pasteurization since the mid-19th century. Luckily, we have plenty of epidemiologists around to investigate any disease outbreaks if needed.

The CDC-authored paper that Rogawski cites reports that between 1993-2006, “of the 65 outbreaks involving cheese, 27 (42%) involved cheese made from nonpasteurized milk. Of the 56 outbreaks involving fluid milk, an even higher percentage (82%) involved nonpasteurized milk.”

The raw data shows more outbreaks related to pasteurized-milk cheeses compared to unpasteurized-milk the relative risk tells a different story.

The authors go on to say:

Because consumption of nonpasteurized dairy products is uncommon in the United States, the high incidence of outbreaks and outbreak-associated illness involving nonpasteurized dairy products is remarkable and greatly disproportionate to the incidence involving dairy products that were marketed, labeled, or otherwise presented as pasteurized.

A 2013  joint FDA/Health Canada risk assessment detailed the relative risks.

While there are foodborne illness risk differences between soft and hard unpasteuized cheeses due to the influence of water activity, raw milk cheeses, regardless of aging carry increased risk (see this 2013 outbreak and others as well as D’Amico and colleagues, 60-day aging requirement does not ensure safety of surface-mold-ripened soft cheeses manufactured from raw or pasteurized milk when Listeria monocytogenes is introduced as a post processing contaminant).

Communicating the risk to the eaters is important, I’m all about informed choice.

Quantitative risk assessment of hemolytic and uremic syndrome linked to O157:H7 and non-O157:H7 shiga-toxin producing Escherichia coli strains in raw milk soft cheeses

Shiga-toxin producing Escherichia coli (STEC) strains may cause human infections ranging from simple diarrhea to Haemolytic Uremic Syndrome (HUS). The five main pathogenic serotypes of STEC (MPS-STEC) identified thus far in Europe are O157:H7, O26:H11, O103:H2, O111:H8, and O145:H28.

raw.milk.cheeseBecause STEC strains can survive or grow during cheese making, particularly in soft cheeses, a stochastic quantitative microbial risk assessment model was developed to assess the risk of HUS associated with the five MPS-STEC in raw milk soft cheeses. A baseline scenario represents a theoretical worst-case scenario where no intervention was considered throughout the farm-to-fork continuum. The risk level assessed with this baseline scenario is the risk-based level. The impact of seven preharvest scenarios (vaccines, probiotic, milk farm sorting) on the risk-based level was expressed in terms of risk reduction. Impact of the preharvest intervention ranges from 76% to 98% of risk reduction with highest values predicted with scenarios combining a decrease of the number of cow shedding STEC and of the STEC concentration in feces. The impact of postharvest interventions on the risk-based level was also tested by applying five microbiological criteria (MC) at the end of ripening.

The five MCs differ in terms of sample size, the number of samples that may yield a value larger than the microbiological limit, and the analysis methods. The risk reduction predicted varies from 25% to 96% by applying MCs without preharvest interventions and from 1% to 96% with combination of pre- and postharvest interventions.

Risk Analysis
Frédérique Perrin, Fanny Tenenhaus-Aziza, Valérie Michel, Stéphane Miszczycha, Nadège Bel, and Moez Sanaa


Is 60 days enough for safety? FDA launching pilot testing program for raw milk cheese

In January, the U.S. Food and Drug Administration will launch a pilot program to sample and test domestic and imported raw milk cheese aged at least 60 days for Salmonella, L. monocytogenes, and E. coli O157:H7. On December 19, members of the American Cheese Society (ACS) Regulatory & Academic Committee attended a conference call held by FDA to share information about the program.

This program will test a new microbiological sampling surveillance model, which should help to fill knowledge gaps on the prevalence of microbiological hazards in commodities raw-milk-cheeseand increase FDA’s understanding of risks, contamination rates, and mitigation strategies.

Along with raw milk cheese, the pilot program will include domestic and imported sprouts and raw almonds.

Sampling will begin in January 2014 (an exact date has not been provided) and will last for approximately 12 months. Sampling may take place at any point in the supply chain for domestic cheeses, including at the cheesemaking plant. For imported cheeses, sampling will occur at locations where the cheese normally enters the U.S.