Testing don’t prove much says Casey Jones: Washington creamery samples show no E. coli but 2 people sick

Sequim-State Department of Agriculture laboratory tests found no traces of E. coli in products from Dungeness Valley Creamery, a raw milk dairy farm north of Sequim, after Department of Health officials linked two cases of E. coli with consumption of the dairy’s products.

Last Friday, the state’s Department of Health issued a press release that said: “Lab results recently confirmed a child under 5-years-old from Island County and (a) resident in their 70s of Clallam County became ill with an E. coli infection after drinking Dungeness Valley Creamery raw milk.”

However, representatives of the state’s Department of Agriculture said that results the following day showed E. coli was not found in random product samples from the farm. Escherichia coli (E. coli) bacteria normally live in the intestines of healthy people and animals.

Chris McGann, spokesman for the state’s Department of Agriculture who regulates raw milk producers, said the agency tested 21 samples of raw milk, with 15 randomly selected from retail locations and six directly from the dairy, and all were deemed “not found” to have E. coli.

Liz Coleman, communication lead for environmental public health, said investigators found unique strands of E. coli in the consumers and the common link was they both drank raw milk roughly around the same time from the creamery.

State health officials said the milk batch that allegedly held E. coli and infected the two patients was unavailable for testing.

Ryan McCarthey, Dungeness Valley Creamery co-owner, said, “They haven’t found any contamination, so I don’t have any reasons to believe our product is contaminated. I guess it’s going to be one of those unsolved mysteries.”

McCarthey said he disagrees with the Department of Health’s wording that the infection came from the creamery.

“We want to know if there was a pathogen,” he said. “We definitely want to do our best to control and mitigate any problem with product.”

Jeni’s Ice Cream uses raw milk?

According to the Charlotte Business Journal, Jeni’s Ice Cream is coming to North Carolina and bringing their fun flavors and tasty desserts. And raw milk?

Jeni’s Splendid Ice Creams is scooping up its signature gourmet ice cream and frozen yogurt in South End.

That roughly 1,000-square-foot boutique ice cream shop is located in the Design Center complex. It marks the brand’s first N.C. scoop shop — and 35th overall.

That spot just fit for the brand, says founder Jeni Britton Bauer.

Jeni’s sets itself apart with how its ice cream is prepared.

That means using raw milk, avoiding stabilizers and emulsifiers and using the best ingredients. For example, whiskey is distilled in the U.S., and the brand uses Fair Trade Chocolate and local ingredients when possible, such as fresh fruit or mint from the farmers market.

I tweeted at the @jenisicecreams handle looking for clarification. Have yet to hear what they mean by raw milk. I read it as unpasteurized milk goes into their ice cream. Other folks on Twitter have pointed out that it might just be marketing speak. Like ‘Hey, we make ice cream out of raw milk, well milk that starts raw, and then gets pasteurized.’

I don’t want to get into the raw milk choice debate here. You can check out Food Safety Talk 53: Raw Milk Hampsterdam for my thoughts on that.

Thanks to Dr. Tara Smith (@aetiology) on sleuthing this passage from the Jeni’s website where they talk about raw milk,

Dairy is the foundation of everything we do, so we use the best we can find. Smith’s, the 110-year-old dairy in Orrville, Ohio, has been sourcing raw cream and grass-grazed milk and pasteurizing it for us for the past couple of years. They work with small family farms within 200 miles of our kitchen.

Back to the Biz Journal article:

“Our ice creams really are fundamentally different from others,” she says.

If they make it with raw milk, yeah. And would be doing so illegally in NC. If they are talking about raw milk that becomes pasteurized before they get it, or they pasteurize it, then they are like pretty much every other ice cream processor in the U.S.

Update: Jeni’s (@jenisicecreams) tweeted back to me with this info:

 

1 dead, 25 sick: No fatal accident inquiry over girl’s E. coli death

BBC reports there will not be a fatal accident inquiry (FAI) into the death of a three-year-old girl from Dunbartonshire following an E. coli outbreak in 2016.

The Crown Office had previously said South Lanarkshire-based Errington Cheese would not face prosecution over the child’s death.

The firm’s Dunsyre Blue was named the most likely source of the outbreak.

The Crown Office said it had considered “all the relevant matters” before ruling out an FAI.

A total of 26 cases of the same strain of E. coli O157 were identified between July and September 2016 as a result of the outbreak, which left 17 people requiring hospital treatment.

A report published by Health Protection Scotland concluded in March 2017 that the source of the infection was consumption of an unpasteurised cows’ milk cheese.

Their incident management team found that potentially pathogenic E. coli were able to enter and survive the cheese production process at the food business.

However, Errington Cheese has repeatedly questioned the quality of the investigation and any suggestion that their product was responsible.

Father of Tennessee E. coli victim ‘Nutritionist recommended raw milk’

James Zenker never imagined his young son would battle for his life at just two-years-old.

“It’s affected his kidneys; they shut down,” Zenker said. “It affected his intestines; he couldn’t digest any of his food and its affected his brain — he has a substantial brain injury.”

His son William got E. coli after drinking raw milk linked to French Broad Farm. Zenker said a nutritionist recommended the raw milk to help William fight allergies.

“He’s not able to speak and not able to do the same activities as before he was ill,” Zenker said.

The vast majority of nutritionists, dieticians and physicians I encounter – and it’s frequent with my brain status and trips to emergency – know shit about microbial food safety.

The odd ones do, and they are food safety heros.

But when hospitals continue to serve raw sprouts to immunocompromised people, when they won’t be sold at WalMart in the U.S., I gotta question their food safety credibility.

To reiterate, I stared the Food Safety Network (the original FSN) over 25 years ago 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).

Of the 15 children sick with E. coli in Tennessee that has now been linked to consumption of raw milk and contact with ruminants from French Broad Farm, William is the last one left in the hospital. His father said East Tennessee Children’s Hospital saved his son’s life.

The Knox County Health Department said an investigation concluded that the outbreak was caused by two separate sources, the exposure to farm animals and exposure to raw milk.

“While it is rare, it appears we had two sets of children sickened by two different strains of E. coli O157 at the same time. The epidemiological evidence overwhelmingly supported the two-source theory: consumption of raw milk and some type of contact, most likely indirect, with ruminant animals,” said KCHD Director Dr. Martha Buchanan.

William has had several blood transfusions during his recovery and still needs more. His home church Temple Baptist in Powell (no relation – dp) hosted a replacement drive Tuesday for William and the community.

“It’s so encouraging to see people take time out of their busy day and donate from their own life to help Will and others affected by E. coli,” Zenker said.

If you would like more information about future blood drives click here: 
Blood drives scheduled to help children infected with E. coli.

Raw is risky: NZ raw milk warning as Campylobacter cases rise

Nelson Marlborough Health said in the last four weeks, 24 cases had been notified to the Medical Officer of Health, compared to a range of 6-16 cases in the same period over the previous five years.

A number of known risk factors for campylobacteriosis had been identified in the people affected. These were: drinking raw (unpasteurised) milk or untreated water, and contact with animals and/or nappies.

Nelson Marlborough Medical Officer of Health Dr Stephen Bridgman advised people against drinking raw milk and said it was risky for anyone to consume, but young children and babies, older people, pregnant women and people with a weakened immune system were especially at risk of severe illness.

The public health service was working with the Ministry for Primary Industries, the Ministry of Health and the Institute of Environmental Science and Research to identify the reasons for the increase.

A single source cause was yet to be found and investigations were ongoing.

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.

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.

‘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

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.