Raw is risky: Drug-resistant brucellosis linked to raw milk

The U.S. Centers for Disease Control and Prevention and state health officials are investigating potential exposures to Brucella strain RB51 (RB51) in 19 states, connected to consuming raw (unpasteurized) milk from Miller’s Biodiversity Farm in Quarryville, Pennsylvania. One case of RB51 infection (brucellosis) has been confirmed in New York, and an unknown number of people may have been exposed to RB51 from drinking the milk from this farm. This type of Brucella is resistant to first-line drugs and can be difficult to diagnose because of limited testing options and the fact that early brucellosis symptoms are similar to those of more common illnesses like flu.­

The New York case is the third known instance of an infection with RB51 associated with consuming raw milk or raw milk products produced in the United States. The other two human cases occurred in October 2017 in New Jersey and in August 2017 in Texas. Those cases reported drinking raw milk from an online retailer and a Texas farm, respectively. In addition to these three confirmed cases, hundreds of others were potentially exposed to RB51 during these three incidents.

RB51 is a live, weakened strain used in a vaccine to protect cows against a more severe form of Brucella infection that can cause abortions in cows and severe illness in people. On rare occasions, cows vaccinated with RB51 vaccine can shed the bacteria in their milk. People who drink raw milk from cows that are shedding RB51 can develop brucellosis.

People who consumed raw milk or raw milk products from this dairy farm since January 2016 may have been exposed and should talk to their doctor.

People who are still within six months of the date they last consumed the raw milk are at an increased risk for brucellosis and should receive antibiotics to prevent an infection and symptoms, and should monitor their health for possible symptoms for six months. If symptoms develop, they should see their doctor immediately for testing.

Milk samples from Miller’s Biodiversity tested positive for RB51. A cow that tested positive for RB51 has been removed from the milking herd.

Use a thermometer, raw is risky: Large number of US consumers ignore advice

Providing consumers with recommendations on specific food safety practices may be a cost-effective policy option, acting either as a complement to or substitute for additional food safety regulations on food suppliers, but it would require a detailed understanding of consumer food safety practices.

Using data from the 2014 to 2016 American Time Use Survey–Eating and Health Module, we examine two food safety practices in which Government health and safety officials, as well as the broader food safety community, have offered unequivocal advice: meal preparers should always use a thermometer to verify that meat has reached a recommended temperature and consumers should avoid raw (unpasteurized) milk.

We found that 2 percent of at-home meal preparers in the United States served raw milk during a typical week; of which 80 percent lived with two or more people, 44 percent were married, 36 percent lived with one or more children, and 28 percent lived with at least one person age 62 or older, indicating the potential that at-risk populations are consuming raw milk.

While preparing meals with meat, poultry, or seafood, 14 percent of at-home meal preparers in the United States used a food thermometer. Meal preparers who use a food thermometer typically earned more, reported better physical health, were more likely to exercise, were more likely married, and had larger and younger households. Last, rates of food thermometer usage were higher for at-home meal preparers whose occupation was food-preparation related, suggesting food safety training or awareness at work may influence food safety behavior at home.

Consumer Food Safety Practices: Raw Milk Consumption and Food Thermometer Use

Rhodes, Taylor M., Fred Kuchler, Ket McClelland, and Karen S. Hamrick.

EIB-205, U.S. Department of Agriculture, Economic Research Service, January 2019.

https://www.ers.usda.gov/webdocs/publications/91110/eib-205.pdf?v=675.4

Raw is risky: Salmonella Dublin in raw milk cheese, France, 2015-16

Nontyphoidal Salmonella is a main cause of bacterial food-borne infection in Europe [1,2]. The majority of human infections is caused by a limited number of Salmonella serotypes among the 2,600 described to date [3,4]. Salmonella enterica serotype Dublin (S. Dublin) is particularly invasive in humans and more often leads to severe disease and higher mortality rates compared with other serotypes [47]. S. Dublin is host-adapted to bovines and is frequently isolated from cattle, with raw milk or raw-milk cheeses as a typical vehicle for food-borne outbreaks [8,9].

A picture taken on November 18, 2011 shows a Morbier cheese from France during the European bi-annual Eurogusto slow food festival in Tours, central France. Slow Food, whose symbol is a red snail, promotes food that is “good at a sensory level,” but also aims to educate people about traditional and wholesome means of production and defend biodiversity in the food supply. AFP PHOTO/ALAIN JOCARD / AFP PHOTO / ALAIN JOCARD

In 2012, a major S. Dublin outbreak occurred in France, with 103 cases linked to Saint-Nectaire (bovine raw-milk cheese) consumption [10,11]. In 2015, 34 S. Dublin cases were reported linked to the consumption of Reblochon (bovine raw-milk cheese) (data not shown; Santé publique France).

In France, the National Reference Center for Salmonella (NRC) and the French Agency for Food, Environmental and Occupational Health and Safety (ANSES) routinely collect and serotype human and non-human Salmonella isolates, respectively [1214], using the Kauffmann–White–Le Minor scheme [3]. The S. Dublin isolates collected are frequently susceptible to all antibiotics and show an indistinguishable pulsed-field gel electrophoresis (PFGE) pattern. To better distinguish S. Dublin isolates, multilocus variable-number tandem repeat analysis (MLVA) has recently been used for surveillance and outbreak investigations [11,15]. Moreover, whole genome sequencing (WGS) of Salmonella has been shown to discriminate between closely related isolates of S. Dublin [16,17].

On 18 January 2016, the French NRC reported to Santé publique France (SpFrance, the French national public health agency) an excess of S. Dublin infections across the country, with 37 S. Dublin isolates identified between mid-November 2015 and mid-January 2016, compared with 10 S. Dublin isolates during the same period in the two previous years. An outbreak investigation team with experts from SpFrance, NRC, ANSES and the French Directorate General for Food (DGAL) launched extensive epidemiological, microbiological and food investigations to confirm the outbreak, identify the vehicle of transmission and propose appropriate control measures.

Disentangling a complex nationwide salmonella Dublin outbreak associated with raw-milk cheese consumption, France, 2015 to 2016, 

Eurosurveillance

Aymeric Ung1,2,3Amrish Y. Baidjoe3,4,5Dieter Van Cauteren1Nizar Fawal5Laetitia Fabre5,Caroline Guerrisi6Kostas Danis1,2Anne Morand7Marie-Pierre Donguy7Etienne Lucas1,Louise Rossignol6Sophie Lefèvre5Marie-Léone Vignaud8Sabrina Cadel-Six8Renaud Lailler8,Nathalie Jourdan-Da Silva1,9Simon Le Hello5,9

 https://doi.org/10.2807/1560-7917.ES.2019.24.3.1700703

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2019.24.3.1700703

Raw is risky, even milk

Dec. 29 is always a bustling day, with my birthday, my 12-year-wedding-at-city hall in Manhattan, Kansas, but most importantly, my mother’s birthday.

I was born on her 21st birthday

How lucky were you (that’s sarcasm)

But my 77-year-old mother, sitting a few days ago with my four Canadian daughters (3 grandsons missing) wouldn’t be there if her father, Homer, hadn’t got rid of the cows.

Mom lived.

It was about 1943, and my mother developed undulate fever from drinking unpasteurized raw  milk.

Homer turned the farm into potatoes (as you do in Alliston, Ontario, that’s in Canada), and then became the asparagus baron of Canada.

A New York resident recently contracted the RB51 strain of the Brucella abortus bacteria after consuming raw milk.

Raw milk convention goerers got sick from raw milk

Katie Burns of JAVMA News writes, what could be more wholesome than chocolate milk from an Amish farm?

In November 2015, the International Raw Milk Symposium in Anaheim, California, brought in unpasteurized chocolate milk from an Amish farm in Pennsylvania. The sale of raw milk is legal in California and Pennsylvania, but the interstate sale of raw milk is illegal. Authorities embargoed the chocolate milk and sent a sample to the Food and Drug Administration—turning up Listeria.

An investigation by the Centers for Disease Control and Prevention and state health departments found that Listeria isolates from the milk seized at the symposium were related to isolates obtained from two people in 2014. One person in California had been hospitalized and the other, a cancer patient in Florida, had died.

The investigation revealed some of the risks of raw milk and some of the complexities of buyers’ clubs, which can be so secretive as to involve drop points and burner phones for temporary use. The AVMA supports laws requiring pasteurization of all milk, but unpasteurized milk has a devoted following despite the safety concerns and varying legality among states.

14 sick from Salmonella in raw milk cheese in France

Since the identification by Public Health France of cases of salmonella infection of people who consumed reblochon raw milk produced by the company La Fromagerie La Tournette, health authorities in connection with the company are mobilized to take all necessary measures for the protection of consumers (something may be lost in translation).

Following the traceability survey that has just been conducted, it was decided as a precautionary measure to withdraw from the sale and recall some reblochons whole and half reblochons raw milk manufactured on this site (sanitary mark FR 74.128 .050 EC) whose expiry dates are between 17/11 and 16/12/2018. Epidemiological, environmental and food traceability investigations are continuing to clarify the origin of the contamination.

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.