April 2012

RealRawMilkFacts.jpgLynne Terry (a.k.a., the raw milk lady) reports today that Oregon health officials suspect two more illnesses are part of a raw milk outbreak traced nearly three weeks ago to a farm near Wilsonville.

William Keene, senior epidemiologist with Oregon Public Health, said the two adults had both consumed raw milk from Foundation Farm, including one person who continued to drink it after being warned about the outbreak.

Keene said one was sickened by campylobacter, the other by cryptosporidium, making 21 likely cases in the outbreak. Nineteen others were infected with E. coli.

  • E. coli O157:H7 was on rectal swabs from two of the farm’s four cows.
  • Milk and manure from the farm also tested positive for the same bacteria.

Sad News

Accordning to Lynne, four children who drank the milk were hospitalized with acute kidney failure – hemolytic uremic syndrome, which is associated with E. coli O157:H7. Two of the patients — 14 and 13 — are Portland area middle schoolers. The others are 3 and 1 years old.

For more information on the risks of raw milk, see www.realrawmilkfacts.com.

Screen Shot 2012-04-30 at 6.01.00 PM.pngThe recall was prompted after samples during a routine inspection tested positive for Salmonella.

The North Carolina Department of Agriculture and Consumer Services announced today the voluntary recall of the 12-ounce packages of Smiling Hara unpasteurized soybean tempeh.  The company says anyone with packages marked with a best-by date of 7/11/12 through 10/25/12 should return the product.  Nearly three dozen people have become sick recently after a Salmonella outbreak traced back to the Asheville area.

According to the Buncombe County Health Department:

“We do not know yet if this is the same strain of salmonella that is causing the current outbreak.”

042612-map.jpgA total of 7 “clusters” at restaurants (unnamed) and grocery stores (unnamed) have been identified by the CDC linked to a Salmonella Bareilly and Salmonella Nchanga outbreak tainded tuna.   In each cluster, at least one ill person reported eating sushi purchased at a restaurant (unnamed) or a grocery store (unnamed).  These clusters were located in five states: Connecticut, Maryland, Rhode Island, Texas, and Wisconsin. Records obtained by FDA and traceback efforts indicated that Moon Marine USA Corporation of Cupertino, California imported the suspect product.  Moon Marine agreed to recall all their frozen raw yellowfin tuna product imported from India, labeled as Nakaochi Scrape AA or AAA, totaling approximately 58,000 pounds.

190 Persons infected with the outbreak strain of Salmonella Bareilly have been reported from 21 states and the District of Columbia. The number of ill persons with the outbreak strain of Salmonella Bareilly identified in each state is as follows: Alabama (2), Arkansas (1), Connecticut (8), District of Columbia (2), Florida (1), Georgia (9), Illinois (15), Louisiana (3), Maryland (20), Massachusetts (24), Mississippi (2), Missouri (4), New Jersey (18), New York (33), North Carolina (3), Pennsylvania (7), Rhode Island (6), South Carolina (3), Texas (4), Virginia (9), Vermont (1), and Wisconsin (15).

10 persons infected with the outbreak strain of Salmonella Nchanga have been reported from 5 states. The number of ill persons with the outbreak strain of Salmonella Nchanga identified in each state is as follows: Georgia (2), New Jersey (1), New York (5), Virginia (1), and Wisconsin (1).

28 ill persons have been hospitalized, and no deaths have been reported.

Past Tuna Salmonella Outbreaks in United States

Twenty-three were sickened in 2010 with Salmonella Paratyphi B linked to the consumption of imported, raw, ahi tuna at various locations on the island of Oahu, Hawaii. The product was said to have originated from Asia, and was previously frozen. Concurrent cases of Salmonella Paratyphi B were reported in five other U.S. states, California, Maryland, Pennsylvania, Massachusetts, and New York. It was not stated whether these cases were also linked to the consumption of raw ahi tuna.

Four were sickened in 2008 linked to an outbreak of Salmonella Barranquilla among people who had eaten raw tuna or bass fish at a restaurant in Massachusetts.

Forty-four were sickened in 2007 with Salmonella Paratyphi B after the consumption of previously frozen, raw, ahi tuna on the island of Oahu, Hawaii. Additional cases were identified in Colorado and California. The tuna had been sent from Indonesia to a U.S. mainland importer.

North and South Carolina, Tennessee and New York impacted.

As many as thirty-four cases of Salmonella paratyphi B have been identified in North and South Carolina, Tennessee and New York since February 28th according to the North Carolina Buncombe County Department of Health.

wmi_02_img0147.jpgAccording to the CDC, humans are one of the only known reservoir sources of Salmonella paratyphi B. Salmonella paratyphi B is most often acquired through consumption of water or food that has been contaminated by feces of an infected person or a chronic, asymptomatic carrier. The most famous example of a human chronic carrier of Salmonella was “Typhoid Mary,” an asymptomatic Irish-American cook linked to 54 cases and four deaths in nine different typhoid fever epidemics in New York City during the early 1900s.

Worldwide some six million cases of Salmonella paratyphi are estimated to occur annually. However, only approximately 150 cases of Salmonella paratyphi are reported each year in the United States, most of which are in recent travelers.

The incubation period of Salmonella paratyphoid B is longer that other Salmonella with onset of infections ranging from 6–30 days. The onset of illness is increasing fatigue and a fever that increases daily from low-grade to as high by the third to fourth day of illness. A rash of rose-colored spots can occasionally be seen on the trunk. Untreated, the disease can last for a month. The serious complications of Salmonella paratyphoid B generally occur after 2–3 weeks of illness and may include intestinal hemorrhage or perforation, which can be life threatening.

kytn.gifAs many as three Stanford Kentucky Elementary School kindergarten students may have contracted E. coli according to the Lincoln County Public Schools. State and local health officials are investigating and have examined the elementary school cafeteria without finding a cause. Two of the 5-year-olds became ill within the last few days and are being treated at University of Kentucky Children’s Hospital.

Three Tennessee children are in the hospital following an E. coli outbreak at a Cocke County daycare facility. According to the Tennessee Department of Health, three children, all of whom attend the same daycare facility in Newport, were diagnosed with E. coli symptoms. The source of the bacteria is currently unknown. State health department officials have not closed the facility, but are continuing to investigate.

The two outbreaks do not appear to be linked.

It has been a bad few weeks for proponents of raw milk.

rawmilkoregon.jpgAccording to the Oregon Department of Health, nineteen people in Oregon are ill with E. coli in an outbreak traced to raw milk from Foundation Farm near Wilsonville, Oregon. Of the 19 people, 11 have culture-confirmed E. coli O157 infections. Fifteen of the 19 cases are children 19 or younger. Four of the children have been hospitalized with kidney failure. On April 19, a Portland hospital confirmed that one of the hospitalized children – a 13-year-old girl – was in critical condition. According to a member of the cowshare implicated in the outbreak, as many as four of the farmer’s children are also sickened, including one with hemolytic uremic syndrome (HUS).

The Missouri Department of Health and Senior Services on Wednesday named Stroupe Farm in Howard County as the possible source of an ongoing E. coli O157:H7 outbreak in central Missouri. The health department has also narrowed their outbreak down to 12. A 2-year-old who consumed raw milk products has been hospitalized for more than two weeks after developing symptoms of hemolytic uremic syndrome (HUS). Eight of the 12 individuals reported consuming raw milk or raw milk products from Stroupe Farm. Of the other four, two are related to people who consumed raw milk, while the remaining two have infections that genetically match the others despite the individuals reporting no connection to raw dairy.

Since 1998, 118 total outbreaks
with 2,123 total illnesses, 2 deaths have been linked to raw milk or raw milk cheese:

– 85 fluid milk: 17 cow, 4 goat, 64 unspecified milk type;

– 27 cheese: 2 aged, 3 homemade, 17 Mexican-style queso fresco, 1 goat chevre, 1 curds, 3 unspecified;

– multiple raw dairy products (fluid milk, cheese, and/or colostrum);

– 2,123 total illnesses, 2 deaths;

– 1,490 fluid milk-related illnesses, no deaths: 225 cow, 63 goat, 1,202 unspecified;

– 576 cheese-related illnesses: 46 aged, 80 homemade, 324 Mexican-style queso fresco (2 deaths), 5 goat chevre, 63 curds, 58 unspecified cheese type;

– 57 multiple raw dairy products related illnesses (fluid milk, cheese, and/or colostrum).

salmonella2304_228x233.jpgThe Buncombe County Department of Health (BCDOH) is currently investigating an outbreak of Salmonella Paratyphi B infection in Buncombe County.

Communicable Disease Nurses and Environmental Health Specialists are conducting interviews with people who currently have or have had the infection, reviewing laboratory reports and inspecting food sources that may be linked to the outbreak.

Communicable disease experts from the NC Division of Public Health and the Centers for Disease Control and Prevention as well as food specialists from the NC Department of Agriculture are assisting with the investigations. As of this morning, 27 possible cases have been identified and the source of contamination has not yet been confirmed.

All cases appear to have been associated with residence or travel to Buncombe County since February 28, 2012. Any reports of possible additional cases are immediately placed under investigation to verify whether the case may be linked to this outbreak.

I have been to Asheville more than a few times:

Western Sizzlin’ Salmonella Outbreak – North Carolina

Robeson Schools E. coli Outbreak – North Carolina

Crossroads Farm Petting Zoo E. coli Outbreak – North Carolina

Olive Garden Hepatitis A Class Action – North Carolina

Wright County Egg Salmonella Outbreak – North Carolina

Peanut Corporation of America Salmonella Outbreak – North Carolina

Last years Listeria Cantaloupe Outbreak is still claiming lives.  December 2011 official CDC report counted a total of 146 persons infected with any of the four outbreak-associated strains of Listeria monocytogenes from 28 states.  However, the CDC still only counts thirty deaths as being reported in addition to one woman pregnant at the time of illness who had a miscarriage.  I believe the death toll is now at least 36, including Mike Hauser:

scraped-tuna-200px.jpg

Are there 5,860 Sickened by Salmonella Sushi?

The CDC’s recent estimates that for every case counted, 29.3 cases go unreported and therefore uncounted. See Table 2 – (http://wwwnc.cdc.gov/eid/article/17/1/p1-1101-t2.htm) in this citation: Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson M-A, Roy SL, et al. Foodborne illness acquired in the United States—major pathogens. Emerg Infect Dis [serial on the Internet]. 2011 Jan. http://dx.doi.org/10.3201/eid1701.P11101. That would mean this outbreak has sickened as many as 5,860 people. If applying a previous CDC estimated ratio of non-reported salmonellosis cases to reported cases (38.6), one would arrive at an estimated 7,720 illnesses from this outbreak. Voetsch, et al. (2004-04-15). “FoodNet Estimate of the Burden of Illness Caused by Nontyphoidal Salmonella Infections in the United States”. Clinical Infectious Diseases, 2004; 38:S3.

190 persons infected with the outbreak strain of Salmonella Bareilly have been reported from 21 states and the District of Columbia. The number of ill persons with the outbreak strain of Salmonella Bareilly identified in each state is as follows: Alabama (2), Arkansas (1), Connecticut (8), District of Columbia (2), Florida (1), Georgia (9), Illinois (15), Louisiana (3), Maryland (20), Massachusetts (24), Mississippi (2), Missouri (4), New Jersey (18), New York (33), North Carolina (3), Pennsylvania (7), Rhode Island (6), South Carolina (3), Texas (4), Virginia (9), Vermont (1), and Wisconsin (15).

10 persons infected with the outbreak strain of Salmonella Nchanga have been reported from 5 states. The number of ill persons with the outbreak strain of Salmonella Nchanga identified in each state is as follows: Georgia (2), New Jersey (1), New York (5), Virginia (1), and Wisconsin (1).

28 ill persons have been hospitalized, and no deaths have been reported.

Collaborative investigation efforts of state, local, and federal public health agencies indicate that a frozen raw yellowfin tuna product, known as Nakaochi Scrape, from Moon Marine USA Corporation is the likely source of this outbreak.

FDA laboratories have identified Salmonella in two samples of Nakaochi scrape yellowfin tuna with a PFGE pattern indistinguishable from the Salmonella Bareilly strain associated with this outbreak. One of the samples also yielded another type of Salmonella with a PFGE pattern indistinguishable from the cluster of Salmonella Nchanga infections.

Testing conducted by the Wisconsin Department of Agriculture Trade and Consumer Protection laboratory isolated the outbreak strain of Salmonella Bareilly from one sample of recalled tuna and one sample of a spicy tuna roll made with recalled tuna.