February 2016

zoo_kids_farmThe Smithsonian’s National Zoo has temporarily closed the Kids’ Farm exhibit because E. coli bacteria were discovered in a few of the animals. The animals are now being managed under quarantine protocols.

To the Zoo’s credit, I am not aware of any other exhibit like this that monitors animals’ stool.

Zoo veterinarians detected the original presence of the E. coli bacteria in the goats through a routine fecal screening process February 18. The goats were moved into the barn and managed separately from the other animals and visitors. Individual fecal cultures were performed February 22. Last Friday, February 26, results revealed that four goats and one cow were positive. 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 animal care team is consulting with experts from the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service and the D.C. Department of Health.

The team will monitor all the animals extremely closely, continue weekly fecal testing and provide the usual high-quality care during this quarantine period. When Zoo veterinarians receive three consecutive weeks of negative test results, the team will start the planning for lifting the quarantine and reopening the Kids’ Farm.

A 2003 study on the prevalence of E. coli O157:H7 in livestock at 29 county and 3 large state agricultural fairs in the United States found that E. coli O157:H7 could be isolated from 13.8 percent of beef cattle, 5.9 percent of dairy cattle, 3.6 percent of pigs, 5.2 percent of sheep, and 2.8 percent of goats. Over seven percent of pest fly pools also tested positive for E. coli O157:H7 (Keene et al, 2003).

According to the National Association of State Public Health Veterinarians’ “Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2013”:

The primary mode of transmission for enteric pathogens [like E. coli O157:H7] is fecal-oral.  Because animal fur, hair, feathers, scales, skin and saliva harbor fecal organisms, transmission can occur when persons pet, touch, feed or are licked by animals.  Transmission also has been associated with exposure to contaminated animal bedding, flooring, barriers, other environmental surfaces, and contaminated clothing and shoes.  In addition, illness has resulted from fecal contamination of food, including raw milk and drinking water.

big-map-2-25-16Eighteen people infected with the outbreak strain of Listeria have been reported from nine states since July 5, 2015. The number of ill people reported from each state is as follows: Connecticut (1), Indiana (1), Massachusetts (1), Michigan (4), Missouri (2), New Jersey (1), New York (5), Ohio (2), and Pennsylvania (1). Whole genome sequencing has been performed on clinical isolates from all ill people and has shown that the isolates are highly related genetically.

Listeria specimens were collected from ill people between July 5, 2015 and January 31, 2016. Ill people range in age from 3 years to 83, and the median age is 66. Seventy-two percent of ill people are female. All 18 (100%) ill people were hospitalized, including one person from Michigan who died as a result of listeriosis. One of the illnesses reported was in a pregnant woman.

Currently, there are 11 cases of Listeria monocytogenes in five provinces related to this outbreak: Ontario (7), Quebec (1), New Brunswick (1), Prince Edward Island (1), and Newfoundland and Labrador (1).

Individuals became sick between May 2015 and early January 2016. Some of the individuals who became ill have reported eating packaged salads. It is suspected that these salads were produced at the Dole facility in Ohio. The majority of Canadians cases (55%) are female, with an average age of 79 years. All cases have been hospitalized, and three people have died, however it has not been determined if Listeria contributed to the cause of these deaths.

Epidemiologic and laboratory evidence indicate that packaged salads produced at the Dole processing facility in Springfield, Ohio and sold under various brand names are the likely source of this outbreak.

Over the last few weeks my interview on the “6 things a food poisoning expert refuses to eat” has gone a bit viral, and for good reason.

RAW MILK – Raw Milk Likely Link in Eight E. coli Cases

SPROUTS – 13 with Salmonella in 4 States after eating Sweetwater Sprouts

SPROUTS – Jack & The Green Sprouts Linked to E. coli Outbreak in Minnesota and Wisconsin

BAGGED SALAD – 26 with Listeria in the U.S. and Canada Linked to Dole Lettuce

RAW OYSTERS – Oregon Norovirus Outbreak Linked to Yaquina Bay Oysters

Alfalfa-SproutsMinnesota and Wisconsin state health and agriculture officials are investigating an outbreak of foodborne illness associated with alfalfa sprouts produced by Jack & The Green Sprouts. Retailers and restaurants should not sell or serve alfalfa sprouts produced by Jack & The Green Sprouts, and consumers should not eat them at this time.

Routine disease monitoring by the Minnesota Department of Health (MDH) identified seven E. coli O157:NM cases in January and early February; E. coli bacteria from those cases all had the same DNA fingerprint. The ill individuals range in age from 18 to 84 years, and five are female. Four of the cases are residents of the Twin Cities metro area, and three live in greater Minnesota. Two were hospitalized, and both have recovered. Two additional cases of E. coli O157 infection, considered part of this outbreak, were identified by the Wisconsin Department of Health Services (WDHS) in Wisconsin residents. Neither case was hospitalized.

Minnesota officials are working with investigators at the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), WDHS, and the Wisconsin Department of Agriculture, Trade and Consumer Protection (WIDATCP). Jack & The Green Sprouts is located in River Falls, Wis., and distributes alfalfa sprouts to states in the upper Midwest and possibly other states. The seven Minnesota cases and at least one of the Wisconsin cases were exposed to implicated alfalfa sprouts from a variety of locations, including grocery/cooperative stores, restaurants, salad bars and commercial food service.

Jack & The Green Sprouts alfalfa sprouts may be packaged in a plastic clamshell with a brightly colored round label on top that notes the sprout variety. The alfalfa sprouts may be mixed in the same package with other sprout varieties.

alfalfa-sproutsThe Kansas Department of Health and Environment (KDHE) has been working with the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, the Kansas Department of Agriculture and the Oklahoma Department of Health to investigate an outbreak of Salmonella linked to sprouts.

Five people in Kansas have become ill as part of this outbreak after consuming sprouts from Sweetwater Farms, Inman, KS. The last date of illness was January 21 in a Kansas resident. In addition, three residents from Oklahoma also have Salmonella infections that match the outbreak strain. Sweetwater Farms was inspected and samples collected of irrigation water and product have tested positive for Salmonella bacteria although the strain has not yet been identified. Sweetwater Farms has decided to voluntarily recall sprouts in lot 042016. Kansas Department of Health and Environment recommends that people not consume any sprout product from Sweetwater Farms at this time.

Salmonella is estimated to cause one million foodborne illnesses in the United States. Most people infected with Salmonella develop diarrhea, fever and abdominal cramps 12 to 72 hours after infection. The illness usually lasts four to seven days, and most people recover without treatment.

Anyone who believes they may have become ill with Salmonella should contact their health care provider.

KDHE recommends that children, the elderly, pregnant women and people with compromised immune systems avoid eating raw sprouts of any kind due to their potential to harbor harmful bacteria.

raw-mealAs of February 17, 2016, 18 people infected with the outbreak strain of Salmonella Virchow have been reported from 15 states. The number of ill people identified in each state is as follows: Florida (1), Massachusetts (1), Maryland (1), Minnesota (2), New Jersey (2), New Mexico (1), North Carolina (1), Ohio (1), Oklahoma (1), Oregon (1), Rhode Island (1), Tennessee (1), Texas (1), Utah (2), and Wisconsin (1).

Among people for whom information is available, illnesses started on dates ranging from December 5, 2015 to February 3, 2016. Ill people range in age from 1 year to 76, with a median age of 34. Fifty-six percent of ill people are male. Among 12 ill people with available information, four (33%) reported being hospitalized, and no deaths have been reported.

In ongoing interviews, ill people answered questions about foods eaten and other exposures in the week before they became ill. Of the 14 ill people who have been interviewed, 14 (100%) reported consuming powdered supplements or meal replacement powders in the week before illness onset; all 14 (100%) specifically reported consuming Garden of Life RAW Meal products.

The Utah Public Health Laboratory and Oklahoma Public Health Laboratory isolated the outbreak strain of Salmonella Virchow from open containers of Garden of Life RAW Meal collected from ill people’s homes in Utah and Oklahoma. Both products that were tested were from lots covered under the recalls announced by Garden of Life, LLC. FDA sampling confirmed the presence of the outbreak strain of Salmonella Virchow in Organic Moringa Leaf powder used in RAW Meal Organic Shake & Meal Replacement products.

On February 12, 2016, Garden of Life, LLC issued an expanded recall of its RAW Meal Organic Shake & Meal products available in chocolate, original, vanilla, and vanilla chai to include these additional lots.

e-coli[1]California Department of Public Health (CDPH):

As of February 11, 2016, eight persons with a unique strain of Shiga-toxin producing E. coli O157 have been identified; four reported drinking Organic Pastures raw milk before they got sick. All eight illnesses occurred in January. The investigation is ongoing.

In this outbreak, two cases of hemolytic uremic syndrome (HUS) have been reported.

A list is now available of the California retailers that received Organic Pastures Dairy Co. raw milk that has been linked to an E. coli outbreak. The unpasteurized raw milk — which expired Jan. 23 and 26 — was recalled Feb. 4 by the Fresno-based organic dairy.

The California Department of Public Health reported Monday that four children who drank Organic Pastures whole, raw milk developed E. coli infections. At least two other children have identical strains of E. coli poisoning.

A department spokesman Monday he could not release additional information because the investigation is ongoing into the outbreak and its link to Organic Pastures raw milk.

The dairy recalled two lots of its whole, raw milk via its Facebook page at 9 p.m. Feb. 4. One lot had an expiration date of Jan. 23. The other expired Jan. 26. Organic Pastures also posted the recall on its website.

Previous recalls and foodborne illness outbreaks linked to Organic Pastures in the past decade include:

October 2015 Organic Pastures raw milk recall and quarantine after CDFA inspectors found Campylobacter as a result of product testing conducted as part of routine inspection and sample collection at the facility.

September 2012Organic Pastures raw milk recall and quarantine after CDFA inspectors found Campylobacter bacteria as a result of product testing conducted as part of routine inspection and sample collection at the facility.

January-April 2012 Organic Pastures products linked to campylobacter outbreak. Raw milk, raw skim milk, raw cream and raw butter were recalled and the dairy quarantined after the confirmed detection of campylobacter bacteria in raw cream.

State officials identified at least 10 people with campylobacter infections throughout California. They reported consuming Organic Pastures raw milk prior to illness onset. Their median age was 11.5 years, with six younger than 18. The age range was nine months to 38 years.

August-October 2011Organic Pastures products linked to E. coli outbreak.

A cluster of five young children with E. coli O157:H7 infections with matching pulse-field gel electrophoresis (PFGE) patterns was identified. Illness onsets were from Aug. 25 to Oct. 25. All five children reported drinking commercially available raw milk from a single dairy, Organic Pastures, and had no other common exposures.

Investigations by the CDPH’s Food and Drug Branch and the California Department of Food and Agriculture showed environmental samples collected at Organic Pastures yielded E. coli O157:H7 isolates that had PFGE patterns indistinguishable from the patient isolates.

September 2008 Organic Pastures Grade A raw cream recall and quarantine after state testing and confirmation testing detected campylobacter bacteria in the cream.

September 2007 Organic Pastures Grade A raw cream recall and quarantine following laboratory confirmation of the presence of Listeria monocytogenes bacteria. CDFA inspectors found the bacteria as a result of product testing conducted as part of routine inspection and sample collection at the facility.

November-December 2007  Organic Pastures cows linked to Campylobacter outbreak. State officials found 50 strains of Campylobacter jejuni plus Campylobacter coli, Campylobacter fetus, Campylobacter hyointetinalis and Campylobacter lari when they cultured feces from Organic Pastures dairy cow feces.

There was only one patient isolate available for DNA fingerprinting, but it was identical to isolates from four cattle fecal samples collected at Organic Pastures.

September 2006 Organic Pastures linked to E. coli O157:H7 outbreak.

Six sick children were identified by state officials. Four had culture-confirmed infections, one had a culture-confirmed infection and HUS (hemolytic uremic syndrome, which can result in kidney failure and stroke), and one had HUS only. The median age of patients was 8 years, with a range of 6 to 18 years.

Organic Pastures’ operators claimed the illnesses were linked to consumption of fresh spinach that was linked to a separate E. coli outbreak in 2006.

However, the five children who consumed Organic Pastures’ products who had culture confirmation were laboratory matches to each other and the CDC reported their specific E. coli isolates “differed markedly from the patterns of the concurrent E. coli O157:H7 outbreak strain associated with spinach consumption.”

9803958_GAccording to a variety of press reports, the Estill County Kentucky Health Department continues their investigation into the Salmonella outbreak. They are hoping to determine a source or a cause.

At this time, 72 people are experiencing gastrointestinal illnesses, 35 of those are confirmed Salmonella cases and eight people were hospitalized due to Salmonellosis.

The Estill County Health Department is continuing to contact and collect information from everyone reported ill and those around them who did not display symptoms.

They advise that people make a special effort to wash their hands right after using the bathroom, before preparing food and before eating food.

If you have experienced symptoms of Salmonellosis, consult your healthcare provider.

You can call the health department at (606) 723-5181 if you have any questions – like, where did this outbreak happen?

e-coli-o157QUESTION: Can you provide any details? CDPH should provide the current case count?

CDPH RESPONSE: As of February 8, 2016, six children with a unique strain of Shiga-toxin producing E. coli O157 have been identified; of these six children, four have reported drinking Organic Pastures raw milk before they got sick. All six illnesses occurred in January. The investigation is ongoing.

QUESTION: The company’s voluntary recall notice indicates they are working with state officials

CDPH RESPONSE: That is correct. After being notified by CDPH of potential cases of E. coli O157 infections that reported a common exposure to Organic Pastures Dairy Company (OPDC) raw milk consumption prior to onset, OPDC initiated a voluntary recall of two lots of raw milk. OPDC is cooperating with the investigation.

QUESTION: How the CDPH is involved?

CDPH RESPONSE: CDPH is continuing to work with local health departments to identify potential case patients that might be associated with this cluster of illnesses. CDPH’s Food and Drug Branch (FDB) has also collected a number of samples from the marketplace, which are currently undergoing laboratory evaluation. FDB has also initiated an environmental investigation at the dairy, but since that investigation is ongoing, we cannot provide any specifics at this time.

162037_171911861180_1504922_nFrom a Organic Pastures recent Facebook Post:

Voluntary Internal Recall of OPDC Raw Dairy Product: In abundance of caution, and as part of our safety program, we ask that Organic Pastures customers and stores immediately dispose of any whole milk with the following lot codes:

Use by date: 1/23/16

Lot code: 20160105-1

Use by date: 1/26/16

Lot code: 20160106-2

This is NOT a State mandated recall. This is a voluntary recall being placed by the Organic Pastures team. However, we are working in collaboration with the State and will continue to have open communications with them.

This product may have been released to the Northern and Central Coast areas of California. These lot codes did not reach Southern California.

We test and hold all of our products prior to release. We have reason to believe that some tests yielded unsatisfactory false negative results. In a cautionary response, we request that this product be destroyed.

October 2015 – Organic Pastures Raw Milk Linked to Campylobacter Test:

Raw milk produced by Organic Pastures Dairy of Fresno County with a code date of OCT 24 is the subject of a statewide recall and quarantine order announced by California State Veterinarian Dr. Annette Jones.  The quarantine order followed the confirmed detection of campylobacter bacteria in raw whole milk.  No illnesses have been reported at this time.

Under the recall, Organic Pastures Dairy brand Grade-A raw milk labeled with a code date of OCT 24 is to be pulled immediately from retail shelves, and consumers are strongly urged to dispose of any product remaining in their refrigerators.

CDFA inspectors found the bacteria as a result of product testing conducted as part of routine inspection and sample collection at the facility.

September 2012 – Organic Pastures Raw Milk Linked to Campylobacter Test:

Raw milk, raw skim milk (non-fat) and raw cream produced by Organic Pastures Dairy of Fresno County and with a code date of SEP 13 are the subjects of a statewide recall and quarantine order announced by California State Veterinarian Dr. Annette Jones. The quarantine order followed the confirmed detection of campylobacter bacteria in raw cream. No illnesses have been reported at this time.

Under the recall, Organic Pastures Dairy brand Grade A raw cream, Grade A raw milk and Grade A raw skim milk, all with a labeled code date of SEP 13, are to be pulled immediately from retail shelves, and consumers are strongly urged to dispose of any product remaining in their refrigerators.

CDFA inspectors found the bacteria as a result of product testing conducted as part of routine inspection and sample collection at the facility.

May 2012 – Organic Pastures Raw Milk Linked to Campylobacter Illnesses:

Raw milk, raw skim milk (non-fat), raw cream and raw butter produced by Organic Pastures Dairy of Fresno County is the subject of a statewide recall and quarantine order announced by California State Veterinarian Dr. Annette Whiteford. The quarantine order came following the confirmed detection of campylobacter bacteria in raw cream.

Consumers are strongly urged to dispose of any Organic Pastures products of these types remaining in their refrigerators, and retailers are to pull those products immediately from their shelves.

From January through April 30, 2012, the California Department of Public Health (CDPH) reports that at least 10 people with campylobacter infection were identified throughout California and reported consuming Organic Pastures raw milk prior to illness onset. Their median age is 11.5 years, with six under 18. The age range is nine months to 38 years. They are residents of Fresno, Los Angeles, San Diego, San Luis Obispo and Santa Clara counties. None of the patients have been hospitalized, and there have been no deaths.

According to CDPH, symptoms of campylobacteriosis include diarrhea, abdominal cramps, and fever. Most people with campylobacteriosis recover completely. Illness usually occurs 2 to 5 days after exposure to campylobacter and lasts about a week. The illness is usually mild and some people with campylobacteriosis have no symptoms at all. However, in some persons with compromised immune systems, it can cause a serious, life-threatening infection. A small percentage of people may have joint pain and swelling after infection. In addition, a rare disease called Guillain-Barre syndrome that causes weakness and paralysis can occur several weeks after the initial illness.

2011 Organic Pastures E. coli Outbreak:

In November 2011, a cluster of five young children with Escherichia coli (E. coli) O157:H7 infection with matching pulse-field gel electrophoresis (PFGE) patterns was identified. Illness onsets were from August 25 to October 25, 2011. All five children reported drinking commercially available raw (unpasteurized) milk from a single dairy (Organic Pastures) and had no other common exposures. Statistical analysis of case­ patients’ exposures with a comparison group of E. coli O157:H7 patients with non­ cluster PFGE patterns indicated a strong association with raw milk. The epidemiological findings led to a quarantine and recall of all Organic Pastures products except cheese aged more than 60 days, and investigations by the California Department of Public Health (CDPH) Food and Drug Branch (FOB) and the California Department of Food and Agriculture (CDFA). Environmental samples collected at Organic Pastures yielded E. coli O157:H7 isolates that had PFGE patterns indistinguishable from the patient isolates. Organic Pastures raw milk consumed by the case-patients was likely contaminated with this strain of E. coli O157:H7, resulting in their illnesses.  Final Report.

Organic Pastures has been involved in recalls and outbreaks in the past:

Organic Pastures products were recalled for pathogens in 2006, 2007 and 2008. It was tied to a 2007 outbreak of Campylobacter. Most notably, it was quarantined in 2006 after six children became ill with E. coli infections – two with hemolytic uremic syndrome.  The State Report from 2006. 

See also, Raw Milk Myth Buster 1 – Organic Pastures 2006 Raw Milk E. coli Outbreak was caused by Spinach.

2006: 3 strains of E. coli O157:H7 cultured from OPDC heifer feces.  Press Release.

2007: 50 strains of Campylobacter jejuni plus Campylobacter coli, Campylobacter fetus, Campylobacter hyointetinalis, and Campylobacter lari cultured from OPDC dairy cow feces after eight people were sickened.  State Report.

2007: Listeria monocytogenes cultured from Organic Pastures Grade A raw cream.  Press Release.

2008: Campylobacter cultured from Organic Pastures Grade A raw cream.  Press Release.