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Marler Blog Providing Commentary on Food Poisoning Outbreaks & Litigation

E. coli might be big this next week too – Salad Bars and Raw Milk

schnucks.jpgWe are still following the St. Louis Missouri E. coli Outbreak that appears to be linked to  Schnuck’s Salad Bar Connection.  New numbers from the St. Louis Department of Health as of last week:

Number of Missourians confirmed to have E. coli connected to the St. Louis investigation: 35

Number of food samples, connected to the St. Louis outbreak, tested to date: 55

Number of food samples confirmed to have E. coli: 0

OrganicPastures.jpgLast week the State of California issued a quarantine order for Organic Pastures Raw Milk Dairy products following a notification from the California Department of Public Health of a cluster of five children who were infected, from August through October, with the same strain of E. coli O157:H7. These children are residents of Contra Costa, Kings, Sacramento, and San Diego counties. Interviews with the families indicate that the only common reported food exposure is raw milk from Organic Pastures dairy.

This quarantine and outbreak is remarkably similar to the one in 2006 involving the same dairy:

FYI – Organic Pastures Dairy E. coli O157:H7 Raw Milk Product Outbreak 2006

And – Organic Pastures – “Where There is Smoke, There is Fire.”

Not surprisingly, here’s what the owner of Organic Pastures had to say during his press conference last week (http://www.youtube.com/watch?v=ZVRBWLVcSLs).  I transcribed it just in case they take the video down at some point.  Here is what I call the spin:

Reporter:  Five years ago there was also another recall, right, where there was a settlement. 

McAfee:  There was. 

Reporter:  Can you talk about that?

McAfee:  That was based on causation not being proved whatsoever.  It was based on epidemiological evidence.  It never got to court.  You have to remember, insurance companies settled this.  They don’t want to litigate this.  It was settled by insurance companies. 

There were 2 children that were sickened in 2006.  They did not have matching pathogens.  In other words, when they were hospitalized they checked the bacteria that made them sick.  They did not match. 

Whenever you accuse somebody of making someone sick, they’ve got to have matching pathogens, and they did not.  They never found any bad bugs in our milk or in our cows’ manure during that period of time.   This was the peak of the spinach incident, that killed 3 people and sickened 200. 

So, we were vindicated but we had a settlement release where they actually paid us for the recall and actually settled, saying, “Hey, listen.  We can’t find the link.  Don’t sue us.”

And from the Sacramento Bee a few days ago talking about the 2006 outbreak:

But Kayleigh Lutz, a spokeswoman for the family-owned dairy, said, “This is not a factual recall. It’s based on hearsay, on what patients have told doctors over an eight-week period.”

Lutz said Organic Pastures was the subject of a similar recall in 2006. After pulling the firm’s raw milk products off store shelves, however, state investigators concluded the cause of the reported illnesses was not unpasteurized milk, but spinach.

Here is what I call the Facts:  Had it been spinach – which it was not – why would I have not sued the spinach manufacturer – Dole – again?  I had multiple lawsuits against it already!  See this from the CDC – there was NO link to spinach:

Escherichia coli O157:H7 Infections in Children Associated with Raw Milk and Raw Colostrum From Cows — California, 2006

On September 18, 2006, the California Department of Public Health (CDPH) was notified of two children hospitalized with hemolytic uremic syndrome (HUS). One of the patients had culture-confirmed Escherichia coli O157:H7 infection, and both patients had consumed raw (unpasteurized) cow milk in the week before illness onset. Four additional cases of E. coli O157:H7 infection in children who had consumed raw cow milk or raw cow colostrum produced by the same dairy were identified during the following 3 weeks. In California, intrastate sale of raw milk and raw colostrum is legal and regulated. This report summarizes the investigation of these cases by CDPH, the California Department of Food and Agriculture (CDFA), and four local health departments and subsequent actions to prevent illnesses. As a result of this and other outbreaks, California enacted legislation (AB 1735), which took effect January 1, 2008, setting a limit of 10 coliforms/mL for raw milk sold to consumers. Raw milk in several forms, including colostrum, remains a vehicle of serious enteric infections, even if the sale of raw milk is regulated.

In mid-September 2006, the parent of one of the two children hospitalized with HUS notified CDFA that both children had consumed raw skim milk from dairy A in the days before illness onset. CDFA notified CDPH and the local health departments of the reports. Dairy A, a licensed raw milk dairy, sells raw milk, raw cream, raw butter, raw cheese, raw colostrum, and kefir throughout California at retail stores and nationwide via Internet sales, all under a single brand (brand A).

On September 21, 2006, based on the reports from CDPH, CDFA issued a recall and quarantine order for all raw milk, raw cream, and raw colostrum produced by dairy A. The order was extended on September 22 to include all raw products from dairy A, except for cheeses aged at least 60 days according to California and Food and Drug Administration (FDA) standards. Dairy A also was placed under a separate restriction by CDFA during September 21–29 that prevented it from bottling fluid milk and cream because of persistent high standard plate counts.

For this investigation, a case was defined as illness with an onset date of August 1, 2006, or later in a California resident with 1) culture-confirmed E. coli O157:H7 infection with the outbreak strain or 2) HUS with or without culture confirmation, and exposure to raw milk. Case finding was conducted by notifying all California local health departments and infection-control practitioners and reviewing molecular subtyping results from the CDPH Microbial Diseases Laboratory. The 61 health jurisdictions in California were notified on September 20, 2006, to be alert for cases of E. coli O157:H7 and other Shiga toxin-producing E. coli associated with consumption of rawmilk. They were asked to report immediately to CDPH any enteric illnesses associated with raw milk or colostrum consumption.

Six cases were identified; four persons had culture-confirmed infections, one had a culture-confirmed infection and HUS, and one had HUS only. The median age of patients was 8 years (range: 6–18 years), and four of the patients (67%) were boys. The six cases identified during this investigation were geographically dispersed throughout California. All six patients reported bloody diarrhea; three (50%) were hospitalized. Illness onset occurred during September 6–24, 2006. Isolates from the five patients with culture-confirmed infections had indistinguishable pulsed-field gel electrophoresis (PFGE) patterns. The PFGE pattern was new to the PulseNet (the National Molecular Subtyping Network for Foodborne Disease) database and differed markedly from the pattern of the E. coli O157:H7 strain associated with a concurrent multistate outbreak linked to spinach consumption. Four of the five E. coli O157:H7 isolates were subtyped by multiple-locus variable-number tandem repeat analysis (MLVA) according to a protocol used by CDPH laboratory and were found to have closely related MLVA patterns.

Five of six patients reported they had consumed brand A raw dairy products in the week before their illness onset; the sixth patient denied drinking brand A raw milk, although his family routinely purchased it. Among the five patients who consumed brand A dairy products, two consumed raw whole milk, two consumed raw skim milk, and one consumed raw chocolate-flavored colostrum. Four of the five patients routinely drank raw milk from dairy A. One patient was exposed to brand A dairy product only once; he was served raw chocolate colostrum as a snack when visiting a friend. No other food item was commonly consumed by all six patients.

It will be interesting to watch the spin on the 2011 outbreak.

Read more on Organic Pastures:

(1) Current outbreak — 5 sick children
 
Raw milk products from a Fresno-based dairy (Organic Pastures) were quarantined Tuesday night after being linked five children who developed E.coli O157:h7 infections, including 3 children who acquired a deadly blood disease (HUS) allegedly from the dairy products:
 
http://www.cdfa.ca.gov/egov/press_releases/Press_Release.asp?PRnum=11-064
 
(2) This raw dairy has been involved in recalls and outbreaks
 
Organic Pastures products were recalled for pathogens in 2007 and 2008. It was tied to a 2007 outbreak of Campylobacter. Most notably, it wasquarantined in 2006 after 6 children became ill with E. coli infections. This is the state report from 2006:
 
http://www.marlerblog.com/rawmilk(1)(1)(1)(1).pdf

 
The state report from the 2006 E. coli outbreak shows clearly that the dairy had very high coliform counts, an indirect measure of fecal contamination. Its “colostrum” products had extremely high levels. From page 6 of the report: “Colostrum and chocolate colostrum had fecal coliform counts ranging from 320,000 to 140,000,000 MPN/g.”
 
2006: 3 strains of E. coli O157:H7 cultured from OPDC heifer feces

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5723a2.htm

2007: 50 strains of Campylobacter jejuni plus Campylobacter coli, Campylobacter fetus, Campylobacter hyointetinalis, and Campylobacter lari cultured from OPDC dairy cow feces.

http://www.marlerclark.com/pdfs/ClusterofCampylobacterinfectionsrawmilkEpi22007.pdf

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

http://www.fda.gov/Safety/Recalls/ArchiveRecalls/2005/ucm112271.htm

2008: Campylobacter cultured from Organic Pastures Grade A raw cream

http://www.cdfa.ca.gov/egov/Press_Releases/Press_Release.asp?PRnum=08-061

  • John Fryer

    E Coli is used in GMO foods. If the E Coli used to GMO products can escape and multiply in somone’s body they die or get permanent health issues.
    The clue is that no E Coli is found in any products as it is locked into that product.
    It also may mean that different persons will allow different E Coli toxins to harm them in the same way others will not be harmed as no conversion occurs.
    Interestingly and tragically those that can break down more efficiently food will suffer.
    GMO food need to be looked at at the molecular level or the march of E Coli and other maladies will kill and harm in our ignorance of science and or even just secure practices.

  • Dog Doctor

    Mr. Fryer, I have a hard time following what point you are trying to make. I am assuming that you are asserting the mantra from Organic Farmers that only large farms have problems with E. coli O157:H7 and that all organic farms are safe.
    I am tempted to ignore your comment and your badly informed statement alone but I am truly feed up with the growing acceptance of pseudo science and other fables.
    Mr. Fryer, I am listing a number of wildlife studies where E. coli O157:H7 was found. E. coli is a normal part of the intestinal flora of mammals and actually creates several vitamins that humans can absorb. O157:H7 is among several strains that produce toxins that affect humans but not ruminants like deer, cattle and goats.
    Here are several articles:
    Prevalence of Escherichia coli O157:H7 in White-tailed Deer from Louisiana
    At http://www.jwildlifedis.org/content/40/2/361.full.pdf+html
    ESCHERICHIA COLI O157:H7 IN FREE-RANGING DEER
    IN NEBRASKA at http://www.jwildlifedis.org/content/37/4/755.full.pdf
    Escherichia coli O157:H7 in Feral Swine near Spinach Fields and Cattle, Central California Coast1 at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2876768/pdf/07-0763_finalD.pdf
    An Outbreak of Escherichia coli O157:H7 Infection from
    Unpasteurized Commercial Apple Juice at http://annals.ba0.biz/content/130/3/202.full.pdf+html
    An Outbreak of Escherichia coli 0157:H7 Infections Traced to Jerky Made From Deer Meat JAMA. 1997;277(15):1229-1231.
    An excellent article concerning the development of E. coli is
    Emerging Foodborne Pathogens: Escherichia coli O157:H7 as a Model of
    Entry of a New Pathogen into the Food Supply of the Developed World
    And can be found at http://epirev.oxfordjournals.org/content/18/1/29.full.pdf
    So Mr. Fryer, I hope you will read this articles and enlighten yourself that e. coli is in the environment. O157:H7 is the environment and it isn’t link to GMO or large modern farms.
    For those that will say that I am paid by these interests I am not. My merger paycheck and those of other public health official paychecks are not enhanced by big pharm or big Ag. I derive no benefit for these comments; it is my humble attempt to enlighten those that have accepted uninformed information about food safety.
    So go out and explore the world try Google scholar and review the scientific journals
    “Ignorance never settles a question. “
    Benjamin Disraeli (1804 – 1881)