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Marler Blog Providing Commentary on Food Poisoning Outbreaks & Litigation

Is Raw Milk Treated Unfairly?

I must admit that I tire of the moans from raw milk advocates that Big Dairy and Big Government is out to get them. I shake my head at the unfounded belief that grass fed cows will never produce a pathogen that can sicken a child. I cringe at the anti-science blather protesting that all outbreaks linked to raw milk never happened, or were caused by something else, or were part of some dark conspiracy designed to discredit what is really a wonder-product. I wish that I had a nickel for each time a raw milk aficionado claimed that I am a tool of the FDA, or State and Local Health Departments, who apparently wrongly nailed a poor raw milk farmer who poisoned a few customers.

Despite the whining to the contrary, raw milk outbreaks do happen and will happen. As I said late last week, Health department officials in Minnesota reported three, and possibly four, E. coli O157:H7 infections linked to drinking raw milk from a dairy in Gibbon, Minnesota. All of the sick were infected with a strain of bacteria that had the same-pulsed field gel electrophoresis (PFGE) pattern, or DNA fingerprint. One infected child developed Hemolytic Uremic Syndrome (HUS), and is still hospitalized.

Despite the protests from the “raw milkies,” there have now been at least nine outbreaks scientifically linked to raw milk since January 2010. The other states with outbreaks include Nevada, Utah (two outbreaks), New York, Pennsylvania, Washington (two outbreaks), and a multistate outbreak in Michigan, Indiana, and Illinois. Dozens of people have been sickened in these outbreaks; some very seriously so.

But, is raw milk treated unfairly? Have health departments brought the hammer down on raw milk, while giving a free-pass to other dangerous products? As someone once said, “just because they are paranoid, does not mean they are not out to get them.”

This may be a bit of a shocker to my raw milk fans, but, on this, I may agree with them—which clearly must mean that I’ve gone off the reservation, or stopped being a so-called lap dog (or attack dog) of the FDA and Big Ag. Let me be clear though: I am not saying that health officials should not crack down on raw milk producers who poison customers. Nor am I saying that raw milk producers should escape being held accountable for the injury and damage caused by contaminated raw milk. I simply believe that raw milk producers should be treated no more—or less—strictly than any other producer of unsafe or contaminated food products. And this is especially true for ready-to-consume products, like raw milk or fresh produce, where there is no kill-step involved in the production process. Bottom line: Raw milk outbreaks should be publicized, but so must outbreaks involving contaminated lettuce.

But the problem here is that I do believe there’s a double standard. Why is raw milk emphatically criticized when it causes illness while some lettuce producers are allowed by public health officials to escape public scrutiny when their contaminated product has caused illness? And just so you don’t think I’m exaggerating, here are some problematic lettuce outbreaks that were essentially kept secret—that is, until I discovered the fact of such outbreaks and went public with the news:

Romaine lettuce, May 2008: In May 2008, Washington State Department of Health learned of a small cluster of E. coli O157:H7 illnesses amongst Pierce and Thurston County residents. Over the several days that followed, a total of 5 E. coli O157:H7 illnesses were reported in those counties. Testing by WSDOH showed that the bacterial isolates from four of these positive stool samples were indistinguishable after PFGE testing. By the end of the week of May 26, 2008, nine laboratory-confirmed cases and one epidemiologically linked case had been reported. WSDOH testing determined that all nine lab-confirmed cases had indistinguishable PFGE patterns.

Interviews revealed three clusters of illness: three cases at Pacific Lutheran University; three cases from a banquet at La Quinta Inn in Tacoma; and three illnesses amongst students in the Olympia School District. Further, investigators learned from the food histories of all cases that the only food consumed by all cases was lettuce.

Traceback investigation ultimately showed that the implicated romaine lettuce had been distributed to these locations by Northwest Fruit and Produce, a Tacoma-area distributor, and had been manufactured and processed by a string of companies from Salinas, California. The lettuce was grown by Andrew Smith Company at Braga Ranch, packed by Paul’s Pak, and shipped to a processing facility owned by True Leaf Farms. Church Brothers ultimately marketed the lettuce for sale on behalf of a now-defunct produce company called Premium Fresh Farms. No recall, no publicity.

Spinach, August 2008: In August 2008, five case patients with E. coli O157:H7 were reported in Multnomah County, Oregon. Testing of patient isolates by PFGE and MLVA revealed that all five patients were infected with a specific subtype. Public health investigators conducted a case-control study. Results showed that consuming raw spinach had the strongest statistical association with illness. Product traceback of spinach led Oregon investigators to spinach grown by an Organic Farm in Monroe, Washington.

A link between E. coli O157:H7 illness and spinach continued when a second outbreak of E. coli O157:H7 that was identified in Washington state. Investigators in Washington identified five laboratory confirmed cases that were a genetic match by PFGE and MLVA to the Oregon cluster. The first date of illness onset was August 28, 2008. The last case became ill on October 2, 2008. Washington case patients also reported eating organic loose spinach at a variety of locations where the spinach was sold. These included the Port Townsend Coop and deliveries of spinach sold through community supported agriculture (CSA) programs. No recall, no publicity.

Romaine lettuce, October 2008: In October 2008, 3 case patients with E. coli O157:H7 sharing an indistinguishable PFGE pattern combination were identified in San Diego and Orange County, California. All three cases had eaten salads containing romaine lettuce served at Cheesecake Factory restaurants within two days of each other. The subtype was unusual, prompting a cluster investigation coordinated by the CDC. Through OutbreakNet, a fourth case-patient in the cluster was identified, an 18 year old resident of South Dakota. This patient, a recent visitor to San Diego, had eaten a salad at one of the two Cheesecake Factory restaurants identified earlier by two patients. Furthermore, the three case-patients had all eaten at the restaurant on the same day.

County restaurant inspectors conducted an investigation into the source of the lettuce at the two Cheesecake Factory restaurants. Both restaurants received Andy Boy brand romaine lettuce from Fresh Point, a company based in Los Angeles. The outbreak quickly grew beyond Southern California. Public health laboratories continued to report PFGE matches to the outbreak strain. Case-patients were identified in Illinois, Florida, New Jersey, and Ohio. These individuals reported restaurant exposures but none ate at a Cheesecake Factory.

This led investigators to suspect a contaminated ingredient was in the marketplace. Canadian investigators in Ontario identified an outbreak involving 55 persons with at least 13 ill case patients culturing positive for the outbreak strain. The majority of cases were linked to one of two restaurants. Illnesses occurred between October 11 and October 28. Canadian investigators conducted a case-control study and lettuce was statistically associated with illness. Product traceback showed that two restaurants tied to the outbreak shared a common produce supplier and that Andy Boy brand romaine lettuce was the only lettuce in common to all Canadian restaurants with outbreak cases. No recall, no publicity.

Romaine lettuce, summer 2009: In late-July and early-August 2009, at least 100 people were infected by a matching strain of Salmonella typhimurium in Oregon, Washington, Idaho, Colorado, Montana, and possibly other states. The cluster of illnesses was first recognized in mid-August. Early in the large-scale investigation that followed, involving the CDC, FDA, and health agencies from all affected states, it was thought that other PFGE-matched typhimurium cases nationally were part of the outbreak, but later MLVA analysis distinguished some of these cases from the July/August 2009 outbreak. Epidemiological investigation by the Washington State Department of Health, in conjunction with information from MLVA-matched individuals in other states, ultimately identified shredded iceberg lettuce from multiple retail locations, some very common, as the outbreak vehicle. In Oregon and Washington, these retail locations included, among others, Subway, Cash and Carry, Taco Del Mar, Burger King, Quiznos, Big Town Hero, Bandito’s Burrito, Taco Lobo, and Jalapeno Restaurant. Washington State health officials conducted traceback analysis on multiple common ingredients served at these locations, including shredded lettuce, cheese, and tomatoes; but only lettuce was found to have uniformly come from a common supplier. No recall, no publicity.

Lettuce, Spring 2010: Finally, health officials in the Upper-Midwest investigated and confirmed a link between several Salmonella illnesses and the consumption of lettuce products from Fresh Express, a subsidiary of Chiquita Brands International Inc over a month ago. Again, no recall and no publicity.

Again, I am not saying that public health officials should ease up on raw milk; they most definitely should not. But, there is still an issue of fairness here. And despite the public health officials telling me that they cannot publicize every outbreak, I don’t buy that as either an explanation or an excuse. I also don’t buy the argument that a perishable item like lettuce is likely to have already been eaten by the time they figure out, after the fact, an outbreak has happened. Can’t the same thing be said about raw milk?

Telling the public that there was an outbreak linked to a given food product is a duty that public health officials may not shirk. Telling the public that a lettuce producer poisoned customers is just as important as reporting about a raw milk farmer’s product. Consumers need that information so they can vote with their pocketbook. Businesses that poison their customers need to have a light shone on them so both policy makers and other business can learn from the mistakes. Our free market does not function if information about the safety of our food is hidden from us.

Treating businesses equally and fairly is the right thing to do. It’s good for consumers and good for business—even ones selling raw milk.

  • Tim Lukens

    Well said Mr. Marler.

  • I agree 100% with what you have written. Governments (Federal or State; US, Canadian or elsewhere) have a duty to inform the public of ALL food safety “incidents”.
    Keep on pushing!

  • Art Davis

    Are there standards that the various regulatory agencies can articulate that determine when they announce an “Outbreak” and following that are there standards for determining when it is appropriate to announce a “Source” for the outbreak? If such standards do not exist in clearly understandable form perhaps they should. The implications and effects of such announcements are of such import that to leave them to a judgment call of any individual or group of individuals seems an invitation to pressures not appropriate to the decision making process.

  • Doc Mudd

    Completely agree. Consumers should be kept accurately informed (accuracy and scientific validity being the key). Paying customers will move the ball down the field…in the market and in the legislatures.

  • karen prue

    ABSOLUTELY agree!
    The public should be informed as soon as possible.

  • mark mcafee

    I think the difference is that big business is most of what makes up the fresh vegetable and lettuce industry. Big business runs the pasteurized milk industry and not the raw milk industry which is 100% small operations and politically incorrect.
    Industry works very hard with its political lobby systems etc….the raw milk producers are completely unrepresented.
    Their are big differences.
    I do appreciate your balanced argument here.
    The most essential and missing part of this discussion is the medical superfood aspect of raw milk. It is a medical food and prevents large numbers of deaths every year. Asthma kills more than 5000 Americans. Raw milk prevents asthma and dramatically improves it or even cures it in some people.The PARSIFAL study showed this clearly. The FDA refuses to discuss this medical aspect, the medical aspect is why the majority of people are drawn to raw milk. No lactose intolerance!!??? Super Immune system builder for kids. The medical superfood aspect is the 800 pound guerrilla in the room.
    Mark McAfee
    Founder OPDC

  • Paul

    I’m glad you admit you see the bias.
    I’m involved in the raw milk movement and I agree with you that there are many problems on our side that we need to address.
    Have you seen the USDA’s OIG report on meat contamination?
    I would think this is a goldmine of liability suits since there are so many violations and so many people involved. There certainly is ample precedent to sue the federal government for not following it’s own laws and regulations.

  • Paul

    I don’t know if you are aware of this, but the most common source of e.coli contamination on produce is irrigation water. I’ve seen studies where 100% of the irrigation samples tested positive for e.coli. And that was with many samples from different sources.
    This is not some “one in a million”, Russian Roulette type problem. This is a systemic flaw. Most of the nations produce comes from irrigated fields in California.

  • Sam Grubb

    Perhaps someone can define “medical food” for me?

  • I wonder how many SWAT teams and raids have taken place on farms growing lettuce and spinach or businesses producing deli meat. How many of these companies have had their entire inventory, computers, paperwork, customers lists, etc., confiscated?
    And how many people get sick from peanut butter and tainted pharmaceuticals because the FDA is too busy chasing after someone because they own cows and *might* be selling raw milk? How many illegal warrants are issued based on the fact that a company didn’t fill out a questionnaire?
    There is a clear bias in the government agencies and media, and it is apparent they’re not trying to FIX the problem so people who want to drink clean, raw milk can be assured of safety. Their agenda is clear: complete elimination of raw milk. And you’ve got to ask yourself why that is?
    The drug companies have produced tainted drugs that sicken and kill people, yet they don’t get shut down. But then, why shut a company down that pays for your payroll and guarantees you a seat on the board of directors once your government job is gone?
    Once the government starts to behave as though they’re trying to fix the food safety problem by working WITH farmers instead of treating them like armed criminals, then I’ll believe they are part of the solution and not part of the problem.
    Make no mistake: this isn’t about food safety. It’s about competition and greed.

  • Harry Hamil

    Thanks, Bill, for the opinion and all of the info.
    I’m expecting the same unequal treatment by the FDA when an outbreak connected to a farmers market, produce stand, CSA or other form of direct selling occurs.

  • Sam Grubb

    The test for coliforms takes 24 hours, and is very inexpensive. If those who sell raw milk can not even make the effort to test for coliforms BEFORE selling their product, then they deserve to be punished to the fullest extent of the law.
    I would personally be happy to offer my services to any dairy wishing to institute regular testing for coliforms.
    “Medical food”? Give me a break.

  • Shannon

    I have been on your blog, Bill, and read some of your other articles. I got the impression that you weren’t completely unreasonable about this issue, just doing your job. I think it’s important for consumers to be aware of the possibility of sickness, and for raw milk producers to acknowledge that it is a reality.
    I was raised in a family of 12 on raw milk and now I have 6 kids of my own. When I was a teenager, we no longer had access to raw milk, so we switched to store bought milk. It never occurred to me to seek out raw milk until I started having health challenges, when my research led me to raw milk.
    I have seen the difference it has made in my family, and it has been compelling enough to cause me to go to the trouble of milking my friend’s cows in exchange for milk so that I can afford to bring as much milk home for my family as we need/want, plus I know how the milk is handled because I handle it myself.
    I am a raw milk advocate.
    Commercial dairies in general do not produce their milk carefully enough to be sold in its raw state, and in addition their cows are fed and cared for in ways that make the cows more likely to carry pathogenic bacteria.
    I realize there is a wide range of methods used to care for cows, and also a wide range of milking protocols. But in general, most raw milk producers are aware of the need to produce a higher quality product and do so. In addition, there is the element of consumer oversight that is mostly absent in commercial food production models.
    I agree with your statement that “I am not saying that health officials should not crack down on raw milk producers who poison customers. Nor am I saying that raw milk producers should escape being held accountable for the injury and damage caused by contaminated raw milk.”
    The problem is, that Raw Milk producers ARE being treated more strictly than other producers of fresh foods.
    They are getting raided and attacked by the FDA regardless of the fact that there have been no complaints against many of them.
    Can you imagine the FDA coming in and raiding a lettuce grower because someone, somewhere… will get sick from eating lettuce in the future? And maybe not even from lettuce grown on that particular farm?
    Just because milk doesn’t undergo a visible physical change that cause it to look “cooked” when you cook it, unlike lettuce (or almost any other food would), doesn’t mean that there are no undesirable changes in the fundamental structure of milk when it is pasteurized.
    I think it would be more constructive to give raw milk producers legality, and allow them the freedom and means to find the best ways to produce a safe, reliable product, rather than harass them and try to eliminate the food that so many people are demanding.

  • An interesting article Bill – Thank you.
    Anyone who decides to consume raw milk by its nature is running a risk of food poisoning and should understand that.
    Raw milk producers should understand the risks they run in selling raw milk and put appropriate controls in place to ensure the milk is safe to drink. In such circumstances I would use a positive release system where each batch is cleared microbiologically prior to sale.
    Your details of lettuce food poisoning incidents do not include any details of the source of the contamination. I have seen problems previously where lettuces have been irrigated with sewage. One comment though – A lettuce is grown in the ground any therefore likely to be dirty/contaminated. Responsible Food Service Operations should always ensure they wash salad items thoroughly.

  • Lots of raw milk drinkers have been making this argument for some time now. Shannon articulates well what’s behind that argument. But coming from you, Bill, this “equal treatment” argument carries considerable weight. Thanks.
    David Gumpert
    Author: The Raw Milk Revolution: Behind America’s Emerging Struggle Over Food Rights

  • David, as I have said often, regardless of the product, manufacturers need to be held responsible for poisoning their customers. I think my last few posts – why go after raw milk, when little is said about leafy green outbreaks and the fact that we do little about sprouts sale, is less about being favorable to raw milk, but trying to point out the unfairness.

  • John Gear

    Why not concentrate on harm reduction using a graded approach, where risk factors like
    a) mixing
    b) using middlemen/distributors/retailers
    c) suppression of identity of grower/dairy on the product
    d) output volume
    e) shipping distances
    f) number of steps and transfers in the “cold chain”
    etc. to determine who gets the attention?
    The FDA on raw milk is like the dept. of the IRS that spends more resources auditing low income filers while ignoring the itemizers with their LLCs and offshore investments. And I’m not a raw milk advocate — I am quite happy to drink pasteurized things. But the treatment of raw milk folks appears to be little more than Big Agribiz using the FDA to squelch competition.

  • Mike

    I have been a raw milk consumer for over 5 years. Not sick once from raw milk.
    I know my farmer, and I trust him. (Have you ever visited your local factory farm? I recommend it, it will open your eyes – if you can actually accomplish the task.) He runs a small farm that is quite hi-tech. His cows graze a pasture all day, no grain feeding here. The milk is delicious, fresh, and pathogen free. He tests it three ways to Sunday, goes well beyond the tests the state and federal government require. I also get grass fed beef, free-range chicken, and eggs from the same farm, and it is an unbelievable difference from supermarket beef or chicken products.
    Factory farms are killing the American people.

  • Jenny

    Thank you. I agree. Our family drinks raw milk and I am fully aware of the risks so when people say aren’t you scared, I remind them that eating in the US is scary. And I trust my farmer 100x more than a factory. He has to be extra cautious cause one outbreak and he’s out of business!

  • Valerie Sharpe-Steinfeld

    How factual are these alledged reports of raw milk infections in Minnesota? 9 outbreaks? What is an outbreak? How many people does an outbreak affect? What is the scientific evidence that this is really so?
    Besides all these arguments for and against…why are we not allowed as Americans to make our own choices, especially at this point when raw milk drinkers have to consciously go outside of the main stream to find it? RESPONSIBILITY is on the consumer in cases of people obtaining raw milk from a farm and the issue is FREEDOM of CHOICE:
    other wise we are living in a police state!!!
    Do you pasturized supporters not see this? Whether you agree with people who think this way or that NEVER gives you the right to control their choices. THIS IS/WAS a FREE COUNTRY. LETS KEEP it THAT WAY!!!