Producing Cheese Safely

Unlike fluid raw milk producers who have been the subject of intense conflict with regulators for many years, artisanal and specialty cheesemakers that use raw milk have maintained a relatively good relationship with state and FDA regulators in the US.   According to their website, the American Cheese Society (ACS) shares resources to help producers adequately prepare for audits and inspections and work collaboratively with state regulators and the FDA.  The recent increase in FDA inspections and Listeria testing of soft cheeses and cheesemaking facilities has no doubt caused tensions between cheesemakers and regulators.  The New York Times reports that FDA inspectors visited 102 facilities beginning in April 2010, including both large and small cheesemakers.  They found Listeria in the facilities of 24 cheesemakers and more than half were small, artisan-scale operations.

While these findings are a cause for concern and have resulted in at least one major recall, fortunately, cheesemaking associations such as the ACS have an infrastructure to address food safety.  For example, the ACS advises their members to:

• take part in ongoing food safety education

• follow a HACCP plan

• regularly conduct their own product and environment testing

• maintain accurate and up-to-date records

• seek third party certification

• build relationships with local regulators

Conclusions

Artisanal raw milk cheeses are distributed around the world and revered by fans for their unique sensory characteristics, as well as the art and tradition of making these cheeses.   Cheeses, especially fresh and soft or semi-soft styles, are susceptible to contamination with pathogens such as Campylobacter, E. coli O157:H7, Listeria monocytogenes, and Salmonella.  Countries where raw milk cheeses are popular take different approaches in their regulations.  Experimental and epidemiological evidence suggests that the 60-day aging rule used in the US and Canada is not a fail-safe approach to cheese safety, which has prompted the FDA to re-evaluate the efficacy of the rule and conduct a national survey of cheesemaking facilities. 

There are at least four potential outcomes that may result from FDA’s recent actions:  1) a ban on all cheeses made from raw milk, 2) an extension of the 60-day aging period to 90-days or longer depending on evidence from the literature, 3) adoption of a European-type approach with intense regulation of animal health and hygiene during processing, but no aging rule, or 4) no change in the 60-day aging rule in the US.  

While the future of the 60-day aging rule for cheeses made from raw milk in the US remains to be determined, the openness of cheesemakers to working with state and federal regulatory agencies will hopefully foster a science-based approach to cheese safety that both protects the public’s health and preserves the unique characteristics and tradition of artisanal cheeses.

APPENDIX

Outbreaks, illnesses and recalls linked to cheeses made from raw (unpasteurized) and pasteurized milk, United States, 2010 (through November 2010)

Year	Month	Location	Pathogen	Number ill	Vehicle*	Comment	Reference (click on link)
2010	Feb	WA	Listeria monocytogenes	5	Queso fresco cheese	Pasteurized milk used to make the cheese	FDA
2010	Feb	WA	Listeria monocytogenes	0	Various raw milk cheeses	60-day aged raw milk cheeses from Montesano plant	FDA
2010	Mar	WA	Listeria monocytogenes	0	Tomme raw milk cheese	Expanded recall of 60-day aged raw milk cheeses from Montesano plant	FDA
2010	Apr	WA	Listeria monocytogenes	0	Queso fresco cheese	Pasteurized milk used to make the cheese; recall with no illnesses reported	FDA
2010	May	NV	Campylobacter	1	Illegal Mexican-style cheese	Type of milk used to make the cheese unknown	Washoe
2010	May	MN	Shiga toxin-producing E. coli	0	Raw milk cheese	Non-O157 found in dairy’s cheese during raw milk outbreak investigation	MDA/MDH
2010	Jun	DE	Brucella and Listeria monocytogenes	2	Raw dairy products including cheese	Two separate incidents	DE DHHS
2010	Jul	PA	Staphylococcus aureus	0	Raw milk hard cheddar cheese	60-day aged cheese; recall with no illnesses reported	PDA
2010	Jul	NY	Listeria monocytogenes	0	Queso fresco cheese	Pasteurized milk used to make the cheese; recall with no illnesses reported	NY AGMKT
2010	Aug	RI	Listeria monocytogenes	0	Queso fresco cheese	Pasteurized milk used to make the cheese; recall with no illnesses reported	RI DOH
2010	Aug	Multiple	Listeria monocytogenes and Staphylococcus aureus	0	Raw milk Cheese	60-day aged raw milk cheese from plant in Missouri; recall with no illnesses	MO AG
2010	Sep	WA	Listeria monocytogenes	0	Raw milk cheeses	Expanded recall of 60-day aged raw milk cheeses from Montesano plant	FDA
2010	Oct	WA	Listeria monocytogenes	0	Raw milk cheeses	Expanded recall of 60-day aged raw milk cheeses from Montesano plant	US AG
2010	Nov	AZ, CA, CO, NM, NV	E. coli O157:H7 and Listeria monocytogenes	38	Raw gouda cheese; other cheeses	60-day aged gouda; E. coli outbreak linked to Costco “Cheese Road Show;” recall expanded to all company cheeses on 11/17/10;  no Listeria illnesses reported	CDC
2010	Nov	CO	E. coli O157:H7	0	Gorgonzola cheese	Cheese imported from Italy, made from pasteurized milk; no illnesses reported	FDA
2010	Nov	WA	Listeria monocytogenes	0	Fresh (Queso and ricotta) Mexican-style cheeses	Made from pasteurized milk; no illnesses reported (previous recall from same plant in April 2010)	FDA

Here is the full article by PDF – “The Raw Milk Beat Goes On: A Look at the Literature and the 60-Day Raw Milk Cheese Aging Rule”

References

1.              Altekruse, S. F., B. B. Timbo, J. C. Mowbray, N. H. Bean, and M. E. Potter. 1998. Cheese-associated outbreaks of human illness in the United States, 1973 to 1992: sanitary manufacturing practices protect consumers. J Food Prot 61:1405-7.

2.              Bachmann, H. P., and U. Spahr. 1995. The fate of potentially pathogenic bacteria in Swiss hard and semihard cheeses made from raw milk. J Dairy Sci 78:476-83.

3.              Back, J. P., S. A. Langford, and R. G. Kroll. 1993. Growth of Listeria monocytogenes in Camembert and other soft cheeses at refrigeration temperatures. J Dairy Res 60:421-9.

4.              CDC. 2000. Outbreak of Escherichia coli O157:H7 infection associated with eating fresh cheese curds–Wisconsin, June 1998. MMWR Morb Mortal Wkly Rep 49:911-3.

5.              CDC. 2001. From the Centers for Disease Control and Prevention. Outbreak of Listeriosis associated with homemade Mexican-style cheese–North Carolina, October 2000-January 2001. JAMA 286:664-5.

6.              CDC. 2008. Outbreak of multidrug-resistant Salmonella enterica serotype Newport infections associated with consumption of unpasteurized Mexican-style aged cheese–Illinois, March 2006-April 2007. MMWR Morb Mortal Wkly Rep 57:432-5.

7.              CDC.  2009.  Campylobacter jejuni Infection Associated with Unpasteurized Milk and Cheese — Kansas, 2007. MMWR Morb Mortal Wkly Rep 57:1377-1379.

8.              CDC.  OutbreakNet.  Foodborne Outbreak Online Database.  Available from:  http://www.cdc.gov/foodborneoutbreaks/Default.aspx

9.              CDC.  2010.  Investigation Update: Multistate Outbreak of E. coli O157:H7 Infections Associated with Cheese.  Available from:  http://www.cdc.gov/ecoli/2010/cheese0157/index.html

10.          Cody, S. H., S. L. Abbott, A. Marfin, B. Schulz, P. Wagner, K. Robbins, J. C. Mohle-Boetani, and D. J. Vugia. 1999. Two outbreaks of multidrug-resistant Salmonella serotype typhimurium DT104 infections linked to raw-milk cheese in Northern California. JAMA 281:1805-10.

11.          D’Amico, D. 2008a. Incidence, ecology, and fate of target foodborne pathogens in the cheesemaking continuum. University of Vermon.  Available from:  http://library.uvm.edu/jspui/bitstream/123456789/165/1/damicofinal.pdf

12.          D’Amico, D. J., M. J. Druart, and C. W. Donnelly. 2008b. 60-day aging requirement does not ensure safety of surface-mold-ripened soft cheeses manufactured from raw or pasteurized milk when Listeria monocytogenes is introduced as a postprocessing contaminant. J Food Prot 71:1563-71.

13.          D’Amico, D. J., E. Groves, and C. W. Donnelly. 2008c. Low incidence of foodborne pathogens of concern in raw milk utilized for farmstead cheese production. J Food Prot 71:1580-9.

14.          D’Amico, D. J., and C. W. Donnelly. 2010a. Microbiological quality of raw milk used for small-scale artisan cheese production in Vermont: effect of farm characteristics and practices. J Dairy Sci 93:134-47.

15.          D’Amico, D. J., M. J. Druart, and C. W. Donnelly. 2010b. Behavior of Escherichia coli O157:H7 during the manufacture and aging of gouda and stirred-curd cheddar cheeses manufactured from raw milk. J Food Prot 73:2217-2224.

16.          Deschenes, G., C. Casenave, F. Grimont, J. C. Desenclos, S. Benoit, M. Collin, S. Baron, P. Mariani, P. A. Grimont, and H. Nivet. 1996. Cluster of cases of haemolytic uraemic syndrome due to unpasteurised cheese. Pediatr Nephrol 10:203-5.

17.          Desenclos, J. C., P. Bouvet, E. Benz-Lemoine, F. Grimont, H. Desqueyroux, I. Rebiere, and P. A. Grimont. 1996. Large outbreak of Salmonella enterica serotype paratyphi B infection caused by a goats’ milk cheese, France, 1993: a case finding and epidemiological study. BMJ 312:91-4.

18.          De Valk, H., E. Delarocque-Astagneau, G. Colomb, S. Ple, E. Godard, V. Vaillant, S. Haeghebaert, P. H. Bouvet, F. Grimont, P. Grimont, and J. C. Desenclos. 2000. A community–wide outbreak of Salmonella enterica serotype Typhimurium infection associated with eating a raw milk soft cheese in France. Epidemiol Infect 124:1-7.

19.          Dominguez, M., N. Jourdan-Da Silva, V. Vaillant, N. Pihier, C. Kermin, F. X. Weill, G. Delmas, A. Kerouanton, A. Brisabois, and H. de Valk. 2009. Outbreak of Salmonella enterica serotype Montevideo infections in France linked to consumption of cheese made from raw milk. Foodborne Pathog Dis 6:121-8.

20.          Donnelly, C. W. 1990. Concerns of microbial pathogens in association with dairy foods. J Dairy Sci 73:1656-61.

21.          FDA.  21 C.F.R. Part 133–Cheeses and Related Cheese Products.  Available from:  http://law.justia.com/us/cfr/title21/21cfr133_main_02.html

22.          FDA.  21 C.F.R. Part 1240.61–Mandatory pasteurization for all milk and milk products in final package form intended for direct human consumption.  Available from:  http://law.justia.com/us/cfr/title21/21-8.0.1.5.48.4.1.2.html

23.          FSANZ.  2006.  A risk profile of dairy products in Australia.  Available from:  http://www.foodstandards.gov.au/_srcfiles/P296%20Dairy%20PPPS%20FAR%20Attach%202%20FINAL%20-%20mr.pdf

24.          Govaris, A., D. K. Papageorgiou, and K. Papatheodorou. 2002. Behavior of Escherichia coli O157:H7 during the manufacture and ripening of feta and telemes cheeses. J Food Prot 65:609-15.

25.          Haeghebaert, S., P. Sulem, L. Deroudille, E. Vanneroy-Adenot, O. Bagnis, P. Bouvet, F. Grimont, A. Brisabois, F. Le Querrec, C. Hervy, E. Espie, H. de Valk, and V. Vaillant. 2003. Two outbreaks of Salmonella enteritidis phage type 8 linked to the consumption of Cantal cheese made with raw milk, France, 2001. Euro Surveill 8:151-6.

26.          Headrick, M. L., S. Korangy, N. H. Bean, F. J. Angulo, S. F. Altekruse, M. E. Potter, and K. C. Klontz. 1998. The epidemiology of raw milk-associated foodborne disease outbreaks reported in the United States, 1973 through 1992. Am J Public Health 88:1219-21.

27.          Honish, L., G. Predy, N. Hislop, L. Chui, K. Kowalewska-Grochowska, L. Trottier, C. Kreplin, and I. Zazulak. 2005. An outbreak of E. coli O157:H7 hemorrhagic colitis associated with unpasteurized gouda cheese. Can J Public Health 96:182-4.

28.          Jaros, P., N. Cogger and N. French.  2008. A systematic review of the human disease evidence associated with the consumption of raw milk and raw milk cheeses.  A report prepared for the New Zealand Food Safety Authority (NZFSA).  Availabel from:  http://www.nzfsa.govt.nz/science/research-projects/final-report-rawmilk.pdf

29.          Johnson, M.E.  2002.  Cheese products.  In:  Applied Dairy Microbiology, 2^nd Ed., Marth, E. H. and J.L. Steele (eds), Ch. 11, p.345-384.

30.          MacDonald, P. D., R. E. Whitwam, J. D. Boggs, J. N. MacCormack, K. L. Anderson, J. W. Reardon, J. R. Saah, L. M. Graves, S. B. Hunter, and J. Sobel. 2005. Outbreak of listeriosis among Mexican immigrants as a result of consumption of illicitly produced Mexican-style cheese. Clin Infect Dis 40:677-82.

31.          Marler, W.  2009.  Comparing the food safety record of pasteurized and raw milk products – Part 3.  Available from:  https://www.marlerblog.com/lawyer-oped/comparing-the-food-safety-record-of-pasteurized-and-raw-milk-products—part-3/.

32.          Marth, E. H. 1969. Salmonellae and salmonellosis associated with milk and milk products. A review. J Dairy Sci 52:283-315.

33.          Oliver, S. P., K. I., Boor, S. C. Murphy, and S.e E. Murinda.  2009.  Food safety hazards associated with consumption of raw milk.  Foodborne Pathog Dis. 6:793-806.

34.          Ostyn, A., M. L. De Buyser, F. Guillier, J. Groult, B. Felix, S. Salah, G. Delmas, and J. A. Hennekinne. 2010. First evidence of a food poisoning outbreak due to staphylococcal enterotoxin type E, France, 2009. Euro Surveill 15.

35.          Reitsma, C. and D. H. Henning.  1996. Survival of enterohemmorrhagic Escherichia coli O157:H7 during the manufacture and curing of cheddar cheese. J Food Prot 59:460-464.

36.          Schlesser, J. E., R. Gerdes, S. Ravishankar, K. Madsen, J. Mowbray, and A. Y. Teo. 2006. Survival of a five-strain cocktail of Escherichia coli O157:H7 during the 60-day aging period of cheddar cheese made from unpasteurized milk. J Food Prot 69:990-8.

37.          Sheehan, J., R. Childers, and S. Clanci.  2004.  Ask the regulators:  enhancing the safety of dairy and other animal based foods.  Available from:  http://www.foodsafetymagazine.com/article.asp?id=1354&sub=sub1

38.          Villar, R. G., M. D. Macek, S. Simons, P. S. Hayes, M. J. Goldoft, J. H. Lewis, L. L. Rowan, D. Hursh, M. Patnode, and P. S. Mead. 1999. Investigation of multidrug-resistant Salmonella serotype typhimurium DT104 infections linked to raw-milk cheese in Washington State. Jama 281:1811-6.

39.          Werner, S. B., G. L. Humphrey, and I. Kamei. 1979. Association between raw milk and human Salmonella dublin infection. Br Med J 2:238-41.