A confidential settlement was reached yesterday in the following outbreak:

On May 12, 2008 the Lawrence County Health Department (LCHD) was notified of a case of HUS in a child with a history of bloody diarrhea. The health care provider reported that the child had consumed unpasteurized goat’s milk obtained from a local store, the Herb Depot, in Barry County, Missouri. The milk had been purchased on April 29, 2008. It was quickly learned that an additional Barry County child that had cultured positive for E. coli O157:H7 had also consumed unpasteurized goat’s milk from the same store. As a result, the LCHD contacted the Missouri Department of Health and Senior Services (DHSS) who began a full epidemiological and environmental investigation of the illnesses. The investigation revealed that the milk consumed by both ill children had been produced at Autumn Olive Farms.

We represent two of the HUS cases. Nicole Riggs is 9 years old. She lives in Willard, Missouri with her mother, Julie; father, Dustin; and her younger sister, Christina. Larry Pedersen is a 2-year-old toddler. He lives in Monett, Missouri with his parents, Brian and Angela, and his two older sisters, Hailey and Kelsey. Both had a severe episode of HUS as demonstrated by over a week of anuria [no urine output], oliguria [low urine output] for an additional week. Both needed dialysis to survive. Both were hospitalized for over a month. Medical bills were over $100,000 for each.

At the conclusion of its investigation, the DHSS ultimately announced that there were four cases of E. coli O157:H7 associated with the outbreak. Of these, three were laboratory confirmed, and one was identified as a probable case. Each of these individuals resided in different counties in Southwest Missouri, and were not known to have any relation to each other. Nonetheless, each shared a common exposure to milk from Autumn Olive Farms. In addition, the three culture-confirmed cases shared a common, indistinguishable genetic strain of E. coli O157:H7. The strain was identified as a unique subtype of E. coli O157:H7, never before reported in Missouri. Each of the four cases had consumed milk from Autumn Olive Farms within 3-4 days of onset of illness. The DHSS reported: “no other plausible sources of exposure common to all four cases were identified [other than the milk.]” The final outbreak report ultimately concluded: “the epidemiological findings strongly suggest the unpasteurized goat’s milk from Farm A [Autumn Olive] was the likely source of infection for each of the cases associated with this outbreak.”

Given the above, I find the below odd: