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CAMPYLOBACTERIOSIS, UNPASTEURIZED MILK - USA: (CALIFORNIA)
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A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Sat 16 Aug 2008
Source: The Daily Triplicate (Crescent City, CA) [edited]
<http://www.triplicate.com/news/story.cfm?story_no=9851>
Alexandre Family EcoDairy Farms ended its raw milk [supply] after
several people who consumed the product got sick, including a Crescent
City woman who remains in intensive care and is partially paralyzed.
The Del Norte County Department of Public Health suspects at least 15
people who ingested raw milk contracted campylobacteriosis, a common
bacterial infection found in domesticated animals that can cause
gastrointestinal illness in people.
Raw milk essentially comes straight from the udder and has become
popular among health-conscious consumers. It is unpasteurized, and
advocates say it contains beneficial microbes that help in digestion
and provide increased nutrition. {It also contains harmful bacteria
-- see comment below].
3 cases of _Campylobacter_ infections have been documented by Del
Norte County health officials since late June 2008, and the other 12
are awaiting confirmation. The Crescent City woman was the only
person who became severely ill.
The outbreak occurred between 10 May 2008 and 5 Jun 2008, and
officials say it is no longer a risk to the public because the source
of the raw milk believed to have caused the infections, Alexandre
EcoDairy north of Fort Dick, voluntarily stopped the [supply].
"As far as we know, the outbreak of _Campylobacter_ has been
controlled, and the source of raw milk has been shut down," said
county Public Health Officer Thomas Martinelli.
About 115 people were signed up for Alexandre EcoDairy's raw milk [supply]
program. Martinelli said the number of people who actually consumed
the product could be 300-500, since it was distributed to family
members. "It depends on how many people are in the family," he said.
"It would be some multiple of 115."
Alexandre EcoDairy stopped the [supply] on 15 Jun 2008 after learning
that one of its customers had become seriously ill and was in a
Medford, OR hospital. The family-owned organic farm contacted each of
its raw milk customers to tell them the news.
"We immediately stopped when somebody got sick," owner Blake
Alexandre said. "We were absolutely concerned that there could have
been a connection." The woman who became sick initially showed
symptoms common with a _Campylobacter_ infection, Martinelli said.
This included episodes of abdominal pain, nausea, diarrhea and
vomiting.
She later developed a form of Guillain-Barre syndrome, a disorder
that attacks the peripheral nervous system and can result in
paralysis. The syndrome is rare, but when it does occur, it often is
associated with a _Campylobacter_ infection, medical studies have
found.
It is illegal to sell raw milk in California, but it is not illegal
to get it from your own animal. The Alexandres devised a cow-share
program that allowed people to buy stock in an Alexandre cow. That
gave them personal ownership of the animal and allowed them to
legally take raw milk from Alexandre EcoDairy.
Before customers could join the cow-share program and get the raw
milk, Alexandre gave them a 3-ring binder full of information. In the
1st section are a number of articles relaying the dangers of
consuming raw milk.
"I wanted people to be very clear on the risks," Alexandre said,
adding that many times people would take that chance. "They're
realizing that the risks are there, and they'll realize that the
benefits outweigh the risks, and they'll come begging for it." [Not
so; the risks are considerable -- see comment below].
To join the cow-share program, customers signed an agreement relieving
the eco-dairy of liability in case of health problems caused by raw
milk.
[Byline: Nicholas Grube]
--
Communicated by:
ProMED-mail <promed@promedmail.org>
[The following is extracted from the 8 Nov 2007 ProMED-mail post
of a CDC (US Centers for Disease Control and Prevention) reported
outbreak related to unpasteurized dairy products with the references
renumbered:
"Raw milk is a well-documented source of infections from _Salmonella_,
_E. coli_ O157:H7, _Campylobacter_, _Listeria_, _Mycobacterium
bovis_, and other pathogens (1-5). In 1938, before widespread
adoption of milk pasteurization in the USA, an estimated 25 percent
of all foodborne and waterborne outbreaks of disease were associated
with milk (6). By 2001, the percentage of such outbreaks associated
with milk was estimated at less than one percent (6). During
1998-2005, a total of 45 outbreaks of foodborne illness were reported
to CDC in which unpasteurized milk (or cheese suspected to have been
made from unpasteurized milk) was implicated. These outbreaks
accounted for 1007 illnesses, 104 hospitalizations, and 2 deaths
(CDC, unpublished data, 2007). Because not all cases of foodborne
illness are recognized and reported, the actual number of illnesses
associated with unpasteurized milk likely is greater.
Consumers have reported consuming raw milk for convenience, taste
preference, or perceived health benefits. Although some advocates
claim health benefits from raw milk compared with pasteurized milk,
including decreased risks for atherosclerosis, arthritis, and lactose
intolerance, such claims are not supported by scientific evidence
(7). Unsubstantiated claims of health benefits of raw milk for
infants and children are particularly concerning for care givers,
because infants and children are dependent on their care givers to
make safe dietary decisions for them. 16 of the 29 ill persons in
this outbreak were aged less than 7 years.
Pathogens that infect humans are shed in the feces of cows, can be
present in or on the udders of cows, and can contaminate their milk.
Standard hygiene practices during milking can reduce but not
eliminate the risk for milk contamination. In a 2001-2002 survey of
Pennsylvania dairy farms, pathogenic bacteria, including
_Salmonella_, were isolated from 13 percent of samples from raw milk
bulk tanks (8). Pasteurization decreases the number of pathogenic
organisms, prevents transmission of pathogens, and has been
determined to improve the safety of milk more than other measures,
including certification of raw milk (3,4).
As of 2004, at least 27 states permitted some form of raw milk sales
to the public, including sales at dairies, farmers' markets, or
through purchase of "cow shares." Certain states also allow public
sales of raw milk but for pet food only (9).
Given the continued interest in raw milk production, policy makers,
parents, and the public need to be informed regarding the potential
health risks posed by raw-milk consumption. The only sure way for
consumers to prevent raw milk-associated infection from _Salmonella_
or other pathogens is to refrain from consuming raw milk.
References:
1. Gillespie IA, Adak GK, O'Brien SJ, Bolton FJ: Milkborne general
outbreaks of infectious intestinal disease, England and Wales,
1992-2000. Epidemiol Infect 2003; 103: 461-8.
2. Leedom JM: Milk of nonhuman origin and infectious disease in
humans. Clin Infect Dis 2006; 43: 610-5.
3. Currier RW: Raw milk and human gastrointestinal disease: problems
resulting from legalized sale of "certified raw milk." J Public
Health Policy 1981; 2: 226-34.
4. Potter ME, Blaser MJ, Sikes RK, et al: Human _Campylobacter
infection_ associated with certified raw milk. Am J Epidemiol 1983;
117: 475-83.
5. CDC: Human tuberculosis caused by Mycobacterium bovis -- New York
City, 2001-2004. MMWR 2005; 54: 605-8.
6. Center for Food Safety and Applied Nutrition: Grade "A"
pasteurized milk ordinance: 2001 revision. US Department of Health
and Human Services, Food and Drug Administration, Center for Food
Safety and Applied Nutrition; 2002. Available at
<http://www.cfsan.fda.gov/~ear/pmo01.html>.
7. Leonard C: On the safety of raw milk (with a word about
pasteurization). Presented at the National Conference on Interstate
Milk Shipments, Columbus, Ohio, 12-17 May 2005. Available at
<http://www.cfsan.fda.gov/~ear/milksafe/milksa1.htm>.
8. Jayarao BM, Donaldson SC, Straley BA, et al: A survey of foodborne
pathogens in bulk tank milk and raw milk consumption among farm
families in Pennsylvania. J Dairy Sci 2006; 89: 2451-8.
9. Dairy Division of National Association of State Departments of
Agriculture. Raw milk survey: November 2004. Available at
<http://www.nasda.org/file.aspx?id=11160>."
Crescent City is the county seat of Del Norte county in extreme
northwest California. The county can be found on a map at:
<http://en.wikipedia.org/wiki/Del_Norte_County,_California>.
- Mod.LL]
[see also:
2007
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Campylobacteriosis, unpasteurized milk - USA (KS) 20071205.3922
Salmonellosis, serotype Typhimurium, raw milk - USA (02): (PA), CDC
report 20071108.3629
Salmonellosis, free unpasteurized milk - USA (PA) (03) 20070815.2667
Campylobacteriosis, unpasteurized milk - USA (GA) 20070803.2520
Salmonellosis, free unpasteurized milk - USA (PA) 20070722.2354
Listeriosis, unpasteurized cheese - USA (IN) 20070425.1351
Campylobacteriosis, unpasteurized milk - USA (UT) (02) 20070324.1033
Campylobacteriosis, unpasteurized milk - USA (UT) 20070322.1004
Yersiniosis, listeriosis - Canada (ON): unpasteurized milk/cheese
20070319.0968
Salmonellosis, serotype Typhimurium, raw milk - USA (PA) 20070303.0748
E. coli O157, unpasteurized milk, 2005 - USA (WA) 20070302.0741
2006
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Foodborne illness, unpasteurized milk - USA (OH) 20060929.2794
E. coli O157, unpasteurized milk - USA (CA) (03) 20060929.2791
E. coli O157, unpasteurized milk - USA (WA): recall 20060929.2790
E. coli O157, unpasteurized milk - USA (CA) (02): background 20060927.2761
E. coli O157, unpasteurized milk - USA (CA) 20060922.2706
E. coli O157, unpasteurized milk - USA (OR, WA) (04) 20060121.0199
2005
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E. coli O157, unpasteurized milk - USA (OR, WA) 20051216.3622
Shigellosis, unpasteurized milk curds, 2004 - Lithuania (Vilnius)
20051203.3494
E. coli O157: H7, unpasteurized milk - Canada (ONT) 20050411.1047
2003
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Salmonellosis, raw milk - USA (Ohio) (03) 20030204.0308
Salmonellosis, raw milk - USA (Ohio) 20030105.0033
1998
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E. coli, unpasteurized milk - UK (England) (02) 19981031.2126
E. coli, unpasteurized milk - UK (England) 19981022.2080
1997
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Brainerd diarrhea - South Africa 19970126.0158]
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