20 sick with campy linked to raw milk in Colorado

Jakob Rodgers of The Gazette reports that up to 20 people have been sickened from raw milk supplied by a ranch in Pueblo County, leading health officials to warn against drinking unpasteurized milk from the farm.

santa-barf_sprout_raw_milk7The outbreak of campylobacteriosis – an infection causing nausea and diarrhea – stems from raw milk distributed by Larga Vista Ranch, which is about 20 miles east of Pueblo, according to El Paso and Pueblo county health officials.

The infections highlight the dangers of drinking raw, unpasteurized milk, said Dr. Christine Nevin-Woods, El Paso County Public Health’s medical director.

“Sometimes people think that raw foods of all kinds are healthier,” she said. “But in this case, raw milk is very dangerous to be drinking.”

Since Aug. 1, health officials have confirmed 12 such cases and eight probable cases, according to the El Paso and Pueblo county health departments. Of those 20 people, half live in El Paso County, and half live in Pueblo County.

The infections stem from milk supplied by a herdshare program, which allows people to purchase stakes in livestock, such as cows or goats, and to receive a portion of each animal’s milk or meat.

Some of the people sickened were not part of the herdshare program. They received the milk from people who were part of it, which is now allowed, health officials said.

An after-hours call to the ranch by The Gazette was not returned.

Campy in Canada: Pets and raw milk underestimated

To inform source attribution efforts, a comparative exposure assessment was developed to estimate the relative exposure to Campylobacter, the leading bacterial gastrointestinal disease in Canada, for 13 different transmission routes within Ontario, Canada, during the summer.

sadie-dog-powellExposure was quantified with stochastic models at the population level, which incorporated measures of frequency, quantity ingested, prevalence, and concentration, using data from FoodNet Canada surveillance, the peer-reviewed and gray literature, other Ontario data, and data that were specifically collected for this study. Models were run with @Risk software using Monte Carlo simulations.

The mean number of cells of Campylobacter ingested per Ontarian per day during the summer, ranked from highest to lowest is as follows: household pets, chicken, living on a farm, raw milk, visiting a farm, recreational water, beef, drinking water, pork, vegetables, seafood, petting zoos, and fruits.

The study results identify knowledge gaps for some transmission routes, and indicate that some transmission routes for Campylobacter are underestimated in the current literature, such as household pets and raw milk. Many data gaps were identified for future data collection consideration, especially for the concentration of Campylobacter in all transmission routes.

A comparative exposure assessment of Campylobacter in Ontario, Canada

Risk Analysis, 18 Sept 2016, DOI: 10.1111/risa.126553

http://onlinelibrary.wiley.com/doi/10.1111/risa.12653/abstract

6 confirmed sick: Crypto linked to raw milk in New Mexico

Officials with the New Mexico Department of Health are investigating cases of cryptosporidiosis among state residents.

napoleon-raw-milkThey say there have been six confirmed cases of “crypto” — a diarrheal disease caused by microscopic parasites — since Aug. 31.

Each reported consuming raw milk products.

The affected individuals are from Bernalillo County.

Epidemiologists, laboratory staff and inspectors are working to confirm the source of the outbreak.

The state Department of Agriculture and New Mexico Environmental Department also are involved in the investigation.

Health Department officials recommend that anyone in New Mexico who has raw milk products discard the product to prevent infection.

Unpasteurized cheese making record number sick in Texas

Claire Z. Cardona of The Dallas Morning News reports a record number of people in Dallas County have been sickened from an infection caused by consuming unpasteurized cheese, health officials said. 

brucellosisThere have been 13 brucellosis infections in residents so far this year, affecting patients between 6 and 80 years old, according to a health advisory released Thursday

All of the patients reported eating the cheese brought into the U.S. from Mexico by friends or relatives, consuming the cheese while traveling in Mexico or eating unidentified cheese products from local street vendors, officials said. 

The county typically sees two to six cases a year, though 11 were recorded in 2004. 

Health officials confirmed all the Dallas County cases by blood culture. In two instances, hospital lab personnel were exposed while handling the samples. 

The Brucella bacteria can infect livestock and is most commonly transmitted to humans who consume the unpasteurized dairy products. Some areas, such as Mexico and Central and South America, are considered high-risk, according to the Centers for Disease Control and Prevention. 

Love it when regulators explain themselves: Scottish cheesemaker will go bankrupt as watchdog says all their cheese is to be destroyed

The family that produces the gourmet cheese at the centre of fresh concerns over a fatal E. coli outbreak say they will be made bankrupt after a food watchdog confirmed all its produce is to be destroyed.

cheese-2-png-galleryInvestigators confirmed that their probe has now been widened after two more people were identified as being infected bring the number who were ill to 22, of which 13 have needed hospital treatment.

They are also examining whether cases of E. coli O157 infection affecting children in the Angus area may also be linked.

Food Standards Scotland (FSS) on Wednesday issued a blanket ban on the sale of all cheese from Errington Cheese, of Carnwath, South Lanarkshire, the producer linked to the outbreak which led to the death of a three-year-old Dunbartonshire girl.

FSS explained for the first time details of tests during the seven-week long alert.

It confirmed E. coli non-O157 was detected in one sample of Dunsyre Blue produced by Lanarkshire-based Errington Cheese which is considered a “serious risk to public health”.

It said 13 samples in different batches of Errington’s Dunsyre Blue and one of Lanark White have tested “presumptive positive” for shiga toxin producing E .coli and are considered to be “potentially hazardous to health”.

While E. coli O157 was detected in one sample of Lanark White cheese it was not shown to contain stx genes which were found in people who were ill. However a food examiner declared it was “potentially injurious to health and/or unfit for human consumption”.

All positive tests were still awaiting “further confirmatory testing”. It was not clear when the testing took place.

A multi-agency Incident Management Team (IMT), that includes Health Protection Scotland and Food Standards Scotland’s Scottish arm has been reconvened to deal with the latest developments.

Ten days ago the IMT had declared the outbreak to be “over” and that it had stood down leaving the FSS working with South Lanarkshire Council to continue food safety investigation.

And Professor Hugh Pennington, an expert on E.coli has questioned the proportionality of the food watchdog’s decision to issue a blanket ban on the sale of all cheeses from Errington.

e-coli-o157-cheeseThe emeritus professor of bacteriology at the University of Aberdeen, said FSS had come down “very heavily” on Errington Cheese, stating there is a “real possibility” the organisation was “over-interpreting scientific evidence.”

He said that the “jury was still out” and while there may be a “moderately strong” case on Dunsyre Blue, there was “no scientific evidence” on any of the firm’s other cheeses.

Humphrey Errington, owner of Errington Cheese insisted there is no evidence linking his cheese to the outbreak insisting investigators will not talk to them about the proof for the sales ban.

FSS deny this, saying all all results from samples were shared with Errington and insist decision take to recall Errington Cheese Ltd products are “evidence-based and informed by interpretation from experts including legally designated food examiners”.

“They have destroyed us, basically. We are completely finished,” said Mr Errington. “It’s a nightmare. Unfortunately, nightmares are things you wake up from.

“They are destroying cheese to the value of £300,000, there is no company of our size that can survive that. “Our reputation is completely destroyed and the family will be bankrupt.

FSS said: “Potentially harmful strains of E.coli and the shiga toxin (stx) genes that can cause illness in humans have been found in a number of different batches of different cheeses produced by Errington Cheese Ltd.

“This means that FSS is not satisfied that the controls and production methods used by the business are producing safe food. Furthermore, the reliance on a limited number of negative test results as evidence that the food is safe provides insufficient assurance.

cheeseheads“Throughout this incident FSS has taken a proportionate approach based on the evidence and it considers that the evidence now

IMT chairman Dr Alison Smith-Palmer said that the IMT has established that 19 of the 22 confirmed cases had eaten blue cheese prior to becoming ill.

Of these, 15 are known to have eaten Dunsyre Blue while others cannot be certain about the brand of blue cheese they have consumed. Investigations are ongoing on the other cases.

Food Standards Scotland stated that on 14 September 2016 Food Standards Scotland (FSS) issued a food alert for action (FAFA) for all products produced by Errington Cheese Ltd. That decision was not taken lightly. FSS is fully aware of the impact on the business, but its priority is to protect public health.

FSS’s primary focus is protection of consumers. FSS has made information available where this has been in the public interest, but it would not be appropriate to conduct an ongoing food safety investigation through the media.

The recent outbreak of E. coli O157 has now affected 22 people, 13 of whom have required hospitalisation, and tragically, one child died as a consequence. The multi-agency Incident Management Team (IMT) chaired by Health Protection Scotland concluded that, based on strong epidemiological evidence, the outbreak of illness in humans was linked to Dunsyre Blue cheese, produced by Errington Cheese Ltd. Of the 22 confirmed cases to date, the IMT has established that 19 had eaten blue cheese prior to becoming ill. Of these, 15 are known to have eaten Dunsyre Blue while others cannot be certain about the brand of blue cheese they consumed. Investigations are ongoing on the other cases.

Since the outbreak was declared over on 5 September 2016, two new cases have been identified with the same outbreak strain of E. coli O157 and the IMT has consequently reconvened. 

Errington Cheese Ltd. has undertaken two voluntary recalls of cheese, and Food Standards Scotland has initiated two further recalls – on 10 and 14 September 2016.

The FSS recalls have been initiated on the basis of evidence available to FSS and South Lanarkshire Council (SLC) as a result of sampling and testing of cheese produced by Errington Cheese Ltd and concerns regarding its Food Safety Management System and its ability to produce safe products, and in view of the new epidemiological information available concerning the two new cases.

Errington Cheese Ltd has publically commented that E. coli O157 has not been found in its cheese. This is inaccurate. Some samples submitted for testing by SLC have tested positive for E. coli O157 and for another (non-O157) strain of E. coli. These organisms are considered a serious risk to public health by the Food Examiner and the Scottish E.coli O157/VTEC reference laboratory. In addition, further samples have tested positive for shiga toxin (stx) genes. These samples have tested “presumptive positive” for shiga toxin producing E. coli (STEC) and therefore are considered to be potentially hazardous to health.

Analysis of samples taken by SLC has been carried out using accredited methods in official laboratories. All results from these samples were shared with Errington Cheese Ltd as soon as they were available. The decisions FSS has taken to recall Errington Cheese Ltd products are evidence-based and informed by interpretation from experts including legally designated Food Examiners.

  1. coli O157 and non-O157 have been detected in different batches of Dunsyre Blue and Lanark White produced by Errington Cheese Ltd. Batch numbers relate to the dates the batches were produced.

Batch F15 Dunsyre Blue: Shiga toxin producing E. coli (STEC) has been cultured and isolated from a sample taken from batch F15 (Dunsyre Blue). This sample has been confirmed as a non-O157 E. coli (STEC). This type of E. coli has been known to cause severe illness. Nine further samples were subsequently taken from this batch, and all have also been found to contain the stx2 gene and one for the stx1 gene (all nine samples are therefore considered presumptive positive for STEC), FSS is awaiting further confirmatory testing on these samples. This product has not been placed on the market.

Batch G14 Lanark White: E. coli O157 has been cultured and isolated from a sample taken from batch G14 (Lanark White). This isolate has not been shown to contain the stx genes and is undergoing further analysis. Stx gene negative strains of E. coli O157 have been isolated from cases of human illness consistent with E. coli O157 infection.The Food Examiner declared this sample to be “potentially injurious to health and/or unfit for human consumption”. Therefore this batch was withdrawn by FSS following the refusal of the food business to withdraw it voluntarily.

Batch E24 Dunsyre Blue: two samples from batch E24 (Dunsyre Blue) have been found to contain the stx2 gene – these samples would therefore be considered as presumptive positives for STEC whilst FSS awaits further confirmatory testing. This batch was withdrawn voluntarily by the food business.

Batch G12 Dunsyre Blue: a sample from batch G12 (Dunsyre Blue) has been found to contain the stx2 gene (a presumptive positive for STEC) and FSS is awaiting further confirmatory testing on this sample. This product has not been placed on the market

Batch H24 Lanark White: A sample from batch H24 (Lanark White) has been found to contain the stx2 gene. This sample would be considered a presumptive positive for STEC whilst FSS awaits confirmatory testing.This product has not been placed on the market.

Potentially harmful strains of E.coli and the shiga toxin (stx) genes that can cause illness in humans have been found in a number of different batches of different cheeses produced by Errington Cheese Ltd.  This means that FSS is not satisfied that the controls and production methods used by the business are producing safe food. Furthermore, the reliance on a limited number of negative test results as evidence that the food is safe provides insufficient assurance, as it is clear that multiple samples across different cheese batches have had positive results.

Throughout this incident FSS has taken a proportionate approach based on the evidence and it considers that the evidence now justifies a full recall of Errington Cheese Ltd. products to ensure the protection of public health. FSS has been in frequent communication with Errington Cheese Ltd. throughout these investigations both directly, through SLC and through the company’s legal representatives.

From the point of issue of the FAFA, all Local Authorities in Scotland will be seeking to ensure all products manufactured by ECL are recalled and held with a view to being destroyed. If consumers have any products from Errington Cheese Ltd. they should dispose of them or take them back to the place of purchase. ‎

10 sick: Unpasteurized, this time ‘green for life’ camel milk in Israel

Ten additional people have come down with brucellosis after consuming camel milk, it was revealed today (Thursday, 8 Sep 2016) when the Ministry of Health extended the administrative closure of a business dealing with this product. A month ago, it was reported that 2 children were hospitalized in mild to moderate condition at the Ichilov Hospital [Tel-Aviv] with brucellosis resulting of drinking the said milk.

camel-milkConcurrently, the Be’er Sheva Magistrate indicted E.L., the manager of an enterprise engaged with the storage and marketing of milk and milk products “Green for Life” or “Genesis Milk” in Moshav Sitria, Shefela district. Prof. Shmuel Rishpon, Acting District Medical Officer [DMO] – Center District, signed today the extension of the closure order of the business, issued by the DMO/Center, Dr. Ofra Havkin, on 11 Aug 2016, for 30 additional days.

The Acting DMO’s decision stated that the closure order was extended because during an inspection/control visit to the enterprise, performed about 2 weeks ago, it was found that — in breach with the previous order — camel milk was encountered in the premises. Even worse, since the decree was issued last month, information on 10 additional brucellosis patients, infected by the consumption of the milk, has been obtained. “This situation is indicative of continued immediate danger to public health from the consumption of the camel milk,” Prof Rishpon stated in the issued order.

Pathogens in raw sheep’s milk cheese

Italy is one of the main producers and exporters of cheese made from unpasteurized sheep milk. Since raw milk and its derived products are known sources of human infections, cheese produced from raw sheep milk could pose a microbiological threat to public health. Hence, the objectives of the study were: to characterize the potential risk of the presence of pathogens Escherichia coli O157, Listeria monocytogenes, and Salmonella in raw ovine milk destined for cheese production obtained from all the sheep farms (n = 24) in the Marches region (Central Italy) that directly transform raw milk into cheeses and to evaluate the equivalence between the analytical methods applied.

gene-wilder-sheepA three-step molecular method (simultaneous culture enrichment, species-specific DNA magnetic isolation, and multiplex real-time polymerase chain reaction) was used for milk (n = 143) and cheese (n = 5) analysis over a 3-year period. L. monocytogenes was not detected on any of the farms, while E. coli O157 was found on three farms, although only using the molecular method. Four farms tested positive for Salmonella spp., and Salmonella enterica subsp. diarizonae serovar 61:k:1,5,7 was isolated in one of those cases.

This information highlights the need to develop preventative measures to guarantee a high level of consumer safety for this specific product line, and the molecular method could be a time-saving and sensitive tool to be used in routine diagnosis.

Presence of Escherichia coli O157, Salmonella spp., and Listeria monocytogenes in raw ovine milk destined for cheese production and evaluation of the equivalence between the analytical methods applied

Foodborne Pathogens and Disease, ahead of print. doi:10.1089/fpd.2016.2159.

G Amagliani, A Petruzzelli, E Carloni, F Tonucci, M Foglini, E Micci, M Ricci, S di Lullo, L Rotundo, G Brandi

http://online.liebertpub.com/doi/abs/10.1089/fpd.2016.2159

2 Detroit kids sick with E. coli from raw milk

Two metro Detroit children have been infected with E. coli, authorities said Friday.

Spew milkThe Michigan Department of Health and Human Services says the cause is unpasteurized milk. The separate cases have been reported in Oakland and Wayne counties.

Officials are now reminding residents of the potential risks associated with consuming raw milk.

“The public should be aware that raw milk and other unpasteurized dairy products have not been heat treated and, therefore, pose a potentially serious risk to human health,” said Dr. Eden Wells, chief medical executive for MDHHS.

133 sickened in Norway: ‘Improvements required in production processing of fresh salad products’

In May 2014, a cluster of Yersinia enterocolitica (YE) O9 infections was reported from a military base in northern Norway. Concurrently, an increase in YE infections in civilians was observed in the Norwegian Surveillance System for Communicable Diseases. We investigated to ascertain the extent of the outbreak and identify the source in order to implement control measures.

radicchioA case was defined as a person with laboratory-confirmed YE O9 infection with the outbreak multilocus variable-number tandem repeat analysis (MLVA)-profile (5-6-9-8-9-9). We conducted a case–control study in the military setting and calculated odds ratios (OR) using logistic regression. Traceback investigations were conducted to identify common suppliers and products in commercial kitchens frequented by cases. By 28 May, we identified 133 cases, of which 117 were linked to four military bases and 16 were civilians from geographically dispersed counties. Among foods consumed by cases, multivariable analysis pointed to mixed salad as a potential source of illness (OR 10.26; 95% confidence interval (CI): 0.85–123.57). The four military bases and cafeterias visited by 14/16 civilian cases received iceberg lettuce or radicchio rosso from the same supplier. Secondary transmission cannot be eliminated as a source of infection in the military camps.

The most likely source of the outbreak was salad mix containing imported radicchio rosso, due to its long shelf life. This outbreak is a reminder that fresh produce should not be discounted as a vehicle in prolonged outbreaks and that improvements are still required in the production and processing of fresh salad products.

National outbreak of Yersinia enterocolitica infections in military and civilian populations associated with consumption of mixed salad, Norway, 2014

Eurosurveillance, Volume 21, Issue 34, 25 August 2016, DOI: http://dx.doi.org/10.2807/1560-7917.ES.2016.21.34.30321

E MacDonald, M Einöder-Moreno, K Borgen, L Thorstensen Brandal, L Diab, Ø Fossli, B Guzman Herrador, AA Hassan, GS Johannessen, EJ Johansen, R Jørgensen Kimo, T Lier, BL Paulsen, R Popescu, C Tokle Schytte, K Sæbø Pattersen, L Vold, Ø Ørmen, AL Wester, M Wiklund, K Nygård

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22561

Minneapolis sees rise in foodborne illness from nororvirus, Vibrio in oysters

When I think Minnesota, I think raw oysters.

No, I never think that about anywhere.

raw.oysters.minnJeremy Olson of the Star Tribune reports that city health inspectors in Minneapolis are investigating a summer increase in foodborne illnesses related to norovirus and Vibrio, a bacteria found in raw oysters.

The increases were highlighted in the city’s “food establishment” newsletter, released Thursday.

“The reason for the spike in norovirus outbreaks is not known,” the advisory stated. “The Vibrio outbreaks are due to higher concentrations of bacteria in some oyster beds during the summer.”

Cases of norovirus, a highly contagious bug that causes severe vomiting and diarrhea, are not required to be reported to the Minnesota Department of Health, but the state agency has received reports of a slight uptick that is unusual for this time of year.