Push to lift raw milk ban in Australia despite the death of 3-year-old

I used to be self-described lots of things, now I’m not so sure.

the.raw.storeSelf-described food activist Rebecca Freer, who owns an organic store in Thornbury in Victoria (that’s in Australia) claims her rights are being infringed and has begun a petition to legalize it even after the product was linked to the death of a three-year-old child.

“We have a long, long way to go to get the numbers required to be taken seriously … our human rights are at risk if we let the government make the decision on this issue,” she wrote.

The petition on change.org only had 100 supporters on December 12 when news broke of the child’s tragic death, but grew to 250 followers overnight and up to 500 by this week.

Supporters argued raw milk is completely safe and full of “beneficial” bacteria.

Current laws only allow the sale of raw milk as cosmetic or as “bath milk” and labelled “not fit for human consumption”.

Ms Freer said she drank raw milk herself and also gave it to her children.

Please, keep the children out of it, just like you wouldn’t share a scotch and a smoke with your six-year-old.

It’s always the kids who suffer.

It was the raw milk that sickened 40 in Wisconsin: Report

State health officials Thursday made public more evidence that raw milk was the cause of a foodborne illness outbreak that sickened nearly 40 people associated with the Durand High School football team, including many players.

santa.barf.sprout.raw.milkIn an investigation report from the Wisconsin Department of Health Services, obtained by the Milwaukee Journal Sentinel through a state open records request, officials said among the 38 people sickened, 32 drank unpasteurized milk and six drank milk which might have been unpasteurized.

Those who fell ill from the Sept. 18 dinner included 33 students and five coaches.

State officials said it was one of the largest raw-milk illness outbreaks they’ve seen. Twenty-six of the illnesses were laboratory confirmed to stem from Campylobacter jejuni, a harmful bacteria sometimes found in unpasteurized milk or undercooked meat and poultry. Ten of those who fell ill were hospitalized.

“Analysis of data pertaining to foods consumed during the team dinner demonstrates that consuming milk during the team dinner was associated with illness,” the report noted.

Last week, state officials said publicly for the first time that the unpasteurized milk served at the dinner came from a farm operated by Roland and Diana Reed, of Arkansaw, located near Durand in Pepin County.

colbert.raw.milkAt least some of the adults and students didn’t know that it was raw milk, according to public health officials. Diana Reed, however, said she had served it at team dinners for seven years.

In an interview, she said she doesn’t believe the milk was to blame for the illnesses — despite evidence that showed Campylobacter in manure on the farm had the same unique genetic “fingerprint” as Campylobacter found in football players’ stool samples.

 

Lesson in epidemiology (not): Wisconsin farmer says raw milk may not have made Durand football team ill

Now that the Reed ranch has been named and shamed as the source of the raw milk linked to at least 38 illnesses of Campylobacter jejuni related to players and staff of the Durand High School football team, the owner is speaking out.

raw.milk.death.1917Diana Reed, whose farm provided the milk said, “Some people got sick who did not drink the milk,” she said Saturday.

State health officials also tested manure of the cows at the Reed ranch and concluded some of the cows contained the strain of Campylobacter that sickened the students.

On Friday, state health officials identified the Reed farm as the source of the milk following an open records inquiry by the Milwaukee Journal Sentinel.

But Reed said there could have been other sources of the bug.

“I discussed it with the epidemiologist in Madison. He gave me some statistics — 56 people ate chicken, 38 got sick; 43 people chose to drink milk and 33 got sick,” she said. “They interviewed everyone who was there.”

That leaves five people who did not drink milk, but who still had Campylobacter.

‘Cosmetic’ milk in Australia: Raw milk remains untested

Raw milk producers are not being subjected to the same rigorous testing as dairy farmers who produce milk for ­human consumption.

raw.milk.aust.cosmetic.dec.14United Dairy Farmers of Victoria president Tyran Jones said milk from dairy farms was subjected to stringent tests to ensure its safe consumption, but no such tests existed for “raw” milk or “bath” milk.

Mr Jones said milk from his Gruyere farm, 50km northeast of Melbourne, went straight into a refrigerated vat to be chilled to 4C. “It is tested daily for bacteria. The milk factory takes a sample and sends if off for independent testing every day,” he said.

His comments come after a three-year-old child died and several others fell ill after drinking “bath” milk from Victoria’s Mountain View ­Organic Dairy, which is sold as a cosmetic product but has been stored next to consumables in many Victorian stores.

Craig Dalton of The Conversation writes that the Australian Competition and Consumer Commission (ACCC) has been investigating the role of microbiological contamination in cosmetic injuries, which has resulted in recalls in some instances. ACCC Deputy Chair Delia Rickard recently noted that cosmetic surveys revealing microbiological contamination were a timely reminder as the trend to produce all natural and all organic products may increase pressure on manufacturers to produce cosmetics with less preservatives or less effective natural preservatives.

Complicating this issue is that bath milk is often sold in containers that look just like drinking milk containers and may be stored in refrigerators alongside drinking milk. This may provide a false sense of security leading people to believe it is a food or as safe as a food.

bath.milkNevertheless, raw milk apologist are out in force, with David Gumpert writing, the vultures are circling in force with news that an Australian three-year-old may have died from drinking raw milk. 

This is news raw milk opponents have lusted after for many years, and now they mean to use it for full effect, tying it to a new study from the U.S. Centers for Disease Control that suggests illnesses from raw milk are rising.  Even though raw milk is already highly restricted in Australia, there are calls for a complete ban now that raw milk has been “proven” by this death to be unacceptably risky. 

Most intriguing, the farmer accused of producing the milk that led to the three-year-old boy’s death says he has been told the child was seriously ill before drinking raw milk. The child’s parents may have been providing raw milk in hopes of improving the child’s health. 

Um, what about the other three kids under five-years-old who developed hemolytic uremic syndrome but have (sorta) recovered?

State identifies farms tied to two raw milk illness outbreaks, refuses to hear appeal

A day after The Milwaukee Journal Sentinel publicly revealed that government types weren’t willing to identify two farms that were the sources of raw milk that sickened dozens at school events, some type of sanity has prevailed; the farms have been identified and separately, the state Supreme Court has refused to consider whether a Sauk County farmer was properly convicted of selling raw milk in 2013.


napoleon.raw.milkIn the most recent incident, this fall in Durand, 38 people associated with the Durand High School football team fell ill after a potluck dinner where unpasteurized milk was served. Twenty-six of the illnesses were laboratory confirmed to stem from Campylobacter jejune, a bacteria sometimes found in unpasteurized milk or undercooked meat and poultry.

A state Department of Health Services memo released Friday by the state Department of Agriculture, Trade and Consumer Protection, said the milk came from a farm operated by Roland and Diana Reed, of Arkansaw, located near Durand in Pepin County.

The agency also identified a local farm whose unpasteurized milk was tied to the illnesses of 16 people, including students, at North Cape elementary school in Racine County in 2011. It was identified as the Schaal Dairy Farm, according to state officials, who said a relative of the farmer took the milk from the farm to the school, without the farmer’s permission. No action was taken against the owner of the farm.

colbert.raw.milkMeanwhile, Vernon Hershberger had asked the court to review his 2013 conviction for violating a holding order on the sales of raw milk from his farm.

He argued he operates a private buying club that’s not subject to the same rules as a farmer. He also argued that he wouldn’t have been found guilty had an unedited copy of the order been placed into evidence and a judge blocked him from introducing evidence to bolster his defense.

The 4th District Court of Appeals rejected his arguments this past summer. The high court announced Friday it wouldn’t take the case.

Dozens sickened by raw milk, yet Wisconsin keeps farm names secret

Wisconsin state officials are refusing to identify a dairy farm that supplied unpasteurized milk at a potluck dinner where 38 participants, including members of the Durand High School football team, were sickened with Campylocater.

sprout.santa.barf.xmasDespite requests from The Milwaukee Journal Sentinel under the state’s Open Records law, officials with the Department of Health Services and the Department of Agriculture, Trade and Consumer Protection, have been unwilling to provide the information.

Moreover, they’ve refused to identify a dairy farm that supplied unpasteurized milk at a June 2011 elementary school event in Racine County where 16 people were sickened.

“It’s outrageous. The public has the right to this information. Who is the state of Wisconsin trying to protect, the public or bad operators?” said Bill Lueders, president of the Wisconsin Freedom of Information Council.

In the Racine County incident, unpasteurized milk from a local farm was served at a school event at North Cape Elementary School in Raymond, about 10 miles northwest of Racine.

“Allegedly, teachers at the school event thought drinking milk directly from a farm would be a good educational experience for the students,” State Rep. Don Pridemore (R-Erin) said in a statement after the illness outbreak.

Always the kids: ‘He turned grey’ says mother of child who fell ill after drinking raw milk

A Melbourne mother has described how her son turned grey when he became seriously ill after drinking raw milk.

bath.milkThe one-year-old boy suffered kidney failure after contracting hemolytic-uremic syndrome – a serious complication of an E. coli infection.

The Melbourne baby’s mother, who spoke to Fairfax Media on the condition of anonymity, said her son developed diarrhea and vomiting, which lasted 10 days, after he had sips of her smoothies made with Mountain View Organic Bath Milk.

“He turned grey, became extremely lethargic and extremely thirsty and was he still sporadically vomiting,” she said.

By the time he reached the Royal Children’s Hospital Emergency Department in late October, his kidneys were failing.

“He had 20 per cent kidney function,” the mother said.

The baby remained in hospital for a week as doctors worked to increase his red blood cells. He is now expected to make a full recovery.

University of Melbourne food microbiology expert Said Ajlouni said he was aware some people may drink raw milk to treat serious medical conditions but warned against it, saying children and people with depressed immunity were more susceptible to infection.

The Australian Medical Association’s Andrew Miller said drinking unpasteurized milk could be fatal or lead to lifelong disabilities, multiple organ failure or brain damage.

colbert.raw.milk“Because these kind of outcomes are relatively rare, people may get away with it [drinking unpasteurized milk] for a period of time, but there are reasons we have food safety laws and that’s so we don’t see children die unnecessarily,” he said.

The mother acknowledged she had been blinded by the wider trend towards raw food, but said she was not aware of the serious risks associated with raw milk.

“If I had heard of anything like this happening to anyone I wouldn’t have brought into my home – I wouldn’t have consumed it myself,” she said.

“It was a wake-up call to make sure I’m no longer blinded by the latest trends. It was a wake-up call to make sure I’m making informed decisions for my family.”

Australian raw milk company defends product after 3yo’s death; urgent recall after ACCC steps in

A day after proclaiming it would continue to sell its unpasteurized bath milk following the death of a three-year old boy, Mountain View Farm is now urgently recalling the product.

raw.milk.headlineOf the four other children – all under five-years old who were sickened, three developed hemolytic uremic syndrome (HUS) and one cryptosporidiosis.

The recall comes after the case was referred to the Australian Competition and Consumer Commission, which said the milk had been recalled due to “a number of recent health concerns” in young children who consumed the milk, and is sold in one and two liter containers.

The ACCC said it would also lead a national investigation of consumer law regulators into possible breaches by suppliers selling raw milk as a cosmetic product.

“The message from health agencies is clear: do not drink unpasteurized milk,” ACCC deputy chair Delia Rickard said. “If you have this product, do not drink it in any circumstances. Return it to the place of purchase for a full refund.”

Authorities have expressed frustration with current regulations allowing the sale of unpasteurized milk in Australia because technically it is not being sold as food.

Dr Rosemary Lester, Victoria’s Chief Health Officer said she had written to Victorian Consumer Affairs and the ACCC about the issue.

“This is correctly labeled as not [for human consumption], so it’s in the domain of consumer law, not food law,” she said.

Vicki Jones, the owner of Mountain View Farm, said she drank the milk herself, but her product was clearly labeled as not for human consumption.

“We label it as bath milk, for cosmetic use only, not for consumption. It’s quite bold, so it’s easy to see,” she said.

“I drink it, but it is a raw product, I can’t say that it’s safe to drink.”

But Ms Jones said the company would change its labels to make them even clearer.

mountain.view.farm“What do I say to [the people who drink the milk]? It’s clearly labeled. At the end of the day what they do with the milk after they purchase it is their choice,” she said.

“Whether they listen to me is out of my hands. … We would probably just put the link to the Health Department website or print what their warnings are.”

Ms Jones said she was aware of the incident and had been contacted by health authorities following the death of the child.

“Apparently [the child's family] had purchased our milk, but I have been told the child had been previously seriously ill and that he had passed away, and that he had consumed our milk,” she said.

“The health department had taken samples of our milk [for] Salmonella, E. coli, dysentery and all the results have come back negative, or not detected.”

She also said her company ran their own tests on the milk every week for bacteria and it always came back negative.

In a Facebook post on Thursday, the company lamented, “waking up to the disgusting front page of the Herald Sun” on Thursday.

“Shame on the reporter and the people that were behind that piece of rubbish that was written. …

“To the health department, you have opened a hornets nest, not for raw milk, but for exposing the garbage that consumers are fed, the chemical laden pesticides, herbicides, antibiotics that are used to grow food to feed families.

Shame on the system that allows this, shame on Food Safety standards, that permit and make up the levels they deem safe. Look at how many people are sick, why our hospitals are overflowing.

“Why is good quality food so expensive and out of reach of young families on low wages, the very people that need to feed our future generation.”

The organic farm has previously mocked the U.S. food authority for labeling unpasteurized milk as unsafe.

A photo shared by the Facebook page of the business on November 20 implies the U.S. Food and Drug Administration (FDA) authorizes the use of harmful substances while wrongly demonizing raw milk.

Jones defended using the image on her Facebook page, saying she questioned many substances in foods and the FDA should do the same.

mountain.view.farm.2Asked whether the image was misleading because of what it implied about raw milk, Jones said: “Maybe the FDA need to revisit the use of chemicals in food.

“I question the use of some chemicals used in food production and the effect it has on children.”

Some people took to the Mountain View Facebook page to criticize the company following news of the child’s death. “Where is the warning that you claim is on your Facebook page against drinking raw milk,” one person wrote.

Others defended the company, describing the media coverage as a “witch-hunt.”

David Tribe, a University of Melbourne professor and friend of the barfblog.com, collected several images from the Mountain View web site, which are included here.

Dr. Lester said she was worried unpasteurized milk was intentionally being given to children despite being labeled not for human consumption.

“There are two issues that concern me – one is the movement out there that people think that something raw is wholesome and better for you, which is clearly not the case,” said.

“Secondly was the potential for confusion with milk that really is for human consumption, given these products are being sold alongside milk for human consumption.”

It was not clear whether the child in this particular case was intentionally given the raw milk. 

I child dead, 4 sick in Australia from raw milk; US says outbreaks quadrupled

Amidst reports that the number of U.S. outbreaks caused by non-pasteurized milk increased from 30 during 2007–2009 to 51 during 2010–2012, a child in Victoria (that’s in Australia) has died and four have become ill from raw milk.

868179-068aae70-8035-11e4-9659-e3748623bf5fUnpasteurised milk is illegal to sell for human consumption in Australia, but the product consumed by the child was classed as cosmetic so was allowed on the shelves.

The child recently died on the Mornington Peninsula after drinking what was marketed as a cosmetic product and labeled “bath milk”, the Victorian Health Department said.

The U.S. Centers for Disease Control and Prevention said Wednesday that the average number of outbreaks from contaminated unpasteurized milk more than quadrupled from three a year between 1993 to 2006 to about 13 between 2007 and 2012.

Overall, there were 81 outbreaks in that last period, sickening nearly 1,000 people, including 73 who were hospitalized. The CDC said that more than 80 percent of the illnesses happened in states where retail sales of raw milk are legal.

Most outbreaks were caused by Campylobacter spp. (77%) and by nonpasteurized milk purchased from states in which nonpasteurized milk sale was legal (81%). Regulations to prevent distribution of nonpasteurized milk should be enforced.

Pasteurization is an effective way to improve milk safety; however, in the United States, illness related to consumption of nonpasteurized milk continues to be a public health problem. The first statewide requirements that dairy products be pasteurized were enacted in Michigan in 1948 (1). In 1987, the US Food and Drug Administration banned the interstate sale or distribution of nonpasteurized milk. However, the laws regulating intrastate sales are set by each state (2). Regulations for intrastate sales of nonpasteurized milk vary from complete bans to permitting sales from farms or retail outlets (2). Even in states in which sale of nonpasteurized milk is illegal, milk can often be obtained through other means. For example, some states allow cow-share or herd-share agreements, in which buyers pay farmers a fee for the care of a cow in exchange for a percentage of the milk produced (3,4).

Consumption of nonpasteurized milk has been associated with serious illnesses caused by several pathogens, including Campylobacter spp., Shiga toxin–producing Escherichia coli, and Salmonella enterica serotype Typhimurium (3,4). Despite the health risks associated with consuming nonpasteurized milk, the demand for nonpasteurized milk has increased (3,5,6). Recently, many state legislatures have considered relaxing restrictions on the sale of nonpasteurized milk (2,6). We report that the number of outbreaks associated with nonpasteurized milk increased from 2007 through 2012.

The Study

A foodborne disease outbreak is defined as the occurrence of >2 cases of a similar illness resulting from ingestion of a common food. State and local health departments voluntarily report outbreaks to the Foodborne Disease Outbreak Surveillance System of the Centers for Disease Control and Prevention through a standard web-based form (www.cdc.gov/nors). We reviewed outbreaks reported during 2007–2012 in which the food vehicle was nonpasteurized milk. Outbreaks attributed to consumption of other dairy products made with nonpasteurized milk, such as cheese, were excluded. We analyzed outbreak frequency, number of illnesses, outcomes (hospitalization, death), pathogens, and age groups of patients. Data on the legal status of nonpasteurized milk sales in each state were obtained from the National Association of State Departments of Agriculture (79) and an online search of state regulations. The sources from which nonpasteurized milk was obtained or purchased were categorized according to the description from the state outbreak reports, when available.

colbert.raw.milkDuring 2007–2012, a total of 81 outbreaks associated with nonpasteurized milk were reported from 26 states. These outbreaks resulted in 979 illnesses and 73 hospitalizations. No deaths were reported. The causative agent was reported for all outbreaks. Of the 78 outbreaks with a single etiologic agent, Campylobacter spp. was the most common pathogen, causing 62 (81%) outbreaks, followed by Shiga toxin–producing E. coli (13 [17%]), Salmonella enterica serotype Typhimurium (2 [3%]), and Coxiella burnetii (1[1%]) (Figure 1). Three outbreaks were caused by multiple pathogens (Figure 1). The number of outbreaks increased from 30 during 2007–2009 to 51 during 2010–2012. During 2007–2009, outbreaks associated with nonpasteurized milk accounted for ≈2% of outbreaks with an implicated food; during 2010–2012, this percentage increased to 5%. The number of outbreaks of Campylobacter spp. infection also increased, from 22 during 2007–2009 to 40 during 2010–2012.

How milk was obtained was reported for 68 (84%) outbreaks. Nonpasteurized milk was obtained from dairy farms (48 [71%] outbreaks), licensed or commercial milk sellers (9 [13%]), cow- or herd-share arrangements (8 [12%]), and other sources (3 [4%]). Of the 81 outbreaks, 66 (81%) were reported from states where the sale of nonpasteurized milk was legal in some form: Pennsylvania (17 outbreaks), New York, Minnesota (6 outbreaks each), South Carolina, Washington, and Utah (5 outbreaks each). A total of 15 (19%) outbreaks were reported in 8 states in which sales were prohibited. Among these outbreaks, the sources of nonpasteurized milk were reported as a dairy farm (6 outbreaks), cow or herd share (4 outbreaks), and unknown (5 outbreaks).

Conclusions

Within this 6-year period, the number of outbreaks associated with nonpasteurized milk increased. The number of outbreaks caused by Campylobacter spp. nearly doubled. The average number of outbreaks associated with nonpasteurized milk was 4-fold higher during this 6-year period (average 13.5 outbreaks/year) than that reported in a review of outbreaks during 1993–2006 (3.3 outbreaks/year) (4). This increase was concurrent with a decline in the number of states in which the sale of nonpasteurized milk was illegal, from 28 in 2004 to 20 in 2011 (79) and with an increase in the number of states allowing cow-share programs (from 5 in 2004 to 10 in 2008) (8,9). The decision to legalize the sale of nonpasteurized milk or allow limited access through cow-share programs may facilitate consumer access to nonpasteurized milk (5). The higher number of outbreaks in states in which the sale of nonpasteurized milk is legal has been reported elsewhere (4).

The legal status of nonpasteurized milk sales in 1 state can also lead to outbreaks in neighboring states. In a 2011 outbreak of Campylobacter spp. infections associated with nonpasteurized milk in North Carolina, where sales of this product were prohibited, milk was purchased from a buying club in South Carolina, where sales were legal. Another outbreak of Campylobacter spp. infection in 2012 implicated nonpasteurized milk from a farm in Pennsylvania, where sales are legal; cases from this outbreak were reported from Maryland, West Virginia, and New Jersey, all of which prohibit sale of raw milk (10). All patients residing outside Pennsylvania had traveled to Pennsylvania to purchase the milk (10).

Outbreaks associated with nonpasteurized milk continue to pose a public health challenge. Legalization of the sale of nonpasteurized milk in additional states would probably lead to more outbreaks and illnesses. This possibility is especially concerning for vulnerable populations, who are most susceptible to the pathogens commonly found in nonpasteurized milk (e.g., children, senior citizens, and persons with immune-compromising conditions). Public health officials should continue to educate legislators and consumers about the dangers associated with consuming nonpasteurized milk; additional information can be obtained at http://www.cdc.gov/foodsafety/rawmilk/raw-milk-index.html. In addition, federal and state regulators should enforce existing regulations to prevent distribution of nonpasteurized milk.

Ms Mungai is a surveillance epidemiologist at the Atlanta Research and Education Foundation and at the Centers for Disease Control and Prevention. Her interests include infectious disease epidemiology and food safety.

References

Steele JH. History, trends and extent of pasteurization. J Am Vet Med Assoc. 2000;217:175–8 . DOIPubMed

Weisbecker A. A legal history of raw milk in the United States. J Environ Health. 2007;69:62–3 .PubMed

Oliver SP, Boor KJ, Murphy SC, Murinda SE. Food safety hazards associated with consumption of raw milk. Foodborne Pathog Dis. 2009;6:793–806. DOIPubMed

Langer AJ, Ayers T, Grass J, Lynch M, Angulo FJ, Mahon BE. Nonpasteurized dairy products, disease outbreaks, and state laws—United States, 1993–2006. Emerg Infect Dis. 2012;18:385–91. DOIPubMed

Buzby JC, Gould LH, Kendall ME, Timothy FJ, Robinson T, Blayney DP. Characteristics of consumers of unpasteurized milk in the United States. J Consum Aff. 2013;47:153–66.

David SD. Raw milk in court: implications for public health policy and practice. Public Health Rep. 2012;127:598–601 .PubMed

National Association of State Departments of Agriculture. NASDA releases raw milk survey 2011 [cited 2012 Nov 2]. http://www.nasda.org/file.aspx?id=3916

National Association of State Departments of Agriculture. Dairy division of national association of state departments of agriculture raw milk survey, November, 2004 [cited 2012 Nov 2]. http://www.nasda.org/File.aspx?id=1582

National Association of State Departments of Agriculture. NASDA releases raw milk survey 2008. [cited 2012 Nov 2]. www.nasda.org/File.aspx?id=2149

Longenberger AH, Palumbo AJ, Chu AK, Moll ME, Weltman A, Ostroff SM. Campylobacter jejuni infections associated with unpasteurized milk—multiple states, 2012. Clin Infect Dis. 2013;57:263–6. DOIPubMed

Suggested citation for this article: Mungai EA, Behravesh CB, Gould LH. Increased outbreaks associated with nonpasteurized milk, United States, 2007–2012. Emerg Infect Dis [Internet]. 2015 Jan [date cited]. http://dx.doi.org/10.3201/eid2101.140447

25 sickened: Listeriosis outbreak linked to consumption of raw milk brie cheese in France

As Australia reviews its ban on raw milk cheese – with the usual arguments about good and bad bacteria and artisinal crafsmanship  – the Institute of Health in France reports that on Oct 1, 2012, six human cases of Lm infection with the AscI/ApaI PFGE pattern 210792-210792 over the previous 6 weeks were identified by the National reference center for Listeria. PFGE-typing using restriction enzyme SmaI identified 2 distinct profiles, D and Q.

brie-nov2012b1On Oct 22, additional PFGE-matching cases were identified. An outbreak investigation was initiated to identify the source of contamination and guide public health actions. We defined a case as a Lm infection with a PCR-genoserogroup IVb and the PFGE AscI/ApaI 210792-210792 profile diagnosed in France between Aug 1, 2012 and Feb 11, 2013. SmaI Q-associated cases were considered epidemic whereas SmaI non-Q-associated cases were considered non-epidemic. Cases’ food consumption history was collected using a standard questionnaire. We conducted a case-case study, aiming at comparing the food consumption history of both epidemic and sporadic listeriosis cases identified during the same period, as well as traceback and traceforward investigations.

The implicated cheese factory was inspected. Food and environmental samples were collected.

Twenty-five cases were identified (11 epidemic cases). Dates of diagnosis ranged from Sep 4, 2012 to Nov 20, 2012. Consumption of raw milk brie cheese was significantly associated with the outbreak SmaI Q strain (Odds Ratio 35, IC95% [5-366]). Traceback and traceforward investigations identified Cheesemaker. A as the likely source of infection. Cheesemaker inspection did not identify any hygiene violation. Food and environmental samples did not yield the outbreak strain. A point-source contamination of the raw milk is suspected to have occurred.

(Thanks to Albert Amgar for forwarding the document.)