CAMPYLOBACTERIOSIS, UNPASTEURIZED MILK - USA: (COLORADO)

A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Tue 14 Apr 2009
Source: Grand Junction (CO) Daily Sentinel [edited]
Click on title above to see original article;



Colorado state health officials Tuesday [14 Apr 2009] announced a
Montrose dairy must meet a series of conditions before it resumes
distribution of raw milk, a week after revealing a series of people
were sickened by a food-borne illness. The Colorado Department of
Public Health and Environment shut down the Kinikin Corner Dairy LLC
on 7 Apr 2009 after 12 Western Slope residents were sickened by
campylobacteriosis. At least 10 of those people reported drinking raw
milk, with 8 of them getting milk from Kinikin.

The state informed the dairy operator it must conduct laboratory
testing of milk collected at the dairy that shows raw milk is
negative for _Campylobacter_, _E. coli_ and other fecal coliform. Lab
tests must also show that raw milk is negative for antibiotics, meets
acceptable standards for total coliform and conforms to Kinikin's
standards for acceptable levels of somatic cell and standard plate
counts.

The dairy must also conduct follow-up sampling for the next 2 weeks
to show the raw milk is free of contamination. Kinikin cannot resume
distribution of milk until it meets all of those conditions.

State health officials emphasized that although the dairy may reopen
after passing the testing criteria, the department can't certify the
milk as safe to drink. "The department cannot ensure the safety of
milk that is not pasteurized," said Ned Calonge, the state's chief
medical officer.

The state is contacting approximately 200 people who are participants
in the dairy's cow-share operation. Those participants buy a share of
a cow and receive raw milk in return. Consumers with raw milk or raw
milk products from Kinikin are advised to throw them out.

[Byline: Mike Wiggens]

--
Communicated by:
HealthMap alerts via
ProMED-mail

[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
.

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
.

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
."

The City of Grand Junction is the largest city in western Colorado.
It is the county seat and the most populous town or city of Mesa
County, Colorado, USA and can be found on a map at:
.
- Mod.LL]

[see also:
2008
----
Campylobacteriosis, unpasteurized milk - USA (CA) 20080817.2557
2007
----
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
----
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
----
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
----
Salmonellosis, raw milk - USA (Ohio) (03) 20030204.0308
Salmonellosis, raw milk - USA (Ohio) 20030105.0033
1998
----
E. coli, unpasteurized milk - UK (England) (02) 19981031.2126
E. coli, unpasteurized milk - UK (England) 19981022.2080
1997
----
Brainerd diarrhea - South Africa 19970126.0158]
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