Campylobacter Outbreak

Wisconsin state and Pepin county health officials are investigating an outbreak of Campylobacter infections in the Durand School District in Pepin County, Wisconsin. Eight people had reportedly been hospitalized with gastrointestinal illness, and dozens more were ill, including members of the high school’s football team and several coaches and managers.

As of Thursday afternoon, there were eight confirmed Campylobacter cases and one with an indeterminate result, said Jennifer Miller, communications specialist with the Wisconsin Department of Health Services in Madison.

“They determined there was no anthrax involved. That had been rumored,” she said. “So it appears to be Campylobacter. The source we don’t know at this time.”

Durand School Superintendent Greg Doverspike said Thursday that four people were currently still in the hospital and that the investigation was focusing on common symptoms among those sickened and potential sources of the bacteria.

“We are testing for anything we can get our hands on,” he said. “There was a team function Thursday night, so we are looking at food and water and what they used to drink from at football practices — anything that seems to be a common thing.”

Utah public health officials are investigating a cluster of illness associated with the consumption of raw or unpasteurized milk. To date, 45 cases of Campylobacter infection have been reported in people who indicated that they consumed raw milk in the week before illness began. Cases have been reported from: Cache, Davis, Morgan, Salt Lake, Utah and Weber counties. Two cases occurred in out of state residents from California and Idaho. Onset dates range from May 9, 2014 to July 21, 2014. The cases range in age from two to 74 years.

All 45 cases are linked to the consumption of raw milk or cream purchased at Ropelato Dairy in Weber County. Utah Department of Agriculture and Food inspectors suspended the dairy’s license to sell raw milk on August 4, 2014, after several tests of raw milk samples taken at the farm were positive for Campylobacter.
According to Larry Lewis, Public Information Officer, Utah Department of Agriculture and Food, “Inspectors have repeatedly visited the dairy, reviewing safety procedures, working with the owner to determine the source of the problem and helping devise corrective actions.”  The dairy has been very cooperative in working with the inspectors, and will be allowed to resume raw milk sales as soon as the milk consistently passes safety tests.
Campylobacteriosis is a bacterial infection that causes diarrhea, abdominal pain, fever, headache, nausea and vomiting. Illness can last for up to a week or more and can be serious, especially for young children, pregnant women, the elderly, and those who have weakened or compromised immune systems. UDOH Epidemiologist, Kenneth Davis adds, “In some severe cases, illness can lead to complications, including paralysis and death. If you have recently consumed raw milk and are experiencing any of these symptoms, contact your health care provider.”
Raw milk is from cows, goats or sheep that has not been pasteurized to kill harmful bacteria. This raw, unpasteurized milk can contain dangerous bacteria such as Campylobacter, Salmonella, Listeria, and E. coli, which are responsible for causing foodborne illness. Other products that contain raw milk, such as cream or queso fresco, can also cause foodborne illness.
Raw milk contaminated with disease-causing bacteria does not smell or look any different from uncontaminated raw milk, and there is no easy way for the consumer to know whether the raw milk is contaminated.
Since 2009, there have been 14 documented outbreaks of Campylobacter infection associated with raw milk consumption in Utah, with more than 200 people becoming ill. In response, public health officials again warn that drinking raw milk may be dangerous. They suggest taking the following steps to avoid illness when purchasing and/or consuming raw milk (or raw milk products):

Since December 2013, Oregon health officials have been looking into the source of Campylobacteriosis that has sickened five individuals in Oregon and Ohio. All cases report eating undercooked or raw chicken livers; most cases consumed chicken livers prepared as pâté. The cases in Ohio ate chicken liver pâté while visiting Oregon. The Oregon Health Authority is working with USDA and CDC.

This is the second reported multistate outbreak of campylobacteriosis associated with consumption of undercooked chicken liver in the United States.

Chicken livers should be considered a risky food. A recent study found up to 77 percent of chicken livers tested were positive for Campylobacter. Washing chicken livers is not enough; chicken livers can be contaminated on the inside and on the outside, which is why thorough cooking is the only way to kill bacteria in contaminated livers.

Pâté made with chicken liver is often undercooked to preserve texture. It can be difficult to tell if pâté is cooked thoroughly because livers are often partially cooked then blended with other ingredients and chilled. Pâté prepared at a USDA inspected facility is considered safe to eat because in order to pass inspection the livers must be cooked to a proper temperature.

Coos Bay Oyster Company of Charleston, Oregon is expanding its previous recall of January 30 to include all of its shellstock oysters because they have the potential to be contaminated with Campylobacter, an organism that can cause serious and some times fatal infections in young children, frail or elderly people, and others with weakened immune systems.

Healthy persons infected with Campylobacter often experience diarrhea, headache and body ache, cramping, abdominal pain, and fever within two (2) to five (5) days after exposure to the organism. The diarrhea may be bloody and can be accompanied by nausea and vomiting. The illness typically lasts one (1) week and some infected persons do not have any symptoms. In persons with compromised immune systems Campylobacter occasionally spreads to the bloodstream and causes a serious life threatening infection.

Product was distributed through wholesale dealers and retail stores in Oregon and California.

Container is a red onion sack containing five (5) dozen shellstock oysters (various sizes) with a Coos Bay Oyster Co. label and shellstock tags with various harvest dates (December 2013-January 2014).

The recall is the result of an epidemiologic investigation of a Campylobacter outbreak in Oregon. There have been three (3) confirmed reported cases of Campylobacter illness related with the consumption of raw shucked oysters to date.

Coos Bay Oyster Company has ceased the production and distribution of the product as the Oregon Department of Agriculture (ODA) and the company continue investigating the cause of the problem.

The Oregon Health Authority has investigated a cluster of three Campylobacter cases among Oregon residents who consumed raw oysters. The oysters came from two different markets in Lane and Coos counties. The oysters were harvested from a single source in Coos Bay, Oregon.

The three Oregon patients who became ill with Campylobacter coli (a less common species of Campylobacter) reported illness after eating raw oysters between January 15-20, 2014. All patients were males between 50-75 years of age. Of the three patients, two were hospitalized and are recovering well.

The Oregon Department of Agriculture, Food Safety Division was informed and visited the company. The company has voluntarily recalled the oysters. Read the press release.

Oysters pose certain health risks when consumed raw. Those who are committed to eating oysters can cook them thoroughly. Read FDA’s article: The Danger of Eating Contaminated Raw Oysters and our factsheet on Safe Eating of Shellfish (pdf) to learn more.

MMWR Weekly

November 8, 2013 / 62(44);874-876

In October 2012 the Vermont Department of Health (VDH) identified three cases of laboratory-confirmed Campylobacter jejuni infection in Vermont residents; the isolates had indistinguishable pulsed-field gel electrophoresis (PFGE) patterns. A query of PulseNet, the national molecular subtyping network for foodborne disease surveillance, led to the identification of one additional case each from New Hampshire, New York, and Vermont that had been reported in the preceding 6 months. An investigation led by VDH found that all six patients had been exposed to raw or lightly cooked chicken livers that had been produced at the same Vermont poultry establishment (establishment A). Livers collected from this establishment yielded the outbreak strain of C. jejuni. In response, establishment A voluntarily ceased the sale of chicken livers on November 9. A food safety assessment conducted by the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) found no major violations at the establishment. This is the first reported multistate outbreak of campylobacteriosis associated with chicken liver in the United States. Public health professionals, members of the food industry, and consumers should be aware that chicken livers often are contaminated with Campylobacter and that fully cooking products made with chicken liver is the only way to prepare them so they are safe to eat.

According the Pennsylvania State Agriculture and Health Department, raw milk consumers are being urged to discard raw milk produced by The Family Cow in Chambersburg, Franklin County, because of potential Campylobacter bacterial contamination.

After the Department of Agriculture received a consumer complaint, it collected samples of raw milk during an investigation of The Family Cow on July 29, 2013. Positive test results for Campylobacter were confirmed today. Additionally, the Department of Health confirmed two cases of Campylobacter infection in people who consumed raw milk from the farm at 3854 Olde Scotland Road.

The packaged raw milk is sold under The Family Cow label in plastic gallon, half gallon, quart and pint containers. It is labeled as “raw milk.” Raw milk is milk that has not been pasteurized.

The Family Cow, owned and operated by Edwin Shank, sells directly to consumers in an on-farm retail store and at drop off locations and retail stores around Pittsburgh, Philadelphia and the Lehigh Valley, as well as south-central Pennsylvania.

Agriculture officials have ordered the owners of the farm to stop the sale of all raw milk until further notice.

Sound familiar?

May 29, 2013

The Pennsylvania Departments of Agriculture and Health today advised consumers to discard raw milk produced by The Family Cow in Chambersburg, Franklin County, because of potential bacterial contamination. Agriculture and Health Department laboratory tests and several recent illnesses indicate the raw milk may contain Campylobacter bacteria.

February 25, 2012

The number of people who became sick with an intestinal infection after drinking raw milk from a Franklin County farm continues to rise. As of today, the Pennsylvania Department of Health said 78 cases of Campylobacter bacteria are connected to unpasteurized milk sold in mid-January by The Family Cow dairy in Chambersburg. Of the cases, 68 people were sickened in Pennsylvania, five in Maryland, two in New Jersey and three in West Virginia. At least nine people were hospitalized.

For information on the risks of raw milk, please see Real Raw Milk Facts.

Bacterial contamination was being blamed Monday for an outbreak of foodborne illness following the popular Burger & Beer Bash in Westchester County earlier this month.

The county Health Department said Monday that the campylobacter bacterium was to blame for the outbreak at the June 6 outdoor food festival at the Kenisco Dam in Valhalla.

The bacterium was identified through tests on samples from several people who got sick at the event. The department did not specify exactly how many people were sickened.

But health officials have not determined the source of the bacteria, since most attendees ate food from many of the 30 different vendors at the event, the department said. The department has launched an investigation and has been interviewing people in an effort to trace the source.

The Pennsylvania Departments of Agriculture and Health today advised consumers to discard raw milk produced by The Family Cow in Chambersburg, Franklin County, because of potential bacterial contamination.

Agriculture and Health Department laboratory tests and several recent illnesses indicate the raw milk may contain Campylobacter bacteria.

The Department of Health has confirmed five cases of confirmed Campylobacter infection in people who consumed milk from the farm at 3854 Olde Scotland Road.

Based on the reported illnesses, the Department of Agriculture collected samples of raw milk during an investigation of The Family Cow, on May 17. Positive tests for Campylobacter were confirmed Tuesday.

The packaged raw milk is sold under The Family Cow label in plastic gallon, half-gallon, quart and pint containers. It is labeled as “raw milk.” Raw milk is milk that has not been pasteurized.

The Family Cow, owned and operated by Edwin Shank, sells directly to consumers in an on-farm retail store and at drop off locations and retail stores around Pittsburgh, Philadelphia and the Lehigh Valley, as well as south-central Pennsylvania.

Agriculture officials ordered the owners of the farm to stop the sale of all raw milk until further notice.

Campylobacter bacteria affect the intestinal tract and sometimes the bloodstream and other organs. It is one of the most common causes of gastroenteritis, which can include diarrhea and vomiting. Nearly 1,300 confirmed cases of Campylobacter are reported each year in Pennsylvania.

Onset of the illness usually occurs two to five days after ingesting the bacteria. Patients may not require specific medical treatment unless they become severely dehydrated or the infection spreads from the gastrointestinal tract.

For more information about Campylobacter, visit www.health.state.pa.us or call 1-877-PA-HEALTH.

The Alaska Section of Epidemiology is investigating another outbreak of Campylobacter infection associated with the consumption of raw milk. This new outbreak is associated with raw milk distributed by the same Kenai Peninsula cow-share program that was linked to a Campylobacter outbreak sickened at least 31 people in February 2013.

In the current investigation, five cases of Campylobacter infection have been identified to date. Two of the five people sought medical attention. Testing by the Alaska State Public Health Laboratory identified the bacteria strain as Campylobacter jejuni. The exact same strain of C. jejuni was found in cow manure obtained earlier this year at the cow-share farm that distributed the raw milk. “The genetic fingerprint of the bacteria isolated from these two people and the cow is unique. It has never been seen before in the United States,” said Dr. Joe McLaughlin, State Epidemiologist. “These outbreaks are an unfortunate reminder of the inherent risks associated with raw milk consumption, and underscore the importance of pasteurization.”

Anyone who has developed gastrointestinal symptoms such as loose stools and cramping within 10 days after consuming raw milk should notify his or her health care provider. Persons who develop concerning symptoms of illness such as bloody diarrhea, fever, abdominal pain, arthritis, or muscle weakness should seek prompt medical attention.

Also, anyone who has consumed raw milk and subsequently experienced acute gastrointestinal illness in 2013 should notify the Section of Epidemiology Infectious Disease Program at 907-269-8000 (in Anchorage) or toll free at 1-800-478-0084.

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