Campylobacter Lawyer & Attorney : Marler Clark : Campylobacter Blog

Following an E. coli outbreak in the state of Washington, the Kansas Department of Health and Environment (KDHE) is joining with the U.S. Food and Drug Administration (FDA) to warn the public against drinking raw milk.

Topeka, KS - infoZine - Raw milk is not treated or pasteurized to remove disease-causing bacteria and may cause life-threatening illness. There is also a potential risk of getting rabies from drinking raw milk.

Eight cases of illness have been reported in Washington state to date associated with raw milk containing E. coli O157:H7 bacteria. Several of these cases were in children. Two of the children remain hospitalized. Health authorities have identified locally (Washington) sold raw milk as a source of the outbreak, and have ordered an unlicensed dairy to shut down.

In addition, an advisory was issued from the Oklahoma State Health Department today about a potential rabies exposure from drinking raw, unpasteurized milk or cream sold from a dairy in Claremore, Oklahoma after one of the cows on the farm was confirmed to have rabies.

"Only pasteurized milk should be considered safe to drink," stated Dr. Howard Rodenberg, KDHE Division of Health Director. "There is only marginal difference in nutritional value between raw and pasteurized milk, and certainly not worth the risk of catching a disease."

According to the Centers for Disease Control and Prevention (CDC), more than 300 people in the United States became ill by drinking raw milk or eating cheese made from raw milk in 2001, and nearly 200 became ill from these products in 2002.

Symptoms of E. coli O157:H7 illness include stomach cramps and diarrhea, including bloody diarrhea. People who have developed these symptoms after consuming unpasteurized milk should seek immediate medical attention. E. coli O157:H7 disease sometimes leads to a serious complication called hemolytic uremic syndrome (HUS), which can cause kidney failure, possibly leading to death.

Pasteurization is the only effective method for eliminating the bacteria in raw milk and milk products. Pasteurization can also prevent diseases as tuberculosis, diphtheria, polio, Q fever, salmonellosis, strep throat, scarlet fever, and typhoid fever.

Federal law requires all milk shipped between states to be pasteurized.

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December 21, 2005
Andy Patrick
AgInfo.netZ

One of the more significant selling points of the segment of agriculture that is dubbed organic, self-sustaining, even alternative, to the consumer is that it claims to offer a more healthy product than goods produced through conventional growing and processing means. But a recent incident in Southwest Washington and one county in Oregon may serve as a warning to consumers that just because a product labels itself as more healthy than its conventional counterpart doesn't necessarily make it gospel truth.

If one were to go to www.localharvest.org, a site that promotes small, sustainable, and organic based agriculture operations across America, and look up "Dee Creek Farm", the following description of the Woodland Washington based operation provided as of January of this year reads like this ... "Our goal is to build an ecologically responsible and self-sustaining farm, using natural methods and humane practices. We are pleased to offer our quality products and services to those who desire an "alternative for a more healthy lifestyle."

Part of Dee Creek's philosophy was extended in the form of providing unpastuerized milk to customers as part of what they call a cow-share program. The cow share program involves consumer purchase of shares in an animal in exchange for a share of the milk produced. However, that practice has come into question after Washington State Department of Agriculture officials and local health officials announced an investigation into an e-coli outbreak.

STOREY: Public health is investigating illness in eighteen individuals.
That includes fifteen children between the ages of one and thirteen for the e-coli infection.

And Marni Storey of the Clark County Washington Public Health Department adds as of Tuesday two of five children hospitalized as a result of e-coli remained in the hospital, and were progressing with their recovery. The owners of Dee Creek Farm previously contended that the outbreak came from another food source. However, W.S.D.A. lab results announced Tuesday seem to indicate otherwise.

STOREY: The Department of Agriculture has informed us that their preliminary laboratory testing of milk samples provided by the shareholders did test positive for e-coli, so those samples will be sent to the Washington State Public Health Laboratory to verify that the strain of e-coli is the same strain that sickened the people who consumed the unpastuerized milk.

How the unpastuerized milk ended up in the food chain is discussed in our next program.

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Drinking water found to be likely Camp Yamhill disease source
From foodconsumer
B.iological A.gents
By Philip Berger - Oregon Department of Health Services/Public Health
June 3, 2005
DHS news release

State and local public health officials have identified water contamination as the likely source of last week's disease outbreak at Camp Yamhill in Yamhill County, which sickened more than 50 people.

Mel Kohn, M.D., state epidemiologist in the Oregon Department of Human Services (DHS), said the camp's water treatment system, which draws water from the North Yamhill River, may have been overwhelmed by surface water run-off caused by recent heavy rainfall.

Kohn said it appears that more than one bacterial contaminant was in the water.

"The laboratory has confirmed cases of both E.coli O157 and Campylobacter, both of which cause diarrhea," Kohn said. "Those who were infected suffered varying degrees of illness, but we are glad to say that most have recovered."

Kohn said that no food item was implicated and that the large number of infections and the 2 different bacteria types makes food an unlikely culprit.

"The camp is planning to upgrade its drinking water treatment system," Kohn said. "We are providing technical assistance to the camp to help evaluate their water system and recommend improvement options.

"Meanwhile, the camp is actively working to correct the situation. They're taking steps to obtain clean municipal water and will be able to reopen this weekend," Kohn said.

Kohn said the camp director has arranged to bring in drinking water from an approved outside source and will continue to do so until treatment improvements are identified and completed.

The investigation, which began last week, involved DHS and 6 county health departments--Clackamas, Lane, Marion, Multnomah, Polk and Yamhill.

Exposure to the bacteria was identified as having occurred between 17 and 20 May [2005]. Public health staff interviewed more than 90 students and adults attending camp during that period.

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Mar 27, 2005

Fifteen people in Florida who visited agricultural fairs recently have developed a life-threatening kidney disease or are infected with bacteria that can cause it, Florida health officials said yesterday.

Eleven of those affected are children, and petting zoos at the two fairs are suspected, but Florida's secretary of health said it was "too early to point to one single element, such as a petting zoo."

Epidemiologists are "trying to triangulate the 15 cases and see if they can be associated with a single point source," the secretary, Dr. John O. Agwunobi, said.

Officials at various Florida hospitals told The Associated Press that they knew of nine children with hemolytic uremic syndrome who had visited petting zoos at the Central Florida Fair in Orlando or the Florida Strawberry Festival in Plant City. One Florida television reporter described the death of a child who had visited a petting zoo, but it was unclear if there was any connection.

The virulent bacteria strain, known as E. coli 0157:H7, lives in the guts of cattle, sheep, goats and other ruminants, and can be picked up by petting or nuzzling the animals, or simply touching one's shoes after walking through manure.

The bacteria can cause bloody diarrhea and, in a small number of cases, can lead to the syndrome, in which the kidneys, overwhelmed by toxins, shut down. In rare cases, it can require dialysis or a kidney transplant. Three percent to 5 percent of cases are fatal.

There were about 73,000 infections nationally with the E. coli strain last year; of those, 61, or less than one-tenth of 1 percent, were fatal.

There have been previous outbreaks associated with petting zoos, notably one at the North Carolina State Fair last year, in which 180 people were reported sick and 15 developed hemolytic uremic syndrome. After an investigation, the North Carolina health department recommended that direct contact with animals be restricted, especially for young children.

Many petting zoos now have hand-washing stations or staff members who squirt liquid sanitizer on visitors' hands. Those measures were used in North Carolina, but some children still became infected, the state health department said.

Children who sat or fell on the ground were five times more likely to have been infected.

The disease is most dangerous to children under 5 and the elderly, and can be transmitted in many settings, Dr. Agwunobi said, including pony rides, rodeos, livestock displays, milking demonstrations, hayrides and pig races.

Bloody diarrhea is the most common first sign, followed by lethargy and failure to produce normal amounts of urine.

The bacteria can also be picked up from undercooked meat, said Dr. John Dunn, a veterinarian with the Centers for Disease Control and Prevention. It does not grow in the animal's muscles, but may be splashed on in slaughterhouses when the animal is butchered.

There has been little testing of petting zoos, Dr. Dunn said, but the bacteria have been known to spread through whole cattle herds when they are penned closely together in feedlots. Cattle are often treated by giving them "probiotics," bacteria that compete with the E. coli strain and reduce it.

A more likely remedy for petting zoo operations, he said, would be to keep all infected animals away from children.

Many other dangerous bacteria are found on petting animals and poultry. Snakes, for example, often have salmonella on their skins, and animal feces may contain campylobacter, shigella, giardia and cryptosporidium.
Young animals and birds - often handed to children because they are cute - are the most likely to transmit infections, according to C.D.C. guidelines.

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On September 3, 1999, the New York State Department of Health (NYSDOH) received reports of at least 10 children hospitalized with bloody diarrhea or Escherichia coli O157:H7 infection in counties near Albany, New York. All of the children had attended the Washington County Fair, which was held August 23-29, 1999; approximately 108,000 persons attended the fair during that week. Subsequently, fair attendees infected with Campylobacter jejuni also were identified. An ongoing investigation includes heightened case-finding efforts, epidemiologic and laboratory studies, and an environmental investigation of the Washington County fairgrounds. This report presents the preliminary findings implicating contaminated well water.

To identify additional fair attendees with diarrhea, the NYSDOH issued press releases, conducted daily press briefings, and contacted emergency departments, laboratories, and infection-control practitioners by fax and telephone. Laboratories were asked to culture all diarrheal stool specimens for E. coli O157:H7 and subsequently for Campylobacter spp.

As of September 15, 921 persons reported diarrhea after attending the Washington County Fair. Stool cultures yielded E. coli O157:H7 from 116 persons; 13 of these persons were co-infected with C. jejuni. Stool cultures from 32 additional persons yielded only Campylobacter. Sixty-five persons have been hospitalized; 11 children have developed hemolytic uremic syndrome (HUS); and two persons died: a 3-year-old girl from HUS and a 79-year-old man from HUS/thrombotic thrombocytopenic purpura. Cases of diarrheal illness among fair attendees have been reported from 14 New York counties and four states.

An environmental investigation of the fairgrounds on September 3 determined that much of the fair was supplied with chlorinated water. However, in at least one area of the fair, a shallow well supplied unchlorinated water to several food vendors who used the water to make beverages and ice. Initial cultures of water from this well yielded high levels of coliforms and E. coli.

A case-control study was conducted to determine risk factors for infection. Case-patients were residents of Washington County who developed diarrhea after attending the fair and in whom stool cultures yielded E. coli O157:H7 or Campylobacter. Controls were residents of Washington County randomly selected from the telephone directory who had attended the fair and were frequency-matched by age group. Thirty-two case-patients and 84 controls were enrolled. Analysis was limited to those attending the fair at least once during the final 4 days of the fair because all ill persons, including those attending only once, attended during that period. Drinking water or beverages made with water from the suspect well was associated with illness. Twenty-six (81%) of 32 case-patients and nine (16%) of 57 controls had consumed water from this well during the final 4 days of the fair (matched odds ratio=23.3; 95% confidence interval=6.3-86.9). When controlled for water consumption, other exposures, such as eating food at the fair and contact with manure, were not significantly associated with illness.

On September 9, the New York State Public Health Laboratory, the Wadsworth Center, used five different polymerase chain reaction assays to demonstrate the presence of E. coli O157:H7 DNA in water from the implicated well and subsequently isolated the organism from water samples from the well and the water distribution system. Pulsed-field gel electrophoresis testing by the Wadsworth Center showed that the DNA "fingerprints" of E. coli O157:H7 isolates from the well, the water distribution system, and most patients were similar. Water sampling for Campylobacter spp. is ongoing.

To prevent secondary transmission of enteric infection, letters were sent to schools and day care centers emphasizing the need to exclude symptomatic children and practice careful handwashing. Letters also were sent to nursing homes and hospitals with recommendations regarding employees and residents with diarrhea. Information to the public about the outbreak also focused on how to prevent secondary infections. On September 13, the state health commissioner issued an order requiring county fairgrounds to use disinfected water when hosting public events; the commissioner also is reviewing laws and regulations applicable to fairs.

Reported by: County health depts in the Capital District; New York state outbreak investigation team; A Novello, MD, Commissioner, New York State Dept of Health. Foodborne and Diarrheal Diseases Br, Div of Bacterial and Mycotic Diseases, National Center for Infectious Diseases; and EIS officers, CDC.

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