A longtime, highly respected Pacific Northwest cheesemaker has been linked through an epidemiological investigation and a confirmed culture sample to an E. coli outbreak, resulting in a nationwide recall of all its gourmet raw milk cheese and revealing sanitation problems at the dairy.

The U.S. Food and Drug Administration announced Friday that Sally Jackson Cheese of Oroville, in northeastern Washington state, had agreed to recall its cheese after eight people were stricken with an identical strain of E. coli O157:H7.

The eight are residents of Oregon, Washington, Vermont and Minnesota. Onset of their illnesses ranged from September into November. One person required hospitalization.

“All Sally Jackson cheese on the market should be avoided because the products were processed under conditions that create a significant risk of contamination,” the FDA said in its news release.

Sally Jackson Cheese is sold in restaurants and retail outlets nationwide, including Whole Foods, Tamales in Berkeley, CA.; Quality Cheese in Seattle and Ideal Foods in New York City.

A spokesman for the State of Washington Department of Agriculture said Sally and Roger Jackson, owners of the tiny dairy, have been cooperating with public health authorities during the outbreak investigation and, for at least eight years, documents show they’ve also been working with regulators to correct food safety issues at their dairy.

Sally Jackson began making cheese in 1979; she was one of the first in the U.S. to craft artisanal cheese from sheep’s milk.

Her cheese wheels, handmade with unpasteurized milk from her own goats, sheep and cows, are wrapped in grape and chestnut leaves gathered from a neighbor’s orchard and tied with twine.

Their rustic appearance–no labels listing ingredients, no pull dates–are part of their appeal. They are ultra-premium and highly sought after by connoisseurs.

Until now, there had been no reports of illness associated with the cheese.  But there were signs that the dairy was not meeting basic safety standards.  According to state agriculture department documents obtained by Food Safety News via a public disclosure request, Sally Jackson Cheese was issued a “notice of correction” in 2002 to remedy multiple safety violations, including being months overdue in testing its private water system for coliforms. Parts of its facility were unfinished or in need of repair and a sink in the processing room drained to the floor, inspectors noted.

The Jacksons complied.

On June 1 this year, the cheesemaker was given another notice after a “routine, semi-annual” inspection in April identified critical issues: no sanitizing of cheese-making utensils, old milk residue in a milk chiller, mold-like substances on an aging table and above a draining table, a dirty floor, peeling ceiling plant, cobwebs, rodent droppings and one dead mouse.

The Jacksons again promised to resolve the problems and inspectors tried to familiarize the couple with food-security preventative measures.

Last month, state regulators observed chickens in the milking areas and milk left outside to cool overnight and gave the Jacksons 30 days to meet the standards of a Grade A dairy.

Not long after, public health officials investigating an E. coli outbreak began to hone in Sally Jackson cheese as its source—not because of problems at the dairy but because a few of the infected patients, filling out food-history questionnaires and in interviews with investigators, mentioned they had eaten cheese.

“It was hard work and some good luck” to so quickly track down the likely link, initiate a recall and possibly prevent more illnesses, because all the investigators had to go on was circumstantial evidence, said Dr. William Keene, senior epidemiologist with the Oregon Public Health Services Acute and Communicable Diseases Program.

None of the cases mentioned Sally Jackson cheese.  Based on invoices they presented, some had eaten cheese at a restaurant that could have offered the cheese, or they had purchased some unknown cheese at a store that might have had Sally Jackson in stock. Another had been at wedding where cheese was served and where “fancy cheese was made nearby,” Keene said.

“I can’t recall any other outbreak we’ve ever worked on with a zero percent recall by cases,” he added. “Even after we deduced the name and asked them directly about it, it didn’t help—-no recall.”

Eventually, after the recall was initiated, the wedding cheese was confirmed to have been the Sally Jackson brand, but to date that remains the only case with a direct history of consumption.

Keene said initial lab test results of a Sally Jackson cheese sample were PCR (polymerase chain reaction) positive, indicating DNA identical to the outbreak strain. Since then those results have also been culture confirmed, and are a pulse-field gel electrophoreses (PFGE) genetic match to the cases, he said.

Although investigators tried to pinpoint which batch of cheese had become contaminated, Keene said the Jacksons’ production records were so sketchy, or nonexistent, that the entire inventory had to be recalled.

Inadequate record-keeping may also make it difficult to determine how fecal contaminants got into the cheese, Keene noted.

The Sally Jackson Cheese recall is the 12th raw milk-related foodborne illness outbreak this year and highlights the safety questions about the use of raw milk–milk that hasn’t been pasteurized to kill pathogens–in food production.

This fall, 38 people raw milk Gouda cheese produced by California-based Bravo Farms were sickened by E. coli O157:H7.

Using raw milk in cheeses that are aged for at least 60 days is permitted under federal law, because the aging process supposedly kills pathogens, but there’s increasing evidence that 60 days may not be enough to make bacteria like E. coli or Listeria harmless.