I must admit that I tire of the moans from raw milk advocates that Big Dairy and Big Government is out to get them. I shake my head at the unfounded belief that grass fed cows will never produce a pathogen that can sicken a child. I cringe at the anti-science blather protesting that all outbreaks linked to raw milk never happened, or were caused by something else, or were part of some dark conspiracy designed to discredit what is really a wonder-product. I wish that I had a nickel for each time a raw milk aficionado claimed that I am a tool of the FDA, or State and Local Health Departments, who apparently wrongly nailed a poor raw milk farmer who poisoned a few customers.
Despite the whining to the contrary, raw milk outbreaks do happen and will happen. Health department officials in Minnesota reported three, and possibly four, E. coli O157:H7 infections linked to drinking raw milk from a dairy in Gibbon, Minnesota the week before Memorial Day. All of the sick were infected with a strain of bacteria that had the same pulsed-field gel electrophoresis (PFGE) pattern, or DNA fingerprint. One infected child developed Hemolytic Uremic Syndrome (HUS), and is still hospitalized.
Despite the protests from the “raw milkies,” there have now been at least nine outbreaks scientifically linked to raw milk since January 2010. The other states with outbreaks include Nevada, Utah (two outbreaks), New York, Pennsylvania, Washington (two outbreaks), and a multistate outbreak in Michigan, Indiana, and Illinois. Dozens of people have been sickened in these outbreaks; some very seriously so.
But, is raw milk treated unfairly?
Have health departments brought the hammer down on raw milk, while giving a free pass to other dangerous products? As someone once said, “just because they are paranoid, does not mean they are not out to get them.”
This may be a bit of a shocker to my raw milk fans, but, on this, I may agree with them–which clearly must mean that I’ve gone off the reservation, or stopped being a so-called lap dog (or attack dog) of the FDA and Big Ag. Let me be clear though: I am not saying that health officials should not crack down on raw milk producers who poison customers. Nor am I saying that raw milk producers should escape being held accountable for the injury and damage caused by contaminated raw milk. I simply believe that raw milk producers should be treated no more–or less–strictly than any other producer of unsafe or contaminated food products. And this is especially true for ready-to-consume products, like raw milk or fresh produce, where there is no kill-step involved in the production process. Bottom line: raw milk outbreaks should be publicized, but so must outbreaks involving contaminated lettuce.
But the problem here is that I do believe there’s a double standard. Why is raw milk emphatically criticized when it causes illness while some lettuce producers are allowed by public health officials to escape public scrutiny when their contaminated product has caused illness? And just so you don’t think I’m exaggerating, here are some problematic lettuce outbreaks that were essentially kept secret–that is, until I discovered the fact of such outbreaks and went public with the news:
1. Romaine lettuce, May 2008:
In May of 2008, the Washington State Department of Health learned of a small cluster of E. coli O157:H7 illnesses amongst Pierce and Thurston County residents. Over the several days that followed, a total of 5 E. coli O157:H7 illnesses were reported in those counties. Testing by the Department of Health showed that the bacterial isolates from four positive stool samples submitted by individuals with E. coli infections were indistinguishable after PFGE testing. By the end of the week of May 26, 2008, nine laboratory-confirmed cases and one epidemiologically linked case had been reported. Department of Health testing determined that all nine lab-confirmed cases had indistinguishable PFGE patterns.
Interviews revealed three clusters of illness: three cases at Pacific Lutheran University; three cases from a banquet at La Quinta Inn in Tacoma; and three illnesses amongst students in the Olympia School District. Further, investigators learned from the food histories of all cases that the only food consumed by all cases was lettuce.
A traceback investigation ultimately showed that the implicated romaine lettuce had been distributed to these locations by Northwest Fruit and Produce, a Tacoma-area distributor, and had been manufactured and processed by a string of companies from Salinas, California. The lettuce was grown by Andrew Smith Company at Braga Ranch, packed by Paul’s Pak, and shipped to a processing facility owned by True Leaf Farms. Church Brothers ultimately marketed the lettuce for sale on behalf of a now-defunct produce company called Premium Fresh Farms. No recall, no publicity.
2. Spinach, August 2008:
In August of 2008, five case-patients with E. coli O157:H7 were reported in Multnomah County, Oregon. Testing of patient isolates by PFGE and Multiple-Locus Variable Number Tandem Repeat Analysis (MLVA) revealed that all five patients were infected with a specific subtype. Public health investigators conducted a case-control study. Results showed that consuming raw spinach had the strongest statistical association with illness. Product traceback of spinach led Oregon investigators to spinach grown by an Organic Farm in Monroe, Washington.
A link between E. coli O157:H7 illness and spinach continued when a second outbreak of E. coli O157:H7 was identified in Washington state. Investigators in Washington identified five laboratory-confirmed cases that were a genetic match by PFGE and MLVA to the Oregon cluster. The first date of illness onset was August 28, 2008. The last case became ill on October 2, 2008. Washington case-patients also reported eating organic loose spinach at a variety of locations where the spinach was sold. These included the Port Townsend Co-op and deliveries of spinach sold through community supported agriculture (CSA) programs. No recall, no publicity.
3. Romaine lettuce, October 2008:
In October of 2008, 3 case-patients with E. coli O157:H7 sharing an indistinguishable PFGE pattern combination were identified in San Diego and Orange County, California. All three cases had eaten salads containing romaine lettuce served at Cheesecake Factory restaurants within two days of each other. The subtype was unusual, prompting a cluster investigation coordinated by the CDC. Through OutbreakNet, a fourth case-patient in the cluster was identified, an 18 year old resident of South Dakota.
This patient, a recent visitor to San Diego, had eaten a salad at one of the two Cheesecake Factory restaurants identified earlier by two patients. Furthermore, the three case-patients had all eaten at the restaurant on the same day.
County restaurant inspectors conducted an investigation into the source of the lettuce at the two Cheesecake Factory restaurants. Both restaurants received Andy Boy brand romaine lettuce from Fresh Point, a company based in Los Angeles. The outbreak quickly grew beyond Southern California. Public health laboratories continued to report PFGE matches to the outbreak strain. Case-patients were identified in Illinois, Florida, New Jersey, and Ohio. These individuals reported restaurant exposures but none ate at a Cheesecake Factory.
This led i
nvestigators to suspect a contaminated ingredient was in the marketplace. Canadian investigators in Ontario identified an outbreak involving 55 persons with at least 13 ill case-patients culturing positive for the outbreak strain. The majority of cases were linked to one of two restaurants. Illnesses occurred between October 11 and October 28. Canadian investigators conducted a case-control study and lettuce was statistically associated with illness. Product traceback showed that two restaurants tied to the outbreak shared a common produce supplier and that Andy Boy brand romaine lettuce was the only lettuce in common to all Canadian restaurants with outbreak cases. No recall, no publicity.
4. Romaine lettuce, summer 2009:
In late July and early August of 2009, at least 100 people were infected by a matching strain of Salmonella typhimurium in Oregon, Washington, Idaho, Colorado, Montana, and possibly other states. The cluster of illnesses was first recognized in mid-August. Early in the large-scale investigation that followed, involving the CDC, FDA, and health agencies from all affected states, it was thought that other PFGE-matched typhimurium cases nationally were part of the outbreak, but later MLVA analysis distinguished some of these cases from the July/August 2009 outbreak. An epidemiological investigation by the Washington State Department of Health, in conjunction with information from MLVA-matched individuals in other states, ultimately led to the identification of shredded iceberg lettuce from multiple retail locations, some very common, as the outbreak vehicle. In Oregon and Washington, these retail locations included, among others, Subway, Cash and Carry, Taco Del Mar, Burger King, Quiznos, Big Town Hero, Bandito’s Burrito, Taco Lobo, and Jalapeno Restaurant. Washington state health officials conducted traceback analysis on multiple common ingredients served at these locations, including shredded lettuce, cheese, and tomatoes; but only lettuce was found to have uniformly come from a common supplier. No recall, no publicity.
5. Lettuce, Spring 2010:
Finally, health officials in the Upper-Midwest investigated and confirmed a link between several Salmonella illnesses and the consumption of lettuce products from Fresh Express, a subsidiary of Chiquita Brands International, Inc. over a month ago. Again, no recall and no publicity.
Back to Raw Milk
Again, I am not saying that public health officials should ease up on raw milk; they most definitely should not. But, there is still an issue of fairness here. And despite the public health officials telling me that they cannot publicize every outbreak, I don’t buy that as either an explanation or an excuse. I also don’t buy the argument that a perishable item like lettuce is likely to have already been eaten by the time they figure out, after the fact, an outbreak has happened. Can’t the same thing be said about raw milk?
Telling the public that there was an outbreak linked to a given food product is a duty that public health officials may not shirk. Telling the public that a lettuce producer poisoned customers is just as important as reporting about a raw milk farmer’s product. Consumers need that information so they can vote with their pocketbook. Businesses that poison their customers need to have a light shone on them so both policy makers and other businesses can learn from the mistakes. Our free market does not function if information about the safety of our food is hidden from us.
Treating businesses equally and fairly is the right thing to do. It’s good for consumers and good for business–even ones selling raw milk.
See Real Raw Milk Facts for more information about raw milk.