Nineteen people in Oregon are ill with E. coli in an outbreak traced to raw milk from Foundation Farm near Wilsonville — up one from the 18 cases reported Thursday — according to a April 20 news release from the Public Health Division of the state’s Health Authority.
Of the 19 people, 11 have culture-confirmed E. coli O157 infections. Fifteen of the 19 cases are children 19 or younger. Four of the children have been hospitalized with kidney failure. On April 19, a Portland hospital confirmed that one of the hospitalized children — a 13-year-old girl — was in critical condition. According to a member of the cowshare implicated in the outbreak, as many as four of the farmer’s children are also sickened, including one with hemolytic uremic syndrome (HUS).
Children, the elderly and those who are frail healthwise are the most vulnerable to being infected by E. coli O157, a potentially fatal foodborne disease characterized by diarrhea (sometimes bloody) and abdominal pain. Kidney failure and related complications may occur. Symptoms usually develop within 2 to 8 days of eating contaminated food or drinking contaminated milk.
Oregon public health officials urge anyone who has consumed raw milk and is experiencing these symptoms to contact a doctor or health-care provider.
On April 10, Multnomah County Health Department received a report of a case of hemolytic-uremic syndrome (HUS), a form of kidney failure, in an 18-month-old child admitted to a Portland area hospital. Interviews with the family revealed that the child had consumed raw milk from Foundation Farm in Clackamas County.
Foundation Farm was operating what is known as a herd share, an arrangement in which people can buy a share of the herd or even an individual cow with the understanding that they are not customers of the dairy but rather owners of the herd and the milk produced by the herd.
Under that arrangement, the farm was providing raw milk to 48 households. The owner, Brad Salyers, provided state officials with a list of the households and stopped distributing raw milk to them.
Oregon has no laws pertaining to cow- or herd shares.
State and local health officials were able to reach 30 of the households, representing 91 people. As part of the investigation, they collected information about raw milk consumption from Foundation Farm since mid-March. They also collected information about other possible food exposures and diarrheal illness in household members.
The only common food item consumed by all of the ill people was raw milk from Foundation Farm. No other food items were consumed by all of the ill people. In addition, the households told health officials that they had bought their food from a variety of stores.
On April 11, staff from Oregon Public Health Division and the Oregon Department of Agriculture visited Foundation Farm to collect samples for testing. Among those collected were samples from some of the farm’s manure, rectal swabs from four of the cows, and samples from environmental surfaces at the farm.
They also collected leftover raw milk samples from two shareholder households.
All of the samples that tested positive for E. coli O157 were then subtyped using pulsed-field gel electrophoresis (PFGE), a type of genetic fingerprinting. The PFGE results revealed a single molecular pattern for eight of the human cases (three more tests are pending) and from some of the samples taken from the farm, as well as from leftover milk from one of the households.
Food safety attorney Bill Marler, publisher of Food Safety News, said the results from the testing further bolster the link to the farm.
“Most foodborne outbreaks are solved by finding the common food item that the ill people all consumed,” he said. “To have an identical E. coli PFGE pattern in people’s stools and in the milk and the cows should leave no room for confusion: It was the raw milk that sickened these people.”
Jim Krahn, executive director of the Oregon Dairy Farmers Association, told Food Safety News that the tragic part in all of this outbreak is that there was no reason for the people to have become ill.
“It was preventable,” he said. “That’s the sad part.”
Looking ahead, Krahn said the dairy industry will be talking with state legislators, Department of Agriculture and Public Health departments, scientists and people in the dairy industry about a possible solution that will “hopefully find a path that protects children and others” from being infected with foodborne pathogens from contaminated raw milk.