I’ve never been much for games of pure chance. They simply leave too much up to, well, chance. Where’s the fun or challenge in that? I prefer activities that involve logic and reason and strategy — like “Clue” or pinochle.
Yah, yah, I know both of those involve an element of chance. There’s the luck of the roll in the board game and the surprise of the shuffle in the card game, both of which skilled players can usually handle.
The thing about games, from Powerball to Othello, is that you can’t win if you don’t play. Which brings us to the transition away from my personal beach beat and toward my professional Beach Beat, which I’ve been pounding with a limp recently because of a story stone in my shoe.
Just as you can’t win if you don’t play the game, if you don’t look for them, you can’t find foodborne pathogens.
Similarly, when you do look for them in the course of your work for governmental entities, and find them, it shouldn’t take you a year and a half to tell the public about it, especially when people are in the hospital because of an E. coli outbreak.
I first became aware of the March 2016 E. coli O157 outbreak in Virginia on July 24 this year when I noticed a headline from The News & Advance in Lynchburg, VA. I was doing my daily beat stroll through cyberspace when I came across “Lynchburg-area raw-milk fans drink up, despite health officials’ concerns” by Rachael Smith. She referenced the 2016 outbreak in passing.
A quick search of my memory banks and the Food Safety News archive showed that we had not reported the outbreak. Google wasn’t any help either. It appeared that no media had reported the outbreak in 2016.
A devoted civil servant at the Virginia Department of Agriculture and Consumer Services responded quickly to an email query from me, confirming that the outbreak had occurred. However, the ag department wasn’t the lead agency on the investigation.
The Virginia Department of Health, specifically the Rappahannock-Rapidan Health District, was the lead entity on the outbreak. I contacted the department July 24 seeking information.
On July 26 District Director Dr. Wade Kartchner told me via email, and through a state spokeswoman, that his office did not go public with outbreak information in 2016 because the implicated raw milk was not available to the general public.
“Consideration was given to putting out a broad public notice, but the nature of the herd-share programs are such that we were confident that we would be able to effectively reach those who were truly at risk of illness,” Kartchner said. “… it is not quite the same situation as a restaurant outbreak where the public at large may be exposed.”
Officials at both the state and district level seemed surprised that anyone would want to know about the E. coli outbreak, which sickened at least dozen children and two adults. They all drank unpasteurized, raw milk from Golden Valley Guernseys dairy before becoming ill.
A health department spokeswoman responded to a follow-up query, saying the final report on the March 2016 outbreak wasn’t finished yet, but it was expected soon. She said they would send it my way when it was available, with an estimated time of arrival sometime in early August. She did not volunteer an explanation regarding why the report had not yet been finished.
I sat on the story for a few days, hoping to provide our readers with a more complete picture.
By Aug. 2, another health department spokesperson was telling me the report was anticipated “next week.” I posted a story the following Monday, Aug. 7, telling our readers that the state expected to release the outbreak report that week.
By Aug. 16, my reporter senses were way beyond tingling. Still nothing from the Virginia health department, despite the fact that Daniel Ferrell, epidemiologist for the Rappahannock-Rapidan Health District had made a 20-minute presentation on the outbreak at the department’s June 2 Field Epidemiology Seminar.
Considering three of the outbreak’s child victims developed hemolytic uremic syndrome, the title of the presentation seemed a bit flip to me — “Breakfast of Champions! An Udderly Horrific Outbreak of E.coli Associated with Raw Milk Consumption” — but it included answers to most of the questions I had been seeking.
But, instead of directing me to the synopsis of the Ferrell’s presentation, the Virginia health department left me and our readers on hold until Aug. 18.
Again I held off writing a story.
I wanted to give the dairy owners another chance to provide comment on the situation, as they had not responded to my initial query in July.
There were also a couple of things I wanted to double check with the Virginia health officials, like why it took so long for them to produce the report and what, if any, regulatory mechanisms they have at their disposal when a dairy refuses to allow environmental swab samples to be collected during an outbreak investigation.
The answers, such as they are
The owners of the Golden Valley Guernseys dairy operation responded through an attorney with the Farm-to-Consumer Legal Defense Fund. The dairy owners are members of the organization and consulted with the group regarding their comments on the outbreak.
“Thank you for the opportunity to comment on the March 2016 events. When we first started working with the Virginia Department of Health in March 2016, we appreciated their input and cooperated fully,” said the dairy owners’ statement, which was emailed Aug. 23.
“Regarding the VDH (Virginia Department of Health) final report, we are not prepared to comment at this time. We received this report from VDH on Friday, Aug. 18. We are in the process of thoroughly reviewing it. We do, however, take issue with any language that characterizes us as less than fully cooperative with the investigation. We welcomed VDH to our farm, and were grateful for their assistance.”
Apparently the dairy owners do not view their refusal to allow environmental swab samples to be collected before they cleaned and sanitized their operation as being “less than fully cooperative with the investigation.” Raw milk herd-shares are virtually unregulated in Virginia, so the investigators’ hands are tied if owners “decline” testing.
As for the 17-month prep time for the state report, the health department had “competing issues,” according to Seth Levine, epidemiology program manager for the department’s Division of Surveillance and Investigation.
“We had competing issues at the local and state health departments. This outbreak occurred during the middle of the response to Zika virus, which drew many public health resources,” Levine said in an Aug. 23 email.
“Also other public health responses were occurring following the end of this investigation. Numerous people from various offices within the Virginia Department of Health and other agencies were part of the effort to supply information for the report. Finally, we have a peer-review process to finalize field reports.”
The Virginia health department officials did not respond to my question about what options they have in situations such as the Golden Valley Guernseys investigation when a producer won’t allow samples to be collected for pathogen testing.
They did look and they did find pathogens
The bottom line is 14 people got sick from drinking unpasteurized milk from Golden Valley Guernseys dairy, which is about 30 miles southwest of Washington D.C. The victims ranged in age from 13 months to 38 years. A dozen of them were children. At least four victims required hospitalization. The children who developed HUS because of their E. coli infections will likely have health problems the rest of their lives.
Following is a rough timeline of the outbreak and investigation, gleaned from the synopsis of Ferrell’s June 2 presentation and the 33-page report that was released Aug. 18. The report’s a pretty thorough document, but it doesn’t explain why the outbreak was kept secret. I doubt anyone will be able to explain that to my satisfaction.
Virginia law allows only members of herd-share operations to receive unpasteurized milk from producers, but it doesn’t prohibit those members from serving it to other people. If I were the parent of a child who goes to school or otherwise interacts with children whose parents serve raw milk, I’d want to know if there was an ongoing outbreak.
We don’t know if the dairy equipment or environment was contaminated with E. coli O157 because tests were not conducted before the owners cleaned the operation. We don’t know if samples of milk collected from bulk tanks at the dairy were contaminated with non-O157 E. coli because they were only tested for the O157 serotype.
We do know milk collected from a herd-share member’s home tested positive for two non-O157 serotypes of E. coli — STEC O98 and STEC O78:H16.
We do know one of the outbreak victims tested positive for the same strain of STEC O78:H16 that was found in the Golden Valley Guernseys raw milk provided by the herd-share member, who lived in a different county than the O78:H16 victim.
We also know raw milk should be legislated like seat belts and cigarettes and booze when it comes to minors. No one, not even parents, should be allowed to serve unpasteurized milk to anyone under the age of 18.
Feb. 22 – March 11, 2016: Herd-share participants received raw milk from Golden Valley Guernseys dairy that was later linked to E. coli infections in people who drank it.
March 4-16, 2016: Illness onset dates for the 14 victims tracked by Virginia health officials.
March 14, 2016: A doctor notifies public health officials that he has four pediatric patients in the hospital, two of them with HUS, and all of them with a history of drinking raw milk from the same dairy.
March 16, 2016: State health and agriculture officials visit Golden Valley Guernseys dairy to inform the owners of the outbreak. The owners said they were aware, but “declined” the ag department’s “offer” to collect environmental swab samples for pathogen testing.
March 18, 2016: Golden Valley Guernseys owners email their herd-share members about the outbreak, including information from state officials about how to identify E. coli infection symptoms. The state information also warned about the dangers of bacteria and other pathogens in unpasteurized, raw milk.
March 21, 2016: State ag and health officials again visit the dairy operation. The owners “walked around” with the officials, who collected milk samples from bulk tanks to test for E. coli O157.
March 25, 2016: Virginia officials returned to the Golden Valley Guernseys dairy. The owners reported they had drained milk tanks, taken apart some equipment for cleaning, and sanitized the entire operation from “top to bottom.” The state officials noted the operation looked much cleaner. Officials again took milk samples from bulk tanks. They also collected one water sample and eight swabs of surfaces and equipment at the dairy. None of the samples collected at the dairy returned positive results for E. coli O157.
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