andrew schneider investigates

June 24, 2008

Raw milk and tomato-illness update

Filed under: FDA,Food Safety,Public health legislation,Risks to children — Andrew Schneider @ 18:32

I don’t mind doing controversial stories. Usually it’s an opportunity to meet new people and plow new ground that the multitude of smarter reporters avoid at all cost. In chasing topics like this, you know the end result will spark lots of feedback.

So, yes, I’ve had lots of company since Monday when the P-I ran my story on the controversy swirling around raw milk � about 250-plus phone calls, e-mail to the newspaper and my personal home accounts (which does puzzle me) and even a letter, hand-written on real paper.

Almost everyone seemed to be eager to share an opinion. Some were angry or wacky, like the 15 or 20 who probably listened to the same very-late-night talk show host who insisted that pasteurization is a “Communist plot” — like fluoride.

Some were literary, as they recalled childhoods when fresh milk was a way of life — one that’s missed. Others shared examples of why their children are healthier because they either did or did not drink raw milk. And many wanted to point out shortcomings in my story or just ask questions, which I welcome.

Some asked me about the risk from Mexican cheese made with raw milk. Great question. In fact, I’d written the following three paragraphs, but didn’t have room for it in the story:

“In reviewing health department and CDC case reports on several of the raw milk national outbreaks, it was obvious that soft Mexican-style cheese was often the villain and children were often the victims.

“In early 1997, 54 cases of salmonella were reported to Yakima County health officials, a five-fold increase. Almost all the victims were young Hispanics who had eaten the queso fresco-type cheese made from raw milk within a week of becoming ill.

“The Ag depertment teamed up with food scientists from Washington State University and local cheese producers. Together, said Ag’s food safety manager Claudia Coles, they created a pasteurized milk queso fresco with taste and texture acceptable to the Hispanic community.”

WSU developed the recipe and then taught Latina grandmothers (Abuelas) how to make the the traditional soft cheese a safer way.

“Each Abuela promised that they would teach 15 others how to make the pasteurized milk queso fresco,” Dr. Val Hillers, Professor Emeritus at WSU, told me this morning.

Another caller, a health department inspector from New Jersey, told me the numbers on raw milk outbreaks of illness that CDC gave me were not the latest. These are, she said:

“CDC’s Morbidity and Mortality Weekly Report for the week of March 2, 2007 identified a total of 45 outbreaks of foodborne illness that implicated unpasteurized milk, or cheese made from unpasteurized milk. These outbreaks accounted for 1,007 illnesses, 104 hospitalizations, and two deaths.”

Other questions involved the outbreak numbers for pasteurized products. The CDC public affairs office said they didn’t track those numbers. However, in studies I pulled off their website and medical journal articles that researchers at Duke University’s School of Public Health were kind enough to provide, we found CDC researchers saying, “Despite the important public health gains achieved, outbreaks associated with pasteurized milk continue to occur.”

One early report cited 12 outbreaks affecting people in 15 states between 1985 and 2000. In one episode in Illinois, antimicrobial-resistant Salmonella infections were confirmed in over 16,000 cases. The illness was traced to two brands of pasteurized 2 percent milk produced by a single dairy plant.

However, the researchers reported that surveys showed the number of people who were actually affected was between 168,000 and 198,000, making this the largest outbreak of salmonellosis ever identified in the United States.

Everyone I spoke to said that almost all of the outbreaks involved inadequate pasteurization or contamination after the milk was pasteurized, and, they added, they were sure the number of outbreaks is much higher than with raw milk.

“But don’t forget to compare the volume,” cautions Dr. Doug Powell, a professor of food safety in Kansas State University’s department of diagnostic medicine/pathobiology.

“There is much, much more pasteurized milk consumed in this country. So, of course, the number of people sickened is far higher. You’ve got to keep that in mind when you compare the numbers.”

A couple of readers made mention of the doctor’s comments in my Monday story, where he noted (in jest, I think) that perhaps tomatoes should also be banned as most states do with raw milk because there are many more outbreaks of illness from the red fruit.

Both wanted to know how many salmonella outbreaks can be blamed on tomatoes. And the answer, according to a 2000 article by a CDC infectious disease specialist, is this: “Since 1990, more than 3,000 Americans have gotten sick from tomatoes contaminated in 24 known outbreaks.”

The USDA and FDA estimated a much higher number of outbreaks, according to a congressional investigator who asked for specifics and is still waiting for the numbers. Of course, those numbers do not include the on-going salmonella-contaminated tomato outbreak.

The latest numbers released by CDC this afternoon raise the number to 613 people infected with salmonella saintpaul in 33 states and the District of Columbia. And that case total may not include two children from New Jersey diagnosed earlier today.

Before you ask, no, FDA is offering no new information as to where the tainted fruit came from, but they do say that agency investigators are still in tomato fields in Florida and Mexico.

Take a look at Dr. Powell’s food safety blog now and then for some interesting observations. It has a goofy name but some solid science.


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