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Outbreak of C. jejuni in Utah linked to raw milk consumption
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An outbreak of Campylobacter jejuni that sickened dozens of people in Utah showed that state-mandated routine testing does not guarantee the safety of raw milk, according to the CDC and local researchers.
An estimated 3% of the United States population drinks raw milk, preferring it to pasteurized milk partly due to its perceived health benefits, researchers noted in their study published in MMWR. They warned, however, “Consumers should be educated that raw milk might be unsafe even if it meets routine testing standards.”
Overall, researchers from the CDC and local health departments linked 99 cases of C. jejuni to consumption of raw milk from a dairy in Weber County, Utah, between May 9 and Nov. 6, 2014. Ten patients were hospitalized, and one died of multisystem organ failure related, in part, to gastroenteritis and underlying medical conditions, according to the researchers. The median age of the patients was 23 years; 32% of the patients were Hispanic.
Farms in Utah wishing to sell raw milk to consumers must have a permit issued by the Utah Department of Agriculture and Food (UDAF) and must submit monthly milk samples to the UDAF for somatic cell and coliform counts to test for contamination. However, routine somatic cell and coliform counts do not ensure the safety of raw milk, the researchers warned.
In fact, test results submitted by the Weber County dairy at the center of the investigation were within acceptable levels before the identification of the C. jejuni cluster. The farm passed three UDAF inspections in June and July 2014 — one routine inspection that occurred before the outbreak was identified, and two outbreak-related inspections.
The dairy continued to sell raw milk after passing the inspections and after tests on its milk failed to detect any pathogens. However, cases of C. jejuni continued to be identified, leading to an enhanced testing effort by the UDAF, the Utah Department of Health (UDOH) and the Utah Public Health Laboratory (UPHL). UDAF and UPHL scientists both isolated C. jejuni after a milk sample was neutralized and cultured using sheep blood agar.
The dairy’s permit to sell raw milk was suspended by the UDAF on Aug. 4, 2014, and the public was informed about the outbreak in a news release 22 days later, which led to the identification of one additional probable case, according to the researchers. The UDAF reinstated the dairy’s permit to sell raw milk on Oct. 1, 2014, but it was permanently revoked 2 months later after seven additional cases of C. jejuni infection were identified. No cases matching the outbreak pattern have been reported since Feb. 19, 2015.
Campylobacter is “ubiquitous” in farm environments but is difficult to detect in milk, the researchers noted. They recommended drinking pasteurized milk as a safe alternative.
They said mandatory reporting, timely sample collection, pathogen testing and on-site milk neutralization likely led to the detection of C. jejuni during the Utah outbreak.
“Specific pathogen testing for raw milk, in addition to somatic cell and coliform counts, might more readily detect contaminated raw milk,” they wrote. “PFGE patterns linking human isolates from Campylobacter cases with raw milk from dairy A provided evidence that led to implementation of control measures.” – by Gerard Gallagher
Disclosure: The researchers report no relevant financial disclosures.
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