I did a lot of traveling this past weekend–driving around Virginia on Friday and Saturday, and around northern New England on Sunday.
By Monday and Tuesday, my stomach was feeling kind of queasy. Uh-oh, I thought. I had had raw milk at three different places I visited over those three days. One of them had gotten me, I immediately theorized. John Sheehan of the U.S. Food and Drug Administration was right–I had been playing Russian roulette, and finally pulled the trigger on a chamber with a bullet.
So I spilled my guts (so to speak) to a friend in the public health arena with expertise in epidemiology, who immediately pointed out that the culprit wasn’t necessarily raw milk–that I had eaten lots of different food at lots of different places. There were crab cakes and french fries at a greasy and not especially clean looking road-side fish restaurant in Virginia, on the way to Staunton, VA, for the Farm-to-Consumer Legal Defense Fund fundraiser. There was a soggy cheesy burrito at Dulles airport on the way home. There was a hard-boiled egg I ate on Sunday while driving that had probably been sitting in my refrigerator for at least several weeks. Hmmm, a public health person not immediately blaming raw milk–that was comforting.
By late Tuesday, the queasiness was gone. Whew! But I thought about something Miguel raised in a comment following my Sept. 10 post on the Michael Hartmann case, in which I said I personally wouldn’t drink the farm’s milk because I believed it had been contaminated…but that I respected the right of individuals who did want to consume it. Miguel inquired, after quoting The Plain Truth’s skepticism about genetic linkages to convict criminals, “So ,David,what evidence besides DNA evidence was used to ‘link’ those illnesses to the milk?”
I guess I’d say, first, that I don’t consider The Plain Truth to be the repository of all truth. Second, I think an epidemiological, or circumstantial, case can be made for linkages between the Hartmann dairy and most of those who became ill, apart from any genetic linkages.
But having said that, I will also say I came to realize after this past weekend that, like many people, I tend to be quick to be suspicious of raw milk as the culprit if I know it’s a food that’s been consumed by someone who has become sick. The propaganda machine that is our media, medical community, and government agencies influences all of us, whether we think so or not.
***
An update on the food safety legislation in Washington: Some supporters are expressing nervousness about whether Senate Bill 510 will come up for a vote. It seems one or more senators are wondering how adding so many new agents to the U.S. Food and Drug Administration, some $1.8 billion worth, by some estimates, is going to be paid for, and are threatening a filibuster. Good question, among many questions associated with this ill-conceived legislation designed mainly to give the FDA more power over business and farmer lives.
Skeptic that I am, I wonder if one or a few senators are seeking to make deals on other legislation, in return for supporting S510. You never know in Washington.
***
I arranged my visit to Virginia last weekend so I’d have time to visit Monticello, the long-time home of Thomas Jefferson–author of the Declaration of Independence, a key framer of the U.S. Constitution, second President of the U.S., and outspoken skeptic of excessive governmental power.
Aside from being set in breathtaking countryside, it is an inspiring place on a number of counts–to see one of the original copies of the Declaration of Independence, as well as to see Jefferson’s vast collection of books and various inventions he prized, like on his desk that era’s version of a copier (a contraption rigged with a second pen that wrote along with the first pen’s writer).
Yes, he also apparently had a taste not only for French food, but for fermented apple cider from a particular kind of apple, and there’s a special fermentation room downstairs, next to the kitchen. As for his book collection, which included classics from Europe, the tour guide described how he donated many hundreds of books to replace the many destroyed when Washington was burned to the ground during the War of 1812. Can you imagine one individual being able to have such a major impact on the nation as to provide its reference book collection, or perhaps more relevant, to care about his country so much he’d give up one of his major pastimes accumulated over many years?
***
NPR broadcast an intriguing segment yesterday on the trillions of microbes that keep us alive and well. It’s certainly interesting that scientists are coming to appreciate the importance of the microbes in our gut, or the microbiome, as it’s known, but the strong suggestion from the program was that scientists are focused on coming up with new technologies and targeting mechanisms for using the microbiome to cure specific diseases. In other words, they’re thinking patents, and drugs. I realized afterwards that what was missing was a public health message about the growing evidence that a well maintained gut can help counter disease.
Then there is this article from the Washington Post about the joys and benefits of fermentation in food.
And finally, one of the major weekly news magazines has just come out with a major article on raw milk that goes a step further than most that have come out thus far, and examines some of the statistics underlying the claims against raw milk, as well as questioning the raids on dairies and food clubs. It quotes Wisconsin dairy farmer Scott Trautman as well as yours truly, among others. ?
Of course we all know that the CDC is a very reliable source of information(oh wait…I guess some of us do have doubts).It is the CDC's Pulsenet that is responsible for casting suspicion on the milk as the source of the illnesses.The Minnesota Dept of Health doesn't want to share with us the details of how they came to their conclusion.The Plain Truth ,on the other hand,does give a long list of links to read supporting their views.
I suppose there is always the epidemiological evidence.We cannot deny that those people thought they had consumed some raw milk before they got sick,and of course "nothing else they consumed before they got sick could have caused the illness".This is all based on the assumption that" raw milk is inherently dangerous" and that nothing else is worth considering when raw milk is involved.
All the DNA evidence set aside, why do you not care about making raw milk as safe as possible? It is obvious that raw milk consumers are disappointed in MN and CO due to contaminated products from Hartmann and Billy Goat farms, respectively. Even WAPF doesn't deny that raw milk has caused illnesses and outbreaks. I agree with Mark that national raw milk food safety standards are needed.
MW
Isn't it great to have a strong immune system?
Thanks for all the great links! That fermentation article is a keeper. And, I'm celebrating that senator from Oklahoma who stalled S. 510. It's a bad bill – mostly because of the money and power doled out to the FDuh to 'fix' the food problem that they largely created, with their pals at USDuh. Now we have 7 E. coli strains that produce shiga toxins. How many more are coming?
Miguel,
Thanks again for teaching. Please keep it coming!
MW,
What is the approved method for collecting milk samples and manure samples from a farm?
Thanks,
-Blair
I agree about the need for taking measures to improve raw milk safety, but just because we form an organization to set standards doesn't mean everyone will follow them. The best we could do is a certification. We can't stop farms without the certification from selling raw milk, but they wouldn't get to display the "seal of approval."
However, there are many problems in forming such an organization and standards. Firstly, the issue has so much political charge to it. We can almost be assured that some corporate dairy people are going to try infiltrating and sabotaging the organization. For a point of reference, when we rallied for legalizing raw milk on the capital steps in Madison, WI (this was just prior to Gov. Doyle's veto of the bill) David Ward of the cooperative network (and a longstanding corporate dairy hack who editorialized heavily against the raw milk bill) showed up and took pictures of everyone present. Clearly, there was some malicious intention there. And that was just an informal rally. Can you imagine if we had a formal organization to certify raw milk, and the kinds of sabotage and disruption tactics that the government and corporate interests would use?
Secondly, each farm is unique, and so any set of standards are going to need to be very broad and open ended, almost to the point of being meaningless. What works for Mark McAfee in southern California milking 300+ cows is not neccessarily going to work or be desirable for Scott Trautman in southern Wisconsin milking 25 cows.
Do you get my point? How are we supposed to create standards when the whole point of raw milk is that every single farm has a unique terrior and set of challenges?
When I was growing up, there was simply an understanding that new foods, or food/water consumed while traveling were going to cause some gastric issues until your body adjusted.
"Montezuma's revenge" and any other various names, depending on where in the world you happend to be, was notorious and unpleasant, but it was a fact of life, not a crisis. I know American's tended to downplay similar events that took place within our nation (because by golly we were so sterile…) but truly, if you traveled as far as a mile and drank the neighbors well water, you knew you'd be on throne later that day. There was term for that 1 mile well water phenomenon, too, but I can't remember right now what it was…( can anyone help me out with that? )
I think that attitudes toward food have changed so much that the general public, and regulators , have expectations about food safety that are approaching the level of obsessive/compulsive disorders. Maybe this is deeper than we realize – can it be the speed of our lifestyles means we no longer have time to excuse someone for a long sit in the johnnie? Certainly when we need antimicrobials in not only in our handsoap and our laundry detergent but it must be manufactured right into the fabric our of socks – this is a signal our society has a collective germ phobia that has run amok. . David, taking a stance like you have means if you do get sick, you will be held up as an example to be ridiculed, so there is no wonder you would feel nervous. But it's great that you realiized that no matter where your queasy episode began, it was just that – a queasy episode.
As for the safety standards, I have an innate sense that cooperating with these agencies has to be done with great care. . For one, I'm recalling that not terribly long ago there was a big fight over changing the acceptable counts in raw milk… I believe the new standards that were being pushed came out of left field and the scientific justification for it was flimsy. Still, the battle was costly and stressful.
I agree that there should be standards and a "seal of approval" system in place, but I still feel
raw food should be clearly legal, outside of the those standards, via direct contract. It is a necessary right and a safety net for the inevitable day when those standards become excessive and oppressive.
What have I said to give you the impression that I don't want to make all milk as safe as possible?We definitely will have differing views on how to make milk safe.People who agree with my methods of safety will be happy to get milk from me,people who agree with you can get the milk you approve of.Is there any problem with that?
BTW I think "phood" is a bit over the top as a word describing fast-food. I think a better word would be "taste," as in, "Let's stop at McDonald's to get some taste."
Maybe I'm misunderstanding you, but it seems like you spend a lot of time arguing the science when a raw milk outbreak occurs (presumably to say that the outbreak was not linked to raw milk). I'd love to see the outbreaks dissected by people who really know raw milk production and do it well. The state investigations usually conclude that unsanitary conditions lead to the outbreak, but do not recommend how to improve the conditions (the mantra is avoid raw milk because it cannot be produced safely). In other types of foodborne outbreaks there are usually a set of recommendations relating to better practices that may range from on-farm to processing to distribution and consumer handling/education, depending on what breakdowns were implicated in the investigation. I'm not sure if that makes sense, but if there is an outbreak that you believe is "real," could you dissect it? I've seen some of your posts about soil mineralization and cattle diet (and LAB in processing), but nothing very concrete that could be measured. But, maybe I'm wrong – is there a raw milk outbreak example you could give with those factors or others that were studied (or could be studied)?
Bill,
I agree that the prospect of writing raw milk industry-driven standards is daunting and cannot be one size fits all, as is the prevailing approach in other industries. But, it could also be an opportunity. Might take awhile to make it work, but seems worth giving a try vs. doing nothing except reacting to regulators and investigators. The number of raw milk-related outbreaks this year is too high, and I can't help but think there could be improvements to reduce that number.
Blair,
On-farm investigations are still relatively new in foodborne illness investigation. I'd guess each state has a different protocol (some may not even have protocols yet). The most stringent that I've seen involves chain of custody, aseptic techniques during collection, assurances of cold chain during transport (may involve a thermometer in the cooler that is recorded before and after delivery), certified laboratories and tests with intense QA/QC (sometimes the time spent during the year in a public health lab doing QA/QC and validation rivels the time actually spent running diagnostic samples). Regulatory laboratories, in contrast to research labs, do every sample as if it might go to court. Hope that helps…its a pretty quick overview.
Steve,
I have heard the same thing about standardization in the fast food world. Did you know that in its early days, Taco Bell used to make all of its own food from scratch in each restaurant? They have since, of course, gone to the current model of more centralized distribution and uniform "taste."
MW
http://hiphopwired.com/2010/09/08/new-study-reveals-that-mcdonalds-nuggets-contain-ingredient-used-in-silly-putty-22222/
http://www.associatedcontent.com/article/195157/exposing_mcdonalds_chicken_nuggets.html
http://www.alnyethelawyerguy.com/al_nye_the_lawyer_guy/2007/03/so_what_really_.html
http://www.fda.gov/Food/ScienceResearch/LaboratoryMethods/ucm114709.htm
http://www.mda.state.mn.us/news/publications/food/dairyproducts/milkprocguide.pdf
http://www.fda.gov/Food/ScienceResearch/LaboratoryMethods/ucm114664.htm
http://www.ams.usda.gov/AMSv1.0/getfile?dDocName=STELDEV3004791
http://www.ars.usda.gov/sp2UserFiles/Place/36553000/pdf%27s/Nutrient_use_efficiency/Data%20validation.pdf
http://www.johnes.org/dairy/diagnosis.html
http://pubs.cas.psu.edu/FreePubs/pdfs/AGRS72.pdf
http://books.google.com/books?id=i4uuzh0r-9MC&printsec=frontcover&dq=Standard+Methods+for+the+Examination+of+Dairy&source=bl&ots=AncPNZGHED&sig=Hz48IqwHN3HDAbwrn8QGGJB38ZQ&hl=en&ei=ixWUTKa5BYKosAPjt4DlCQ&sa=X&oi=book_result&ct=result&resnum=4&ved=0CCsQ6AEwAw#v=onepage&q&f=false
http://www.fda.gov/Food/ScienceResearch/LaboratoryMethods/BacteriologicalAnalyticalManualBAM/default.htm
http://www.bioamerica-inc.com/pdf/library_whatman/environmental_sampling_for_detection_of_mycobacterium_avium_ssp_paratuberculosis_on_large_california_dairies.pdf
To start with,I do not agree with the approach taken where the assumption is made that some strain of bacteria contaminating the food is responsible for the illnesses.Sanitizers,detergents,milk stone acids and other chemicals are used in milking and milk processing systems to kill the bacteria in the system.If these chemicals are in the milk in a high enough concentration they can lead to illness.A stool sample may show that the bacteria in the colon is out of balance with predominantly one type of bacteria.The bacteria was selected for by the chemical contamination of the food .It was not introduced into the gut along with the food.If we want to test food for safety,we need to understand that the environment or terrain determines the type of bacteria that will populate the food.In milk we want the lactic acid bacteria to be dominant.We can test for this by leaving a pint of milk at room temperature for 24 to 48 hours until it sets up.It should have a pleasant flavor still when it sets.If it forms gas bubbles or smells or tastes bad it is contaminated.
What would make the lactic acid fail to dominate?Often it is contamination with a chemical that was used to clean equipment.
http://itchmoforums.com/recall-nonpet-food/stonyfield-fat-free-plain-yogurtfood-grade-sanitizerrecall-t8029.0.html
Recalls because of sanitizer contamination appear to be common.Maybe it is over concern about killing bacteria and lack of concern about sanitizer contamination that is responsible for many outbreaks.
Are you suggesting that the people who got sick from raw milk, for example the Billy Goat dairy outbreak,would not have become ill if certain chemicals weren't used on the farm? I wonder if there is any data about the chemicals used on that farm or others who experienced an outbreak vs. farms without outbreaks. Must admit some skeptisism about putting forward a recommendation to: "test…by leaving a pint of milk at room temperature for 24 to 48 hours until it sets up.It should have a pleasant flavor still when it sets.If it forms gas bubbles or smells or tastes bad it is contaminated." Do you do that for each lot before selling your raw milk, or do you do it on a weekly, monthly, or other schedule?
MW
Every day we milk the cows (tasting the milk from each cow) and bring a bucket of milk into the house.We feed the calves morning and night from that bucket.The next day the left over milk has clabbered and it gets fed to the chickens or pigs.We notice how the milk has clabbered and what it smells like.Twice a week we make kefir with fresh milk,we notice how it smells,looks and tastes.Twice a week we culture cream to make butter.Once a week we make cheese culture with the milk.Once a week we make cheese.All of the information from these "tests" tells us that the milk is good.Anyone can check their milk with the test I suggested,so I think consumers should try it if they think their milk might be contaminated.Letting the milk sit at room temperature is just a way to grow the bacteria in the milk to the point that the bacterial waste products are easily detectable by the sensitive instruments most of us have, the eyes, nose and tongue.In the lab they might be more precise about times and temperatures but they are in a hurry.Their instruments might be more mysterious and sophisticated but not necessarily more sensitive or accurate.
Why is it that when someone gets sick after drinking fresh milk that the milk is always the cause in your mind.That the health department feels that it can link the illnesses together because of some DNA profiles is not very convincing to me.
Sanitizers should not be in the milk.Somehow you jump from this to" chemicals should not be on the farm".
It is a bummer you were ill for a few days with vomiting and diarrhea, but thank goodness it was only a few days. Maybe you had a Norovirus infection. It typically lasts 1-2 days. http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus-factsheet.htm
A serious case of food poisoning looks a little different. You would have extremely painful bloody diarrhea and vomiting every 15 to 20 minutes for a week. When your rectum becomes over used, you can develop rectal prolapse. When this happens, it is important to have someone there to push it back in for you. http://www.gastrolab.net/y0140.jpg
This was posted on FSN today. http://www.foodsafetynews.com/2010/09/blocking-e-coli-before-it-moves-in/
Mary
http://www.mayoclinic.com/health/food-poisoning/DS00981/DSECTION=symptoms
http://www.suite101.com/content/foodborne-illness-widespread-a120630
http://www.hmc.psu.edu/healthinfo/f/foodpoisoning.htm
Food poisoning usually last anywhere from one day to a week. Most lasting just a few days. Most people have experienced a bout of sudden onset diarrhea, possible vomiting, and abd cramps. Most times it is self limited and will resolve its self. Just stay hydrated. Unless your poop and/or blood is tested (possibly many stool samples) you may not know if it is virus vs food poisoning- both have similar symptoms. There is probably more cases of "food poisoning" that "stomach flu". (You are responsible for checking with your health care provider).
That was really gross…
Mary
I believe that it was last year that the FDA approved the release of a new
"desensitzing" product ( I do not have a clue as to what it is called)
If consumed it is supposed to help desensitize people to local allergies….geeez, do you think that the reason that the "gummit'" is cracking down on raw milk and honey is because it is getting in the way of a big corporation's ability to justify a "manufactured" high profit product" after all, who would buy such a thing when raw milk and raw honey can do the same except cheaper and probably better?
Ahh conspiracy theories! Where would we be without them????
if you or your family ever encounters food poisoning again, I highly encourage you to use activated charcoal..it isAMAZING at how quick it works.
You can get it at just about any pharmacy.
Two thoughts come to mind:
1. Modern medicine is a sure method to get sicker if you follow blindly into the antibiotic darkness. Doctors do not know how to deal with gut problems and openly say that on "Doctor Radio" when questioned about gut problems….they relieve the pain and perhaps the diarhea, or the cramping but do not know why the problem occured. They are clueless when it comes to the gut. They are not even practicing medicine…they are guessing at it.
2. On Thursday last week we made two batches of delicious raw milk icecream ( on site… the old fashion way ) and served it at the FOX studios Health Awareness event…hundreds of people had some and loved it…raw eggs, raw cream and raw milk and all. So many people claimed that they could not drink pasteurized milk….they said that it made them sick. Yet….no one had a problem drinking raw milk or eating raw ice-cream.
One more thing…a close friend of my daughter has a 10 month old son with terrible allergies, snotty nose, ear infections and diarrhea and would not sleep well at night. The mom finnally took my daughters advice and switched to raw milk…just like my grandson James. With in two week the kid was thriving….no more ear infections, sleeping well and a clear nose and no allergies. She took him to the doctor for a checkup and the doctor said how well his prescrtipiton of iron and special and expensive baby formula was working…the mom then told him that she was feeding the baby raw milk and had not done any of his recommendations because all they did was make the baby sicker…the doctor started to berate her and actually yell at her saying that she was putting the baby at risk. The young mom fired the doctor immediately and stormed out of his office. She now goes to Dr. Fields that prescribes Raw Milk…and the baby is healthy and healthy as never before.
So many doctors are harming children by prescribing antibiotics….it is a national tragedy.
Mary…it is tragic what happened to your son..,..what is even more tragic is that you do not come out strong to help prevent the use of antibiotics in kids…..and why you do not come out strong for nutrition and probiotics….it seems as if you are just filled with spite and not really supporting anything positive to prevent anything.
Mary….what exactly do you advocate for?? Pasteurized milk is the source of illness for many children…what is it that you want???
I know for a certain and for a fact that raw milk is a source of health for untold thousands of children in CA and nationally.
http://www.californiarawmilk.org see for yourself!!
Mark
3.
The article you linked was interesting but I'm not sure what to make of it in light of raw milk, and this blog in particular.
I understand the need for a "wake up call" among producers who may be getting sloppy in their practices.
Bringing it to this group, however, comes across as fear mongering, as in "do what I say, children, or the boogeyman Bill is gonna getcha…"
Stop it already. These folks here are bending over backwards to avoid sloppy practices and there is never any encouragement to cut corners.
CP, there is another way and many of us live it every day. We produce the best food we can and sell it directly to customers who know us by name and can see the methods we use. However, this world is not a fairy tale where everything is always wonderful. We farmers deal with bad weather, bad economics and personnel problems on a regular basis. Still we perseverve and thrive and produce quality food for grateful customers.
Let me be crystal clear, at the end of the day the things that motivate me to do it again tomorrow are not the "fear" of the Marler types and "got ya" regulators. I do it because I love to produce life giving food for people who actually appreciate me and the products of my toil. I feel sorry for you that you can't understand that.
Most people who eat food contaminated with a pathogen will suffer symptoms of diarrhea and vomiting for a few days to a week and then recover. Chris suffered from a severe case of food poisoning (diarrhea and vomiting) because he consumed the contaminated food more than one time (probably 4 times). Chris suffered from what I described for 5 days. This is BEFORE antibiotics were given. The rectal prolase and abdominal swelling began after 3 days of intense symptoms. This is when we were transferred from the community hospital to the facility with the pediatric specialists. Unfortunately for us, all the fecal tests came back negative for pathogens so the doctors were shooting in the dark. A sigmoidoscopy revealed a severe cases of colitis. This is when the antibiotic was given. They were concerned about his colon becoming damaged (perforated colon) and requiring surgery.
The symptoms of HUS (blood in his urine) and his last bowl movement which was a golden, thin liquid that filled one of those blue bed pads occurred at the same time. The antibiotics stopped the diarrhea and saved his colon. Mark did you know that many children with HUS die because their colon died? Once a child becomes this ill everything in medicine is a crap shoot. A procedure that may kill or damage one child may save another. There is no crystal ball to let a doctor know if he or she made the right choice.
For example, Chris pancreas was the last organ to heal. When we were at Loma Linda, they tried a risky medicine to see if they could get it working again because discussions were taking place about the possibility that Chris pancreas may be permanently damaged. This means he would have to remain on intravenous nutrition for the rest of his life. This medicine was given on the day Kaiser decided to yank us back to one of their hospitals. When we arrived back at Kaiser, the pediatric G.I. doctor freaked out when he saw Chris was on this medicine. He had previously had a negative experience with this drug and permanently damaged a childs pancreas using it, so he immediately stopped this drug with Chris. Thankfully the small amount of this medicine he received jumpstarted his pancreas and his lipase levels finally began to fall. It took another week, but Chris was finally able to eat again after almost two months on intravenous nutrition.
Moral of the story, dont eat food that is contaminated with a pathogen.
Mary
http://www.marlerblog.com/uploads/image/2010%20dairy%20through%20AIG_REVISED.pdf
I think the best person to share his thoughts on this subject would be Mark McAfee. Pre Bill Marler in his life there was not a RAMP safety model. Post Bill Marler there is a RAMP safety model. I think it would be safe to say that Mark is not interested in having Mr.Marler in his life again.
cp
The technique Miguel is talking about is actually very common, even for dairy processors. Many milk plants, particularily in fluid milk, run "P.I. tests" on raw milk that they incubate at 55F for 18 hours. This encourages the growth of pyscrotrophic bacteria (cold loving bacteria), which are then ennumereted the same way as a standard plate count, and compared to the standard plate count of the raw milk when it was fresh.
http://www.extension.org/pages/How_Milk_Quality_is_Assessed
Some artisan Cheesemakers will often incubate a sample of raw milk at room temperature or warmer for several days, as a way to test the natural microflora of the milk. If it has a putrid off smell or gas bubbles, it is likely because there is something wrong with the milk.
In fact, I've heard veteran WI cheese researchers talk about the old way they used to make starter cultures, decades ago, before the modern commercial freeze-dried monocultures used in most cheese plants today. They would take a few gallons of raw milk from their best farmer, and put it by the boiler overnight to keep it warm. In the morning, you have your bulk starter culture.
And miguel is absolutely right about chemical contaminants (sanitizers and cleaners) effecting the microbiology of the milk. Some organisms (such as listeria and pseudomonas) have the ability to build resistance to chlorine, while the beneficial lactic acid bacteria don't so much. If you were to swab and test samples from the chlorine footbaths at the entrance to most dairy plants, chances are you will find listeria or pseudomonas.
We aren't just running an occasional test on our milk.We are continuously monitoring it for quality every day in many different ways.This is the way things traditionally were done before we had laboratories to do the testing. When you are familiar with how the milk normally acts when make cheese or butter or kefir ,etc. any change is glaringly obvious.
1. The Minnesota Department of Health (MDH) gets all isolates of E. coli 0157 (EC) from humans sent to their lab for PFGE with 2 enzymes (clinical labs send the isolates to MDH). In this instance, the MDH lab identified 2 isolates that had indistinguishable PFGE patterns. These patterns had never been seen before in MN. The info about the PFGE matches were sent to the epidemiologists for follow-up. The lab has very little info about these people so there is no way to identify that this could be a raw milk outbreak.
2. The MDH epidemiologists routinely interview all cases of EC with an extensive questionaire. These interviesws take 30-60 minutes and they attempt to identify all food that the case had consumed for 5 days before illness. Questions about previously identified risk factors are also asked such as swimming is fresh water, visiting a farm, and raw milk consumption.
3. When there are a cluster of cases, the interviews are compared to see if there are similarities between the exposures (consumed common food, ate at the same restaurant, etc). In this case, it was noted that the first several cases in this cluster all consumed raw milk from Hartmann Dairy. I believe that 8 of 9 cases that had this PFGE type consumed raw milk from Hartmann's. This is very strong epi evidence. As an aside, MDH is extremely good at at identifying outbreaks. They are one of the best health depts in the country (google team diarrheae, which is their nickname, for more information).
4. Based on this evidence, the Minnesota Dept of Agriculture inspected the dairy and took samples. The inspector noted a lot of concerns about the cleanliness of the dairy-I am not a farmer so I don't know whether these are valid concerns. Some of the concerns seemed picky and some seemed legitimate. Some of the concerns were dead animals in the barns (owls, a calf, and chickens-note only the owl is mentioned in the link below).
http://minnesota.publicradio.org/display/web/2010/08/19/raw-milk-sales/
5. Environmental samples from the farm tested positive for E. coli 0157 and had the same PFGE as the EC that sickened the humans (I believe it was 28 of 80 specimens had EC 0157 with the same PFGE type). It is not surprising that EC would be found in the environment (which contains cow poop), but the fact that humans had the same 2 enzyme pattern provides reasonable explanation why humans would have become ill (contamination of the milk).
6. Testing at MDH of the raw product from the farm yielded no EC 0157 but some cheese did contain some non-0157 shiga toxin producing EC (called STEC). Non-0157 STEC are also considered a pathogen. The MDH laboratorian testified that it is extremely hard to detect EC 0157 from milk. Plate counts were very high on some of the milk (I was not there that day so I am relying on second hand and media accounts)
http://minnesota.publicradio.org/display/web/2010/08/26/raw-milk-hearing/
7. Tim Wigtman testified on behalf of the defendant. He inspected the facility and said that quality milk could be made their, but he also had concerns. By some of the qualities he uses to evaluate the quality of the dairy, this farm failed. I think it was clear he felt this was an optimal operation.
http://minnesota.publicradio.org/display/web/2010/08/20/milk-hearing/
Other links of interest:
http://minnesota.publicradio.org/display/web/2010/09/07/hartmann-raw-milk-case/
http://www.startribune.com/business/102498279.html?elr=KArksUUUoDEy3LGDiO7aiU
http://www.startribune.com/local/102399924.html?elr=KArksUUUoDEy3LGDiO7aiU
I hope this helps understand this hearing better. I tried to stick to the facts as much as I could.
David says, "So I spilled my guts (so to speak) to a friend in the public health arena with expertise in epidemiology, who immediately pointed out that the culprit wasn't necessarily raw milk–that I had eaten lots of different food at lots of different places."
I am the "friend" who advised David. There are countless investigations that do not lead to raw milk. Indeed, only a relatviely few involve raw milk, but, given the small population drinking raw milk (especially when concentrated in herd shares), the rising number of outbreaks/illnesses since about 2005 is of great concern. The increased numbers follow a general decrease in the 1990's.
Professionally, I'm interested in problem solving. Clearly, there are raw milk dairies doing something wrong, and most of the others doing something right. This is not a conspiracy theory. Most importantly, there are probably solutions. Bill/miguel – I'm open to your ideas. From a microbiologist point of view, I find the "set aside a pint" more related to quality than safety, but, hey, why not use and include your approaches in combination with other principles.
Per my question to miguel, I'd love to see the raw dairy outbreaks dissected to try to figure what happened. I doubt any government agency will do that because raw milk is not debatable; so it's up to your industry to isolate where the problems exist.
But, regarding the implication that hand sanitizers caused the Hartmann or other outbreaks: show me the data. I see no data linking the illnesses to sanitizers in anything you have presented, and won't make any decision based on "pet" theories. Be aware, I think chemical abuse has no place in food safety, but you simply cannot discount all the data from MN (or CO) based on an unproven theory that illnesses would not have occured if hand sanitizers or other chemicals wern'et used on the dairy. Geez, has anyone even documented the type, concentration and frequency of sanitizers on the Hartmann or Billy Goat dairies? The DNA fingerprinting has been taken to task – lets do the same with your chemical sanitizer data.
Just my thoughts.
MW
We use many of the same tests you do to assess our milk quality. A further test (or observation) is the health of the calves that are nursing some of the cows part of the day.
However, smell and taste tests are not completely objective or reliable due to the variability and sensitivity of the test instruments. For instance, our son's sense of smell is such that he could tell if there was gasoline in the milk but otherwise it would smell and taste good to him. Is there some way to sensitize a person's taste and smell senses to off flavors and odors in milk? How can different people's senses be objectively compared?
Has any research shown that fermenting milk turns gassy at a level of contamination lower than that which would negatively affect a human lacking discriminating taste and/or smell senses? I realize that no funding agency is interested in such research but I was hoping that there is some info available.
Thanks,
steve
The FDA does not get its budget or its teeth to go out on its long awaited "search and destroy" missions against Raw Milk everywhere….
http://www.foodsafetynews.com/2010/04/food-safety-bill-stalls-behind-financial-reform/
Halla Fricken Luhya!!!
Mark
I always value a second opinion from someone who has experience behind their opinion.What I am hoping is that farmers and consumers will realize that they do have the tools to form their own first opinion not just about quality but about safety.To me quality and safety are connected.
No,we can't detect 10 cells of e.coli o157:H7 in a ml of milk,but we aren't going to put that ml of milk in a solution of antibiotic and special o157:H7 growth medium.We are going to leave it in a solution of milk with(hopefully) plenty of lactic acid bacteria.When I suggest leaving the pint of milk out,I am looking to see if there is enough lactic acid bacteria in it to create an environment hostile to opportunistic bacteria.I have made my own cheese starter the way that Bill related and I guarantee that any starter that isn't perfectly sweet and delicious is going to be added to 100 gallons of milk.That would be foolish.If the starter is contaminated it will show itself in the finished cheese by puffing up.Any off taste or smell or lack of sweetness or bubbles is a reason to discard the starter.
When I referred to sanitizers I was talking about pipeline sanitizers,detergents and milk stone acid used to clean milking equipment not hand sanitizers.I don't know why you would use hand sanitizers while milking the cows.
Steve,
Gas is something best detected with your eyes.Normal clabbered milk does not have any bubbles in it.Bubbles in fermented milk indicate contamination.
To sensitize your taste buds start by comparing milk fresh out of each teat.When you find a teat that gives an unsweet taste,usually salty(high scc),save a cup of that milk and a cup of sweet milk from another teat.Let them clabber and taste them again.There are several tastes to consider in different parts of your mouth and the aftertaste.
http://www.foodscience.uoguelph.ca/dairyedu/grading.html
experience is the best way to learn.
Of course taste ,smell and sight are subjective,but so are the tests done in the lab.You can't depend on lab testing to insure quality and safety.At best they are a second opinion to keep you on your toes.
"I have made my own cheese starter the way that Bill related and I guarantee that any starter that isn't perfectly sweet and delicious is going to be added to 100 gallons of milk."
MIguel, surely you meant that any starter that isn't perfectly sweet and delicious IS NOT going to be added to 100 gallons of milk? That is, you would only add perfectly sweet and delicious starter to 100 gallons of milk.
Mark,
The byline for the link you posted http://www.foodsafetynews.com/2010/04/food-safety-bill-stalls-behind-financial-reform/ is dated April 16, 2010. Is the stall in S.B. 510 current news or old news? Is there anything newer than the April 16 article to give us hope that the vote on S.B. 510 will continue to be delayed?