Food Poisoning, Foodborne Illness Information and Research : International Food Safety Network : BarfBlog

Oh, unpasteurized apple cider, when will you stop providing food safety moments?

It was 13 years ago last night that U.S. health investigators figured out that unpasteurized juice with apple cider as a base was making people sick with E. coli O157:H7 in the Pacific Northwest region.

On Friday, Amy made a stop at a local plant and produce shop to pick up a pumpkin.

Amy writes:

The woman behind the counter quipped, “It looks like you already have a little pumpkin” motioning towards Sorenne who was hanging off my hip.

As I was paying the woman asked me, “Did you get a chance to have a swig of our apple cider?”

There was a tray with about 10 dixie cups full of cider on the counter. I had looked at them with interest while waiting to pay. I used to love apple cider but Doug has taught me to be skeptical. I asked without thinking, “Is the juice pasteurized?”

The woman looked at me as if to say, of course not, but she said, “No, but there is a preservative in it,” sort of apologetically for the preservative not being natural.

“No thanks then, and especially not for my daughter.” “Oh no!” she replied. “I didn’t mean for her but for you.” I left it at that. I was in a hurry, the woman was helping me to the car with the pumpkin, and maybe she just didn’t know better.

In my mind I was screaming, “Lady, I don’t want to die from your juice either.” I called Doug to thank him for teaching me about food safety. Four years ago I would have unthinkingly and gladly drank the cider. And if I had a child, I would have also offered it to her, not knowing about E. coli or even questioning whether someone in a store would serve me unsafe food.

From the cider files:

In October, 1996, 16-month-old Anna Gimmestad of Denver drank Smoothie juice manufactured by Odwalla Inc. of Half Moon Bay, Calif. She died several weeks later; 64 others became ill in several western U.S. states and British Columbia after drinking the same juices, which contained unpasteurized apple cider --and E. coli O157:H7. Investigators believe that some of the apples used to make the cider may have been insufficiently washed after falling to the ground and coming into contact with deer feces.

In the fall of 1998, I accompanied one of my four daughters on a kindergarten trip to the farm. After petting the animals and touring the crops --I questioned the fresh manure on the strawberries --we were assured that all the food produced was natural. We then returned for unpasteurized apple cider. The host served the cider in a coffee urn, heated, so my concern about it being unpasteurized was abated. I asked: "Did you serve the cider heated because you heard about other outbreaks and were concerned about liability?" She responded, "No. The stuff starts to smell when it's a few weeks old and heating removes the smell."

Here's the abstract from a paper Amber Luedtke and I published back in 2002:

A review of North American apple cider outbreaks caused by E. coli O157:H7 demonstrated that in the U.S., government officials, cider producers, interest groups and the public were actively involved in reforming and reducing the risk associated with unpasteurized apple cider. In Canada, media coverage was limited and government agencies inadequately managed and communicated relevant updates or new documents to the industry and the public.

Therefore, a survey was conducted with fifteen apple cider producers in Ontario, Canada, to gain a better understanding of production practices and information sources. Small, seasonal operations in Ontario produce approximately 20,000 litres of cider per year. Improper processing procedures were employed by some operators, including the use of unwashed apples and not using sanitizers or labeling products accurately.

Most did not pasteurize or have additional safety measures. Larger cider producers ran year-long, with some producing in excess of 500,000 litres of cider. Most sold to large retail stores and have implemented safety measures such as HACCP plans, cider testing and pasteurization. All producers surveyed received government information on an irregular basis, and the motivation to ensure safe, high-quality apple cider was influenced by financial stability along with consumer and market demand, rather than by government enforcement.
 

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I try and take baby Sorenne and the dogs out every day for a three-mile walk. The dogs get to run off-leash on the trail, and I get to work on burning off that baby weight.

Sorenne usually conks out after 15 minutes of walking, and then I catch up on phone calls. It’s my kind of multi-tasking.

A reporter called a few days ago while out on one of these walks. She asked me about raw milk, I said I don’t care, it gets far too much attention and that public health folks have better things to do.

I also told her I had baby brain and was having trouble articulating. There’s a reason people have kids when they’re young -- like I did with the other four – and not when they’re 46. Ah but it’s fun (see the video clip below – and I do compost).

The Canwest News Service story reporting that interview showed up tonight, and has the usual raw milk stuff, with me saying it is difficult to change the minds of people who hold "hocus-pocus scientific theories about the nutrient benefits of raw milk."

Amy laughed at that.

"From a public health point of view, it's a no brainer, don't drink it," Powell said. "From a consumer point of view, why not make raw sprouts illegal because there is the risk of Salmonella or E. coli?"

Powell said he doesn't take issue with adults choosing to drinking raw milk, but it's usually children who get sick because of their parents dietary choices.

What I would have added is that with sprouts and other foods, there’s no simple control like there is with raw milk – pasteurization.

A table of raw dairy outbreaks is available at http://www.foodsafety.ksu.edu/articles/1138/Raw_Milk_Outbreak_Table.pdf

And here’s an op-ed Brae and I wrote a couple of years ago that predated barfblog.com. But the video at the end is far more interesting.

About Choice

Michael Schmidt, Ontario’s raw milk lord along with his evangelical disciples, maintain that their crusade is about choice.

Choice is a Good Thing.

But the 19th century English utilitarian philosopher, John Stuart Mill, noted that absolute choice has limits, stating, "if it [in this case the consumption of raw unpasteurized milk] only directly affects the person undertaking the action, then society has no right to intervene, even if it feels the actor is harming himself."

Excused from Mill’s libertarian principle are those people who are incapable of self-government – children.

In September, two children who drank raw milk from a Whatcom County dairy in Washington State became ill with E. coli O157:H7. At the same time, four children, including two eight-year-olds in San Diego County, Calif., were hospitalized with E. coli infection after consuming raw milk products.

In December 2005, 18 people in Washington and Oregon, including six children, were infected with E. coli O157:H7 after drinking an unlicensed dairy's raw milk.

Two of the kids almost died.

In April 2005, four cases of E. coli linked to unpasteurized milk were reported to Ontario health officials -- in this case, from an individual who routinely sold raw milk from the back of a vehicle parked in the city of Barrie. Dozens of other outbreaks are listed at: http://www.foodsafety.ksu.edu/articles/384/RawMilkOutbreakTable.pdf

Ontario finance minister Greg Sorbara can obliviously insist that "raw milk is safely distributed in parts of the United States and Europe" but politicians are expected to spin facts.

So are lobbyists. Thus it was that the Toronto contact for an organization strongly advocating raw milk successfully passed himself off in the National Post this morning as a food safety researcher.

Schmidt, celebrity chefs and the wannabe fashionable can devoutly state that grass fed cattle is safer than grain-fed by spinning select scientific data, except cattle raised on diets of grass, hay and other fibrous forage do contain E. coli O157:H7 bacteria in their feces as well as salmonella, campylobacter and others.

Poop happens, especially in a barn, and when it does people, usually kids, will get sick. That's why drinking water is chlorinated and milk is pasteurized.

From Kansas, this looks like an awfully familiar clash of science and faith. But it's not so simple as natural is good, and science -- in this case pasteurization -- is bad. Science can be used to enhance what nature provided; further, society has a responsibility to the many -- philosopher Mill also articulated how the needs of the many outweighed the needs of the one -- to use knowledge to minimize harm.

There are lots of other foods that make people sick. On the one-year anniversary of the Ontario salmonella-in-sprouts outbreak that sickened 650 people, raw sprouts are widely available and no one seems to notice. After being banned for three weeks, raw mung bean sprouts were back on grocery store shelves and being placed ever so gingerly on gourmet, supposedly healthy sandwiches.

This fall, it was spinach, lettuce and tomatoes sickening hundreds across North America. So why aren't Ontario government-types, who treat an outwardly eco-friendly and holistic health product like raw milk as a major biohazard, setting their sights on fresh produce?

Part of the answer is that the risks associated with fresh produce have only been recognized in the past decade; the risks associated with raw milk have been recognized for over a century. Further, unlike fresh produce, there is a relatively simple and benign solution for producing safe milk: pasteurization.

And perhaps that is why health officials are adamant that a ban stay in place: there simply isn't the resources to manage all the microbial food safety outbreaks that strike down 11-13 million Canadians each year, let alone someone proselytizing the virtues of raw milk while flaunting the law.

The only things lacking in pasteurized milk are the bacteria that make people - especially kids - seriously ill. Adults, do whatever you think works to ensure a natural and healthy lifestyle, but please don't impose your dietary regimes on those incapable of protecting themselves … your kids.
 

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Hollywood heavyweight Martin Sheen is lending his voice to the battle to protect consumer choice, as a measure to help keep safe, well-regulated raw milk on California store shelves heads to Governor Arnold Schwarzenegger for signature.

At least that’s what the press release from California State Senator Dean Florez, D-Shafter, says. Sure, consumers can have choice. And lawyers like Bill Marler and the victims of foodborne illness have the choice to litigate against those who peddle poop. Whole Foods may as well paint a bullseye on its logo.

The Connecticut Department of Agriculture has a comprehensive report on its most recent investigation of raw milk related illness at

http://www.ct.gov/doag/lib/doag/marketing_files/bulletin/Wednesday_Augus t_20_2008_issue.pdf

On July 16th, 2008 the Connecticut Department of Agriculture began an investigation of a possible link between several reported illnesses and the consumption of Retail Raw Milk (unpasteurized milk). Recently we concluded that investigation. The investigation was prompted when the Department was notified by Connecticut Department of Public Health (DPH) Epidemiologists of 2 reported illnesses in which both patients had consumed Retail Raw Milk from a dairy licensed to produce Retail Raw Milk and pasteurized milk and milk products. The patients were aged 2 and 7, one was on dialysis. After notifying the dairy of the investigation, the dairy voluntarily stopped sale of all milk. Soon after the initial 2 reported illnesses, DPH reported 2 additional cases linked to the dairy. By the time we concluded our investigation a total of 7 known individuals were sickened from consuming Retail Raw Milk and several were hospitalized. The Retail Raw Milk implicated in this incident was purchased from 2 separate national, natural food, chain store locations and directly from the farm. None of the reported illnesses were linked to pasteurized milk and milk products produced at this dairy. The individuals sickened had acquired a condition known as Hemolytic Uremic Syndrome (HUS) and one case of Thrombotic Thrombocytopenic Purpura (TTP). HUS is a disorder that occurs when an infection in the digestive system produces toxic substances that destroy red blood cells. …

After extensive testing of milk, milk contact surfaces, water sources, the environment in and around the farm and processing plant and, analysis of feces from each milking aged animal, the department obtained a genetic fingerprint match between E. coli O157:H7 recovered from the feces of 1 cow and E. coli O157:H7 isolated from 3 patients. Approximately 170 separate samples and specimens of milk, water, feces and swabs of milk contact surfaces were analyzed by the DPH Public Health Laboratory in a 3 week period. …

The department has concluded that the most likely cause of this food borne illness outbreak was the consumption of Retail Raw Milk contaminated with E. coli O157:H7. While good sanitation and management practices can lower the incidence of pathogens in raw milk we believe and studies support the position that pasteurization is the only proven way to eliminate pathogens from raw milk.
 

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