OPDCrawmilkThose January illnesses in California from E.coli O157:H7 linked to Organic Pastures Dairy Co. raw milk are continuing to stir controversy.

The latest controversy is being sparked by a new summary report on the illnesses issued by the California Department of Public Health, and  is at two levels:

1. The number of total illnesses from raw milk.

The CDPH reports there were ten illnesses associated with very similar E.coli O157:H7 in January, and at least six of them were likely caused by raw milk from OPDC.

“As of February 26, 2016, ten northern and central California residents infected with the outbreak strain of E. coli O157 and with illness onset in January have been identified,” the CDPH says in a summary report. The agency acknowledges that it could link only six of the illnesses to OPDC. “Of the nine (patients) that were interviewed, six (67%) reported consuming OPDC brand raw milk prior to illness onset and three denied known raw milk exposure.” A tenth person “was lost to followup and couldn’t be interviewed,” the agency says.

In conclusion, CDPH says, “The epidemiologic, laboratory, and environmental investigation strongly indicates that raw milk produced by OPDC in early January 2016 was contaminated with E. coli O157 and caused illness in at least six California consumers.” It adds its belief that all ten illnesses were associated with the dairy, noting “that the outbreak strain of E. coli O157 identified in this cluster is very uncommon. The predominant PFGE pattern combination EXHX01.6177 / EXHA26.0628 had only been seen once in the national PulseNet database prior to January 2016, in a child with illness onset in October 2015 who did not drink raw milk, though her family reported that they frequently drank OPDC raw milk…..the laboratory findings to date support that the outbreak strains are from a single source.”

Mark McAfee of OPDC has argued all along that not all ten illnesses were associated with raw milk.

2. The number of children sickened by raw milk and the number who may have developed hemolytic uremic syndrome (HUS). 

Here, McAfee is in disagreement with CDPH. The agency says, “The patients are primarily children, with a median age of 8 years (range, 1 to 26 years). Onset dates of illness ranged from January 14 to January 28, 2016. Four were hospitalized, including two children with hemolytic uremic syndrome.”

McAfee questions the state’s suggestion that the two children with HUS were associated with raw milk consumption. He contends that two of the four hospitalized children were among the group of at least four not known to have consumed raw milk, or had contact with those who consumed raw milk.

Of the two hospitalized children associated with raw milk, according to McAfee, one was hospitalized for two days, and never developed HUS. The other was hospitalized for 11 days, with HUS, and needed a blood transfusion, but didn’t require kidney dialysis.

“The state report implies four cases of HUS, and that is not true,” says McAfee.

McAfee says he has asked the CDPH to change the summary findings to clarify the number of HUS cases, and which were associated with raw milk.

The CDPH also appears to take issue with OPDC’s conclusion that a single cow was responsible for the entire episode of illnesses associated with OPDC in January. CDPH reports that it found the same rare strain of E.coli O157:H7 at OPDC in February, after Cow 149, thought by OPDC to be the only source of the offending pathogen, had been removed from the herd. “Feces, soil, and water collected from OPDC on February 8, 2016 tested positive for E. coli O157:H7, and PFGE patterns for those isolates also matched those patterns associated with the illnesses. The collection of environmental samples from OPDC on February 8, 2016 focused on feces likely deposited on February 6, 7, and 8. It is unlikely that the positive findings from February 8, 2016 represent conditions linked entirely to Cow 149. The isolation of E. coli O157:H7 and non-O157 Shiga toxin-producing E. coli from cattle used to produce raw milk for human consumption is concerning and could result in additional illness to raw milk consumers in the future if not addressed at the dairy.”

McAfee says he disagrees with the CDPH conclusion about the risk of additional illnesses. “They found the pathogen in dirt and manure in certain areas” during the February inspection. “That cow (#149) was not in those areas.” He says the presence of the E.coli pathogen in such places is something that occurs on dairy farms of all types. He blames the moisture of a very wet December. “Cow 149 was the vector” in the illnesses connected with OPDC, he maintains.

But he adds that in response to this latest outbreak, he has doubled OPDC’s testing so that it is testing 20 samples each day “in a co-mingled protocol.” That should reduce further the chances of contaminated milk being distributed, as was the case in January, when he says tainted milk was distributed because of a “false negative.”

McAfee also takes issue with my comparison in a previous post between OPDC and a previous producer of raw milk on California, Alta Deena, which had illness outbreaks associated with its milk. “We have 500 cows on 500 acres,” he says. Alta Deena was a confinement operation he says, with thousands of cows.