I think it’s important in the debate I summarized in my last posting to distinguish between mindsets and ideology.
For myself, I’m talking about a mindset. I’ve come to see the world of healthcare and disease much differently than I did five years and ten years ago. But while I suspect that the obsession of our society with chasing down E.coli is a fool’s errand, and a diversion from bigger problems like chronic disease, I don’t pretend to have definitive answers. To Melissa, I’d just say that I’ve had my own life-threatening illness, and I now apply my new mindset to that as well—that it was likely an outgrowth of an imbalance in my own system.
I don’t have a problem with those like Mary McGonigle-Martin and others who want to rinse their organic vegetables in a solution with a bit of hydrogen peroxide or provide warnings with food. Where I really agree with her is that the challenge in changing attitudes is an educational one.
To me, the biggest education challenge is getting people to change their mindsets in the face of a culture that is so heavily oriented toward praying for miracle drugs to solve our health care problems. I wrote recently in BusinessWeek.com about a man—William Parker, the owner of a Detroit restaurant—who made a radical shift in his views about his own health problems. But the decision to transform his restaurant from a greasy spoon into a health oasis where he won’t serve food he wouldn’t eat himself was a function of a big shift in mindset.
On the ideology side, we have Mark McAfee, the owner of Organic Pastures, the Californian raw milk dairy. For what I can only assume are ideological reasons (though maybe they are legal reasons), he can’t acknowledge even the possibility that individuals might have become ill from his milk last fall.
He expresses his version of what happened to Mary McGonigle-Martin’s son in a very interesting exchange with Mary in the comments following Suzanne Nelson’s excellent article on raw milk in a North Carolina paper. (For the exchange, take a look at the last four comments, though many of the earlier comments from other individuals are extremely interesting as well.)
An ideologue like McAfee heard what he wanted to hear, and no additional facts are going to change his mind of what occurred. That kind of approach tends to sidetrack the discussion, and turn off individuals like William Parker who want to learn and are open to changes in their mindsets.
From 1973 through 1992, there was one out break of e-coli contamination involving raw milk. The date, state, and details are not specified, but it involved 6 people. This data was taken from a study which was published in the American Journal of Public Health. The article was titled, The epidemiology of Raw MilkAssociated Food Borne Disease Outbreaks Reported in the United States, 1973 Through 1992.
In 2005, you have the Washington outbreak infecting 18 people.
In 2006, you have the OP incident involving 4 children, but technically it is unfounded because unlike the Washington case, there were no hard facts implicating the milk.
What this means is that in 34 years you have possibly 28 people that were contaminated from e-coli 0157:H7 due to drinking raw milk. I say possibly only because we dont have any details on the first group of six and the OP incident is only speculation. We only have hard facts on one incident involving 18 people. This incident is outlined below.
The CDCs March 2, 2007 MMWR ( Morbidity & Morality Weekly Report) is titled Escherichia coli 0157:H7 Infection Associated wth Drinking Raw Milk; Washington and Oregon, November, December 2005. In short, it is an analysis of a retrospective cohort study conducted on this outbreak.
This study provides many useful insights into e-coli contamination in general and especially regarding e-coli contamination involving raw milk.
Heres the facts:
This was an unlicensed cow-share program involving 5 cows and 45 families
43 of the 45 families were interviewed and information on 157 persons was collected. 140 of the 157 drank raw milk during the outbreak (November 20-December 13
18 cases of e-coli 0157:H7 were identified but only 8 were laboratory confirmed
5 of the 18 were hospitalized and 4 of the 5 developed HUS
17 were shareholders or children of shareholders and 1 child, age 10, was a friend of a shareholder (DG wrote about this possibly in an earlier postShould you give your neighbors child raw milk?)
The relative risk for illness increased with the average number of cups of milk consumed daily
E-coli 0157:H7 was isolated from raw milk samples obtained from the farm and one shareholder and seven environmental samples collected from the floor of the farms milking parlor.
No e-coli was isolated from stool samples of any of the farms five cows
This is what was written about the sanitation standards on the farm;
During inspections of the farm, officials from the Washington State Department of Agriculture noted mud and manure accumulation in the entrance to the milking parlor and on the rubber mats covering the dirt floors of the parlor. The bucket used for milk collection had direct contact with these surfaces. Inspectors also noted inadequate hand-washing facilities and improper procedures for cleaning milking equipment and handling fresh milk.
My thoughts on this information:
140 people drank the raw milk, but only 18 became ill. This provides evidence that each persons immune system plays a role when exposed to this pathogen.
Only 44% of the people infected were confirmed cases of e-coli 0157:H7. This demonstrates that it is not always easy to isolate the bacteria.
Cows typically shed e-coli in the spring and summer months, but this study reveals that they can shed e-coli at any time. There is no safe time of the year regarding e-coli contamination.
If you end up in the hospital with e-coli, your chances of developing HUS are extremely high.
Absence of e-coli 0157:H7 in the cows colons does not mean anything. This supports the information Miguel provided about the transient nature of e-coli. Here one minute and gone the next.