The U.S. Centers for Disease Control and Prevention (CDC) issued a multistate outbreak alert on Friday, March 19, 2016, for a fatal outbreak of Listeriosis linked to raw milk produced by Miller’s Organic Farm in Pennsylvania.
Breaking Down the Outbreak
One illness involving the outbreak strain of Listeria was confirmed in Florida. A second outbreak case was confirmed in California, for a current total of two cases involved in this outbreak. The outbreak cases occurred in individuals 73 and 81 years old. The CDC has not released information regarding which case originated in Florida and which case originated in California.
Both cases required hospitalization. While the case from California was able to recover from the illness and eventually leave the hospital, the outbreak victim in Florida died as a result of the infection caused by ingesting contaminated raw milk.
To determine the source of the outbreak, public health officials spoke with the recovered patient, who reported consuming raw milk prior to becoming ill. Family members of the deceased outbreak victim were also contacted by officials. The family confirmed that raw milk was also consumed by their late relative, and were also able to identify the source of the raw milk as Miller’s Organic Farm, an Amish farm located in Bird-in-Hand, Pennsylvania.
Tests run by public health officials on samples of Miller’s Organic Farm raw milk collected in November 2015 generated results that confirmed the presence of Listeria bacteria in the product. In January, the FDA conducted testing on samples of raw chocolate milk produced by Miller’s Farm and again confirmed the presence of Listeria in the raw milk tested.
Better Regulation, Better Coordination, Better Cooperation, and Better Results
Any outbreak is a significant public health event, and some, such as this one, produce particularly cruel and tragic results. That being said, at this point in our discussion of the outbreak, it would appear to be a fairly straightforward outbreak investigation; however, in this case, appearance does not reflect reality. The investigation, characterized by the CDC as a “collaborative investigative effort…of state, local, and federal public health and regulatory official” identified a previously undetected outbreak that dated back two years, to 2014, and then proceeded to identify the outbreak’s likely source.
Both the case requiring hospitalization and the fatal case occurred during 2014. Despite the fact that the illnesses occurred two years ago, the source of the bacteria was not known until the U.S. Food and Drug Administration (FDA) contacted the CDC on January 29th, 2016, to inform the agency that recently-conducted whole genome sequencing of Listeria bacteria recovered from samples of raw organic chocolate milk produced at Miller’s Organic Farm revealed that the bacteria that was then being tested was genetically closely related to the Listeria bacteria from the two 2014 cases.
Once the two outbreak cases were identified, public health officials began the task of identifying the outbreak source. To obtain the information regarding the outbreak cases’ consumption of raw milk discussed above, officials spent several weeks interviewing the outbreak survivor and friends and family members of both individuals that were infected.
It was in the course of those interviews that health officials confirmed that the surviving outbreak case had consumed raw milk in the days leading up to the outbreak, and that the fatal case had purchased and consumed Miller’s Organic Farm raw milk. These findings were consistent with officials’ theory of the case. That raw milk was concluded to be the source of the outbreak makes logical sense: persons who consume raw milk increase the likelihood of experiencing a an illness associated with foodborne pathogen by a factor of one hundred and fifty times (150); both cases confirmed consumption of raw milk and, in one of the cases, confirmed that the specific raw milk purchased was raw milk produced at Miller’s Organic Farm, where – to take things full circle – Listeria bacteria, found in milk produced there in late 2015, were found to be an incredibly close genetic relative of the strain that led to the 2014 outbreak.
There may be additional outbreak cases in addition to the two that have already been confirmed. The investigation into the outbreak “is ongoing,” states the CDC, which along state and public health partners is continuing laboratory surveillance through PulseNet to identify other individuals that may have contracted the outbreak strain of Listeriosis.
If Raw Milk is Risky, Miller’s Organic Farm Raw Milk May Be Outright dangerous…
We now know that raw milk produced at the Bird-In-Hand, Pennsylvania establishment contained the virulent Listeria bacteria in 2014, a contamination that cost at least one individual their life. We also know that raw milk produced at the same establishment two years later was not only contaminated with Listeria, but was contaminated with a strain of Listeria with a high degree of genetic relation to the strain that had led to at least one hospitalization and one death two years prior.
These facts have not escaped the CDC. In Friday’s outbreak alert, the CDC makes explicit its concerns regarding Miller’s Organic Farm going forward into the future, stating that “because Listeria was recently found in raw milk produced by Miller’s Organic Farm,” the organization “is concerned that conditions may exist at the farm that may cause further contamination of raw milk and raw dairy products distributed by this company and make people sick.”
The CDC evidences its level of concern again near the end of the alert, this time focusing on biological threats currently in or about to enter the stream of commerce (as opposed to the future-looking concerns voiced earlier in the alert that evidenced fear of future outbreaks – perhaps not far out in the future, but in the future nonetheless). The CDC speaks on its own behalf, stating that “because Listeria was recently found in raw milk produced by Miller’s Organic Farm, we are concerned that raw milk and other dairy products from this company could still be on the market and make people sick.”
…though Miller Himself Disagrees.
The owner of Miller’s Organic Farm, Amos Miller, expressed no great concern regarding the current developments and ongoing events.
Miller stated that the company is arranged to operate as a private membership club. Pursuant to the arrangement, only members in the club may purchase the milk and other products that are produced on the farm. The arrangement is legal under Pennsylvania state law, and the establishment does not distribute its products to retail stores or other outlets.
Though the farm is an Amish operation, Miller, who agreed to an interview with CBS News, was updated regarding the situation and continued to receive the most recent information regarding the developments in the 2014 cases and the recent positive test results. Confronted with all of the evidence, some recently uncovered, indicating that at least some raw milk produced at the facility in 2014 was contaminated with Listeria bacteria and that the milk again very recently tested positive and would be considered adulterated by virtue of Listeria contamination. Miller stated that he was unaware of any health problems caused by his company’s raw milk, which he is presently and plans to continue selling, and further asserted that there was no proof that any contamination occurred on his physical farm grounds.
“I don’t know that it was proved its on the farm here,” the owner stated, adding that “we hope and pray for the best.”
Despite Miller’s insistence that raw milk is safe for human consumption, the FDA and CDC both adamantly recommend that consumers avoid raw milk. The FDA warns that unpasteurized milk may “harbor dangerous microorganisms that can pose serious health risks to you and your family,” while the CDC provides raw milk fact sheets and studies, including one study that concludes the risk of an outbreak caused by raw milk is at least 150 times the risk of an outbreak caused by pasteurized milk.