Wise Traditions 20091 Impacts of Public Reporting of Outbreaks It is acknowledged that when any...

Wise Traditions 2009 1

Impacts of Public Reporting of Outbreaks

It is acknowledged that when any apparentoutbreak is announced, there is an increase in:

– Number of people reporting similar illness

– The health professionals focus their surveillance to that specific illness and food

– Decrease in awareness of illness not associated with the announced food


Ease of Recognizing Milkborne Illnesses by Spotting Clusters

Characteristic FUWM Operation Industrial Dairy

Herd size Small Large

Comingling milk from different farms Rare Standard Practice Inputs NO Universal

Diversity of Products Limited Common

Distribution Range (geographic) Very Limited Extremely wide

Traceability Nearly instantaneous Extraordinarily difficult

Potential exposed population Modest and well defined Huge, Undefined Number of customers from single batch

(batch size)Small , easily determined Huge

Exposure interval Usually one week Long

Public Health Impact Very small Huge


Outbreaks and Public Health Impact


* There are a number of slide coming up that show “outbreaks” of illness.

• An outbreak is defined as 2 or more illness that are considered to have common cause.

• There are a number of sources for the data I will be showing. But they are not my data.

• Furthermore, by showing the data I am not saying that they actually reflect proven cases of illness associated with a given food. In nearly all cases they have been identified by a government agency, investigated, and reported in official documents or published in journals.

• Some of the associations are questionable, but I am showing the data unedited. The * will indicate that I am NOT saying the data is valid.


Foodborne Outbreaks in USA *

0

200

400

600

800

1000

1200

1400

Sal

mon

ellla

spp

E. c

oli O

157:

H7

Cam

pyoo

bact

er je

juni

List

eria

mon

ocyt

ogen

es

Yer

sini

a

USA Identified Foodborne Outbreaks1997-2006 [CDC data]

Total Identif ied FoodborneOutbreaks USA 1990-2006

Milk related Outbreaks tenyrs (1997-2006)

76 Million people sick from foodborne illness

Includes 350,000 hospitalizations

5,000 deaths

In USA each year

Bars are accumulated totals over period

1997-2006



Est Cases in Outbreaks Attributed to Pasteurized MilkData from CDC and Oliver review

050

100150200250300

1973

1975

1977

1979

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

2007

Listeria ( 2,500 )

Yersinia ( 100,000 )

Staph ( 185,000 )

E.coli O157:H* ( 73,000 )

Campylobacter ( 2,500,000 )

Salmonella (1,400,000 )

Est. Cases in Outbreaks Attributed to Raw MilkData from CDC and Oliver review

0

50

100

150

200

25019

80

1982

1984

1986

1988

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008


0

5

10

15

20

25

30

35

Prior 2004 2005 2006 2007 2008 2009

Total Dairies Licensed

Texas Grade A Raw Milk



Est Cases in Outbreaks Attributed to Pasteurized MilkData from CDC and Oliver review

050

100150200250300

1973

1975

1977

1979

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

2007

Listeria ( 2,500 )

Yersinia ( 100,000 )

Staph ( 185,000 )

E.coli O157:H* ( 73,000 )

Campylobacter ( 2,500,000 )

Salmonella (1,400,000 )

Est. Cases in Outbreaks Attributed to Raw MilkData from CDC and Oliver review

0

50

100

150

200

25019

80

1982

1984

1986

1988

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008


Relative Risky Behavior

• 1 out of every 4 people have a foodborne illness every year

• 1 out of every 20,000 people who drink fresh unprocessed milk may become sick each year

• More people are killed each year from lightning strikes on golf courses than die from milkborne illness.

• More people die from defective toasters

• Unpasteurized milk is not even on the list of the top 10 most risky foods.


What are the real food safety Risky Behaviors ?

• Industrial operations that favor investor profits rather than public health/safety

• Highly processing foods

• Co-mingled of ingredients and products

• Sourcing from variable and multiple locations

• Wide final distribution of the product

• Distribution under numerous brand names


Any illness and certainly death is a genuine tragedy to the individuals and an empathetic community. And every outbreak must be aggressively investigated to determine if there was a breakdown of best practices, or to determine if new practices would have averted the outbreak.

However, outbreaks should not be exploited to fuel the obsession of those that want to eliminate any access to raw milk. Responsible public health policy must start with the acknowledgment that our lives can never to totally free of risk. No food can ever be considered completely safe.


Reframing the question: Is there evidence that pasteurization would have prevented these outbreak?

• Examination of the actual historical records in the period after 1900, confirm reports of outbreaks of the epidemic illnesses associated with milk.

• Nearly all of these identified milk handlers who were either sick or carriers; or milk containers that were contaminated.

• And since it was not “the milk” pasteurization would not have prevented those outbreaks.

Currently, outbreaks should not be attributed to raw milk unless you confirm that the milk that was consumed contained the specific virulent bacteria causing the illnesses


What is a Health Hazard?

What is the Public Health Interest ?


9 And don’t forget…milk is inherently hazardous


Irrational conclusion based on these dogma

Since it will be shown that ultimately there are illness and even some deaths attributed to each fresh food.

Therefore, based on the words and actions of those obsessed with banning raw milk the government will be obligated to ban all fresh food that has not been pasteurized in some form!


Shedding of C. jejuni


Positive tests for E. coli O157:H7 in feces

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