A 10-month-old baby in Tennessee developed a life-threatening condition last year and spent 27 days in the hospital with kidney failure after drinking raw milk from a cow, Tennessee health officials reported Thursday.
At least five people became sick from raw milk from the cow’s share, including another 10-month-old baby who spent a day in hospital.
The direct sale of raw milk is illegal in Tennessee because of the danger that the unpasteurized dairy product can easily contain deadly pathogens that come from livestock. Nevertheless, the law is circumvented through cow or herd shares, whereby one buys part of an animal or herd and is allowed to use the milk from the animals for personal use.
In this case, the cow share served 125 households across Georgia, North Carolina and Tennessee. The two seriously ill babies were not among them – their families obtained the raw milk second-hand from participants in the cow share.
After reports of the two sick babies, health officials launched an outbreak investigation and contacted the farm – which was not easy. The farm was in a rural area and had no telephone or electricity. Health researchers had to go there in person to inform the study owners before returning for the environmental assessment. Once they did, they identified “possible routes of fecal contamination during milking” and unsafe milk storage temperatures.
Instead of refrigerating the potentially contaminated raw milk, the farm kept it cool using “mechanical circulation of cool spring water” and coolers filled with ice. As a result, the milk did not stay at the recommended temperature of 4°C (40°F) or lower. Samples taken from the farm revealed a Shiga toxin producing Escherichia coli (STEC) that genetically matched the strains found in one of the sick babies.
Outbreak risk
The farm gave the researchers a list of the 125 cow share participants. But the researchers could only get phone numbers for 109 of them, and they could only reach 50 of those (40 percent of the participants). That contact attempt helped identify three more cases in one household. Those three cases did not require hospitalization like the cases of the two babies.
One of the sick babies, the one who nearly died, developed hemolytic uremic syndrome (HUS) from the bacterial infection, which is most common in young children. HUS is characterized by the destruction of red blood cells, inflammation of blood vessels, and kidney damage, which can lead to high blood pressure, seizures, blood clotting problems, kidney failure, coma, and death. The baby required hemodialysis during the month-long hospital stay, but thankfully recovered.
Such outbreaks involving raw milk are relatively common. While outbreaks with pasteurized milk do occur occasionally, the risk of an outbreak is about 150 times higher with raw milk than with pasteurized milk, the Centers for Disease Control and Prevention estimates. And hospitalizations are 13 times higher for outbreaks related to raw milk than for pasteurized milk, which usually involve mild viruses or toxins.
Nevertheless, Tennessee health officials reported that the farm at the center of the outbreak planned to continue producing raw milk. And the state can do little about it. The health officials sent out educational letters to the cow share participants and asked the Agriculture and Natural Resources Team at the University of Tennessee Extension to visit the farm and discuss best milking practices with the owner.
“Raising awareness of inherent health risks of raw dairy products in Tennessee could prevent further morbidity,” the officials concluded.
