October 2010

Enterobacter sakazakii was first described as a new bacterial species in 1980, and over a hundred scientific papers have been written about it. From 1980 to 2007 it was known as Enterobacter sakazakii, but in 2007 there was a proposal to reclassify it into a new genus Cronobacter as Cronobacter sakazakii. (1) For simplicity and for the reasons mentioned later, this discussion will continue to use the original name Enterobacter sakazakii. The proposed alternative classification is given as a section at the end and includes a discussion of the problems and the need for future studies.

Enterobacter sakazakii is a Gram-negative rod-shaped bacterium classified in the family Enterobacteriaceae. It has been isolated from three types of infection — devastating meningitis in very young babies (neonates), bacteremia (blood steam infection) in older babies, and a wide variety of infections (or colonization) in older babies, children and adults. The majority of infections reported in the peer-reviewed literature have described neonates—newborn infants, including premature infants, post-mature infants, and full-term newborns—with sepsis, meningitis, or necrotizing enterocolitis. (2) Although it has been isolated from cases of necrotizing enterocolitis, its causative role is unclear. (3)Continue Reading About Enterobacter Sakazakii (E. Sakazakii)

Bovine spongiform encephalopathy (BSE), referred to as "mad cow disease," is a chronic degenerative nervous system disease affecting cattle. The disease was first diagnosed in 1986 in Great Britain. BSE is so named because of the spongy appearance of the brain tissue of infected cattle when sections are examined under a microscope.

Affected animals may display changes in temperament, such as nervousness or aggression, abnormal posture and difficulty in rising, decreased milk production, or loss of body weight despite continued appetite. Affected cattle die or are killed.

The incubation period (the time from when an animal becomes infected until it first shows signs of disease) is from 2 to 8 years. Following the onset of clinical signs, the animal’s condition deteriorates until it dies. This process usually takes from 2 weeks to 6 months. 

Currently, there is no test to detect the disease in a live animal; veterinary pathologists confirm BSE by postmortem microscopic examination of brain tissue or by the detection of the abnormal form of the prion protein.Continue Reading Bovine Spongiform Encephalopathy, BSE, or “Mad Cow” Disease


Clostridium difficile (C. difficile) is a spore-forming, gram-positive anaerobic bacillus that produces two toxins: toxin A and toxin B. These toxins typically cause gastrointestinal disease, often with severe complications. In rare cases, C. difficile-associated disease can be fatal. Although C. difficile bacteria can be present in human intestinal tracts and cause no clinical symptoms (a condition called colonization), some individuals with C. difficile colonization are at increased risk of becoming ill. The most common risk factor for C. difficile-associated disease is exposure to antibiotics, especially those with broad-spectrum activity. Although less common, exposure to agents that suppress the immune system may also increase the risk of illness. Advanced age, severe underlying illness, gastrointestinal surgery, use of nasogastric tubes, and gastrointestinal medications (such as gastrointestinal stimulants or antacids) have also been associated with an increased risk of colonization. Most cases are acquired in hospitals or nursing homes, but an increased incidence of community–acquired C. difficile has been reported as well. Recent studies indicate that C. difficile can also be found in food products, thus raising a significant question: Can C. difficile cause foodborne illness?Continue Reading About Clostridium difficile

Cyclospora is a parasite composed of one cell, too small to be seen without a microscope. The organism was previously thought to be a blue-green alga or a large form of Cryptosporidium. Cyclospora cayetanensis is the only species of this organism found in humans. The first known human cases of illness caused by Cyclospora infection (that is, cyclosporiasis) were first discovered in 1977. An increase in the number of cases being reported began in the mid-1980s, in part due to the availability of better diagnostic techniques. Over 15,000 cases are estimated to occur each year in the United States. The first outbreak in North America occurred in 1990 from contaminated water. Since then, several outbreaks of cyclosporiasis have been reported in the U.S. and Canada, many associated with eating fresh fruits or vegetables. In some developing countries, cyclosporiasis is common among the population and travelers to those areas have become infected as well.
Continue Reading What is Cyclosporiasis?

Staphylococcus aureus (S. aureus), often referred to as "staph," is a bacterium commonly carried on the skin or in the nose of healthy people. S. aureus typically causes a skin infection, but can cause infections in the bloodstream and major organs. Methicillin-resistant S. aureus (MRSA) occurs when the bacteria become resistant to the antibiotic, methicillin and other more common antibiotics such as oxacillin, penicillin and amoxicillin, making it more difficult to treat. The rate of invasive MRSA (infections in typically sterile sites like the bloodstream) is estimated to be 32 per 100,000 persons in the United States; the mortality (death) rate is thought to be about 6 per 100,000 persons. The risk of invasive MRSA infections is highest among older individuals, Blacks/African Americans, and men.

MRSA infections were initially limited to hospitals and nursing homes, especially among patients with weakened immune systems. Since the 1980s, community-acquired cases and outbreaks also have been reported. Community acquired cases are those not related to past year hospitalization or medical procedures like dialysis, surgery, or catheterization. These infections typically occur among otherwise healthy individuals and are more likely to be limited to skin infections. An increase in the virulence of MRSA bacteria in the past decade, however, has been responsible for more severe and sometimes fatal community acquired infections. More recently, MRSA has been identified in food animals and a few outbreaks have been ‘food-initiated’ or foodborne. In one such outbreak, those affected developed typical foodborne illness symptoms, such as vomiting and stomach cramps.Continue Reading About MRSA (Methicillin-Resistant Staphylococcus Aureus)

In apparently unrelated matters, two corporations are recalling pork products due to listeria concerns.  To this point, neither recall has been linked to reported illnesses.  Valley Farm Meats, also known as Strasburg Provision, of Wooster Ohio is recalling 3,600 pounds of (primarily) pork products.  Autentico Foods of California is recalling 54,000 pounds of pork.

The…

Early last summer, at least 8 people were infected by E. coli O157:H7 after consuming raw milk produced at the Hartmann dairy farm in Sibley County.  Environmental and animal samples tested positive for the same strain of E. coli O157:H7 as had infected the outbreak victims.  Minnesota state health officials also, however, collected animal and environmental samples…

The Facts:

On October 21, 2010, the US Government filed a complaint for forfeiture in rem (meaning, a legal action to seize and condemn violative products) of raw milk-based cheese products manufactured by Estrella Family Creamery in Montesano, Washington. The government’s complaint identifies Estrella cheese products as having the potential to be contaminated by Listeria monocytogenes, a bacteria that can cause severe illness in human beings, including death in unborn children, the elderly, or people with compromised immune systems.  Finally, the government’s complaint was filed only after the FDA requested that Estrella recall all of its cheese products, which Estrella declined to do.

Post complaint is where the facts end and opinions and rhetoric begin.  Some comments are important, in some senses, and obviously true, like that the Estrellas are good people who do not want or intend their products to cause illness or death, which would be both bad for business and contrary to the principles by which the Estrella family obviously live their lives.  Many other comments from various corners, including the Estrellas themselves, are totally Irrelevant and only serve to perpetuate the view that certain raw milk devotees, including many producers whose products have sickened and killed people, can’t see the forest for the trees.  We are only a few months removed from the Hartmann debacle, where a Minnesota raw milk farmer fought the good fight, in his view, against indisputable evidence gathered by arguably the most competent health agency in the world.  These attempts to control the moral and scientific high-ground are as pathetic, in the face of competently gathered evidence, as they are, ultimately, totally misguided and wrong. 

So where is the reason in the debate over the current raw milk-based debacle in Montesano?  One place it doesn’t seem to be is in all the post-complaint rhetoric.  Neither God, nor guns, nor local versus monolithic agriculture really matter at all.  Each producer of food must be judged only by the quality of his products.

Again, The Facts:

The affidavit (see full affidavit below) filed in support of the government’s complaint against Estrella states that, in February and March 2010, listeria monocytogenes was isolated from finished cheese samples, salt brine used in the production process, and "throughout the production and storage areas."  On August 2, the FDA lab isolated listeria monocytogenes from processing and aging rooms at Estrella, including one room where cheese was being actively cut and wrapped for sale to consumers.  On August 16, a sample of "Caldwell Crick Chevrette" tested positive for listeria monocytogenes.  Notably, the August 16 positive test was generated from cheese produced on April 27, and was ready for sale and consumption in August.  Finally, FDA’s PFGE analysis showed that the February and August samples contained identical strains of listeria monocytogenes.

The gist of the evidence is that Estrella had a problem that went uncorrected and thus posed a continuing threat to consumer health.  This was not a facility that produces a product with a very finite shelf life.  Some cheeses are aged for two months, and some, evidently, for up to six months.  Notably, we are only a little more than two months removed from the last positive test in Estrella products and, again notably, the August and February tests were positive for an identical strain of listeria monocytogenes.  Estrella had a problem in its production processes that it did not, or could not, control.

In this situation, reason lies only in the facts.  The FDA has a public health mandate, and it must act to protect the public health (whether it does so indiscriminately is another matter altogether).  Fortunately for Estrella, it is now in an adversarial process where it will have the opportunity, in court, to prove that seizure and forfeiture of its products is unwarranted, and that the government is, in fact, incorrect. Continue Reading Is there reason hidden in the debate over Estrella cheeses?