It may be only a rarity that a widely contaminated food product distributed to a major grocery chain all over an entire region of the country does not cause many severe illnesses. Even though there are at least 37 confirmed illnesses in the cheese E. coli outbreak, many people probably escaped severe illness under some relatively difficult epidemiological circumstances. It is important to recognize an ongoing, collaborative job very well done by local, state and federal health organizations involved in the investigation.

Sick people in the outbreak purchased or ate Bravo Farms gouda cheese at many different Costco locations in a number of major metropolitan areas throughout a 5 state region, including California, Arizona, New Mexico, Colorado, and Nevada. Important to also note that the cheese was not only sold to consumers, but also tasted by them at sampling stations. If people’s food recall is bad with major items that they may have eaten, what’s it like with items that are merely sampled as a shopper walks by?

Nevertheless, health agencies from affected states, together with CDC and PulseNet, recognized the pattern of matching E. coli illnesses and didn’t hesitate to call the outbreak when they saw it. Their work has resulted in detection of the outbreak strain in multiple packages of opened Bravo Farms gouda cheese. And the CDC stated yesterday that the New Mexico Department of Health isolated the outbreak strain of E. coli in an unopened (intact) package of cheese.  And it certainly doesn’t hurt that Denver/Boulder and New Mexico are FoodNet sites, which is a collaborative epidemiological project with the CDC and several states and metro areas.  Also, although Arizona and Maricopa County are not FoodNet members, they are particularly aggressive in investigating reported cases of foodborne pathogens.

But still, questions remain. What was the precise cause of the outbreak? Was the raw milk used to make the gouda cheese from a reputable producer (I think we know it was the milk)? Or was it CAFO-style milk from somebody who had no business supplying product for human consumption. Was the mandatory 60 day aging period for raw milk-based cheeses adhered to? Does it even matter if the answer is yes? Or is the 60 day period really an insufficient prophylactic against contamination, given the nature of the raw material used to produce the cheese. And what was the production environment like? FDA is at the Bravo Farms facility testing environmental and product samples; we’ll publish the results when they are released.