The State Milk Board, in conjunction with the Missouri Department of Agriculture and the Missouri Department of Health and Senior Services, announced today that Homestead Creamery of Jamesport, Mo. is voluntarily withdrawing a batch of its Flory’s Favorite cheese from the marketplace.

Preliminary test results received from the Missouri State Health Laboratory indicate the cheese may be contaminated with Shiga-Toxin producing E.coli, which can lead to food borne illness. Confirmatory tests are ongoing.

The Homestead Creamery plant license to sell milk products in Missouri has been temporarily suspended, pending the results of the investigation by the State Milk Board and Missouri departments of Agriculture and Health and Senior Services.

The withdrawn product, Flory’s Favorite, is a 60-day aged cheese made with raw milk. Packages of the cheese are marked with “Packed On 210” on the label. This affects approximately 250 pounds of cheese and does not affect any other dairy products from Homestead Creamery.

The withdrawn cheese was sold at Homestead Creamery facility in Jamesport, Mo. and may have been sold by the following retailers:

HyVee in Liberty, Mo.

HyVee in Trenton, Mo.

Benedict Builders’ Farm in Knob Noster, Mo.

Milton Creamery in Milton, Iowa.

The Missouri State Milk Board continues to review the company’s records to determine when consumers may have purchased the product. Anyone who has purchased the cheese may return the unused portion to the store from which they purchased the product.

Yesterday the Missouri Department of Health and Senior Services (DHSS) announced that several cases of diarrheal illnesses in northwest Missouri, possibly caused by Shiga-toxin producing Escherichia coli (STEC) and including at least one confirmed case of E. coli O103.

According to information contained in the alert, the possible outbreak may be due to consumption of locally produced raw milk and other unpasteurized dairy products. Anyone with the signs or symptoms of STEC infection should seek immediate medical care, DHSS says. It suggests health providers evaluate patients adequately to determine if testing for STEC infections is warranted.

Symptoms of STEC infection include severe stomach cramps, diarrhea (which is often bloody), and vomiting. If there is fever, it usually is not very high. Most patients’ symptoms improve within 5–7 days, but some patients go on to develop hemolytic uremic syndrome (HUS), usually about a week after the diarrhea starts.

Acute renal damage, microangiopathic hemolytic anemia, and thrombocytopenia are the “triad of findings” that DHSS says add up to HUS. The Missouri health alert continues with advice for those making clinical decisions. It cautions that the use of antibiotics in patients with suspected STEC infections is not recommended until complete diagnostic testing can be performed and STEC infection is ruled out.

It says some studies have found that administering antibiotics in patients with STEC infections might increase their risk of developing HUS. If a patient has severe intestinal inflammation and perforation is a concern, antibiotic use may be warranted.

The Missouri public health alert includes specific instructions for medical personnel submitting patient stool samples that will be cultured to STEC O157:H7 and simultaneously assayed for non-O157 Shiga toxins. The Missouri State Public Health Laboratory is conducting the tests.