Consumption could lead to E. coli infection, serious illness

The Kentucky Department for Public Health is warning consumers about the dangers of consuming unpasteurized milk as well as other products that could lead to disease-producing E. coli infection, following a recent outbreak in North Central Kentucky and the hospitalization of four children.

DPH has been working with local health departments, hospital and the provider community to investigate the outbreak. Four of the five children associated with the cluster developed Hemolytic Uremic Syndrome (HUS), a disease caused by the most severe E. coli infections which may result in life-threatening kidney failure.

“At this time, we know that all of the children consumed unpasteurized milk, which is different from the milk and dairy products you purchase at the grocery store,” said DPH Commissioner Stephanie Mayfield, M.D. “Unpasteurized milk is dangerous and has not undergone a process to kill bacteria before it is consumed, meaning it could contain disease-causing agents such as E. coli. The health of anyone who drinks unpasteurized milk can be affected if they are exposed to E. coli or other bacteria that can cause very serious illness, but the risk is even greater for children.”

The sale of raw, unpasteurized milk is illegal in the state of Kentucky. However, individuals sometimes gain access to unpasteurized milk and consume the product despite the associated health risks.

“Raw milk, no matter how carefully it is produced, may contain pathogens,” said Mayfield. “Just as we recommend that you don’t eat raw hamburger, pork or fish, we also advise that consumers don’t drink raw, unpasteurized milk.”

According to DPH, children are more likely than adults to develop complications of E. coli infection, especially if they are younger than 5. Signs of an infection include diarrhea, stomach cramps, nausea and vomiting. HUS only develops in a small percentage of children with E. coli infection, but is a serious health concern. The condition can cause seizures, altered mental states, confusion, fatigue, dehydration, neurological complications and kidney failure. Patients with severe kidney disease may require dialysis. Three to 5 percent of HUS cases result in death, according to the National Institutes of Health.

Confirming a direct link to a given source of food or milk that causes an outbreak can be difficult, especially in situations where exposures occurred over a brief window of time. Laboratory testing has not yet definitively identified the source of the recent illnesses.

DPH is stressing the dangers of unpasteurized milk after learning all the affected children had consumed it and because it is a known source of E. coli bacteria, as well as numerous other pathogens that can lead to illness.

The pasteurization process, which uses heat to treat raw milk and kill pathogens, has been used since 1908 to assure the health and safety of the milk supply. All milk sold in Kentucky must be pasteurized, which is noted on the product label. If individuals are unsure if milk is pasteurized, they are advised to check the product labeling, ask their clerk or grocer, or to throw it out if pasteurization cannot be verified.

“Do not purchase milk unless you can verify that it has been pasteurized,” said Lewis Ramsey, manager of the DPH milk safety branch.

According to the Centers for Disease Control and Prevention (CDC), from 1998 through 2011, 148 outbreaks due to consumption of unpasteurized milk or unpasteurized milk products were reported. These resulted in 2,384 illnesses, 284 hospitalizations and two deaths. Most of these illnesses were caused by E. coli, Campylobacter, Salmonella or Listeria.

“Unpasteurized milk is not safe for consumption,” said Mayfield. “Anyone who consumes or is planning to consume unpasteurized milk should consider the risks. We are asking you to do what is necessary to avoid exposure to E. coli or other sources of illness that could result from consuming products that have not been properly treated to eliminate bacteria.”

In addition to only drinking pasteurized milk, the public can help prevent HUS and E. coli infections by:

• Thoroughly washing produce before eating;

• Washing hands frequently for at least 20 seconds with soap and water, especially after going to the bathroom, handling raw meat and eggs, or petting animals;

• Thoroughly cooking meat;

• Cleaning and sanitizing food preparation areas;

• Avoiding swallowing lake or pool water;

• Drinking only pasteurized apple cider;

• Frequently cleaning and sanitizing restrooms, including door knobs and faucets; and

• Reporting diarrheal illnesses to your physician.