Biological Health Hazard – Multi-state Listeriosis Outbreak (Fatal): Food contamination/recall, USA
LISTERIOSIS – USA (02): FATAL, UNPASTEURIZED SOFT CHEESE, AGED 60 DAYS, RECALL
Published Date: 2017-03-12 18:42:17
Subject: PRO/AH/EDR> Listeriosis – USA (02): fatal, unpast soft cheese, aged 60 days, recall
Archive Number: 20170312.4896013
Date: Thu 9 Mar 2017
Source: CDC Listeria (Listeriosis) [edited]
The Centers for Disease Control and Prevention [CDC], public health and regulatory officials in several states, and the US Food and Drug Administration (FDA) are investigating a multi-state outbreak of _Listeria monocytogenes_ infections (listeriosis). Listeria can cause a serious, life-threatening illness. Six people infected with the outbreak strain of listeria have been reported from 4 states since 1 Sep 2016. All 6 people were hospitalized, and 2 people from Connecticut and Vermont died. One illness was reported in a newborn.
Epidemiologic and laboratory evidence indicates that soft raw milk cheese made by Vulto Creamery of Walton, New York is the likely source of this outbreak. Six of 6 people interviewed reported eating various types of soft cheeses in the month before their illness started.
The outbreak strain of listeria was identified in samples taken from 3 intact wheels of Ouleout cheese collected from Vulto Creamery. On 7 Mar 2017, Vulto Creamery recalled all lots of Ouleout, Miranda, Heinennellie, and Willowemoc soft wash-rind raw milk cheeses. The soft raw milk cheeses were distributed nationwide, with most being sold at retail locations in the northeastern and Mid-Atlantic states, California, Chicago, Portland, Oregon, and Washington DC.
CDC recommends that consumers do not eat, restaurants do not serve, and retailers do not sell recalled soft raw milk cheeses made by Vulto Creamery. This investigation is ongoing. Updates will be provided when more information is available.
Date: Fri 10 Mar 2017
Source: New York Times [edited]
Two people have died following an outbreak of listeriosis linked to a popular artisanal raw milk cheese made in upstate New York the authorities said this week.
The deaths occurred in Vermont and Connecticut, local officials said. Four other people in New York and Florida reported feeling sick after eating Ouleout, the artisanal cheese, which is produced by Vulto Creamery in Walton, NY. Illnesses started on dates between 1 Sep of last year  to 22 Jan 2017, the FDA said. All 6 people were hospitalized, and 2 people died.
Vulto Creamery, which produces Ouleout, said it was recalling the product, and, as a precautionary measure, 3 other soft wash-rind raw milk cheeses: Miranda, Heinennellie, and Willowemoc. “We are very busy working on this recall with FDA and our customers,” the creamery said in an email, without offering details on the cause of the outbreak.
Vulto Creamery began contacting clients on 3 Mar , asking them to return purchases of Ouleout after being informed of a listeria strain in a sample, the health department said. It issued a recall on 7 Mar 2017 and extended it to the 3 other brands.
The deaths highlighted concerns over safety regulations around artisanal cheese production in the United States, particularly around the raw milk cheese segment, which emerged only about a decade ago, experts say. The outbreak has also revived a continuing debate between the virtues of raw milk cheese, which aficionados say tastes better, and safety. Some customers swear only by pasteurized-milk cheese.
Europeans have eaten raw milk cheese for hundreds of years. In France, for example, 15 per cent of its cheese is made of unpasteurized milk, according to French agricultural statistics. The thinking is that when milk is cooked, or pasteurized, many of the flavor-rich enzymes are destroyed.
Ouleout, a soft washed-rind cheese that is aged for 60 days, “requires real craftsmanship” because it needs to retain a good amount of moisture even as it matures, said Carlos Yescas, program director at Oldways Cheese Coalition, a nonprofit organization that promotes artisanal cheese making. “Otherwise, the cheese will dry out really quickly.” Washed-rind cheese is made by washing and curing the cheese in beer and other solutions, helping create its pungent flavor.
More than half of artisanal cheese produced in the US is made of unpasteurized milk, Mr Yescas said, adding that there are a number of ways in which the cheese could be contaminated. Listeria, he said, could originate from the wood boards used to age the cheese, the water supply or improper sanitation, like walking in dirty boots. “It’s hard to pinpoint,” Mr Yescas said.
In the US, regulations on raw milk cheese are less stringent than in Europe, where more steps are required to ensure that there is no contamination, he said. Here, there is only a single national standard for raw milk cheese production, Mr Yescas said, which requires that the cheese be aged for at least 60 days to block _Escherichia coli_ from developing. “We need to take a look again at the 60-day rule and have a consensus with the scientific community, regulators and cheese producers,” Mr Yescas said.
[byline: Kimiko de Freytas-Tamura]
Date: Sun 12 Mar 2017
From: Christopher Henry <firstname.lastname@example.org> [edited]
FDA regulations prohibit the sale across state lines of raw milk itself or of cheeses made from raw milk that have been aged for less than 60 days. Raw milk cheeses aged for more than 60 days may be sold, provided that they are clearly labeled as such. All of the cheeses sold by Vulto Creamery appear to fall into the latter category.
PhD student in Epidemiology
University of Michigan
[ProMED-mail thanks Christopher Henry for his submission.
The US FDA prohibits interstate commerce of fresh, un-aged (uncured) cheeses made from unpasteurized (raw) milk. These cheeses, however, can be sold within states that permit sales of unpasteurized dairy products. Because aging/ripening of cheese for at least 60 days is thought to reduce bacterial contamination, the FDA permits interstate commerce of cheese made from raw milk if the cheese is aged (cured) at a temperature of not less than 35 F [1.6 C] for at least 60 days (http://www.foodsafetynews.com/2011/02/publishers-platform-60-day-rule-the-facts/#.WMWFxLGZPjA).
As suggested by Christopher Henry, the 2nd news report above says that the soft cheese made from raw milk manufactured by Vulto Creamery in New York State that is responsible for the multistate listeriosis outbreak is aged for 60 days, which likely explains why it was able to be distributed nationally.
However, ageing raw milk cheese for 60 days may not totally ensure safety when _Listeria monocytogenes_ is introduced as a post-processing contaminant (https://www.ncbi.nlm.nih.gov/pubmed/18724749). In 2014, the FDA tested cheese made from unpasteurized milk that had been aged 60 days for the presence of the pathogens salmonella, _Listeria monocytogenes_, and Shiga toxin-producing _E. coli_ (https://www.fda.gov/downloads/Food/ComplianceEnforcement/Sampling/UCM512217.pdf). Of the 1606 raw milk cheese samples tested, 29 per cent were of domestic and 71 per cent were of international origin; most were semi-soft (63 per cent) and hard (35.5 per cent), but only 3 per cent were soft-ripened, like the Vulto cheese, and 1.5 per cent were fresh. Although the overall contamination rate for each of the pathogens was less than one per cent, the FDA detected _L. monocytogenes_ in 10 of the 1606 cheese samples tested, 5 in domestic (3 of the 5 collected at a single firm) and 5 imported cheeses; 9 of the 10 samples that tested positive for _L. monocytogenes_ were of the semi-soft type. – Mod.ML
A HealthMap/ProMED-mail map can be accessed at http://healthmap.org/promed/p/106.]
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Listeriosis, a serious infection usually caused by eating food contaminated with the bacterium Listeria monocytogenes, is an important public health problem in the United States. The disease primarily affects older adults, pregnant women, newborns, and adults with weakened immune systems. However, rarely, persons without these risk factors can also be affected. The risk may be reduced by recommendations for safe food preparation, consumption, and storage.
Listeria bacteria can survive refrigeration and even freezing. The incubation period is typically between two and three weeks, but can be as long as 70 days. People who are at higher risk of serious infections should avoid eating the types of food most likely to contain listeria bacteria.
Note: Category B bioterrorism pathogens are the second highest priority organisms/biological agents. They are moderately easy to disseminate, result in moderate morbidity rates and low mortality rates and require specific enhancements for diagnostic capacity and enhanced disease surveillance.
These pathogens include food safety threats. Category B agents are bacteria and viruses that may cause only mild disease to humans, but sometimes may be fatal, they are difficult to contract via aerosol in a lab setting.