Two outbreaks of campylobacteriosis associated with the consumption of raw cows' milk

• Published in: International journal of food microbiology Vol. 134; no. 1; pp. 70 - 74
• Main Authors: Heuvelink, Annet E., van Heerwaarden, Caroliene, Zwartkruis-Nahuis, Ans, Tilburg, Jeroen J.H.C., Bos, M. Hanna, Heilmann, Frank G.C., Hofhuis, Agnetha, Hoekstra, Trynke, de Boer, Enne
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier B.V 31-08-2009; [Amsterdam; New York, NY]: Elsevier Science; Elsevier
• Subjects: Animals; bacterial contamination; Beverages; Biological and medical sciences; bulk milk; Campylobacter; Campylobacter Infections - epidemiology; Campylobacter Infections - transmission; Campylobacter jejuni; Campylobacter jejuni - isolation & purification; campylobacteriosis; Cattle; Child; Colony Count, Microbial; dairy cattle; diarrhea; Disease Outbreaks; enteritis; Enteritis - epidemiology; Enteritis - microbiology; epidemiology; feces; Feces - microbiology; Female; food contamination; Food Contamination - analysis; Food industries; Food Microbiology; food pathogens; Fundamental and applied biological sciences. Psychology; Humans; Male; microbial genetics; Milk - microbiology; Milk and cheese industries. Ice creams; Netherlands - epidemiology; pandemic; public health; Raw milk; restriction fragment length polymorphism; risk assessment; school children; Netherlands; Raw milk; Campylobacter; Surveillance; Campylobacteraceae; Dairy product; Bacteria; Cow milk
• ISSN: 0168-1605; 1879-3460
• DOI: 10.1016/j.ijfoodmicro.2008.12.026

The present paper summarises the investigation of two different outbreaks of milk-associated
Campylobacter enteritis in the Netherlands. In 2005, after a school trip to a dairy farm, 22 out of a group of 34 children developed diarrhoeal illness and
Campylobacter
jejuni was cultured from the stool samples of 11 of the cases. The illness was found to be epidemiologically associated with drinking raw milk during the farm visit; 86% of the cases could be explained by drinking raw milk.
C.
jejuni was also isolated from three of 10 faecal samples from dairy cattle collected at the farm. The human isolates and
C.
jejuni isolates from one of these three samples of cattle faeces revealed identical restriction patterns by both pulsed-field gel electrophoresis (PFGE) and flagellin (fla) typing by polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP). Both epidemiological and bacteriological evidence implicated contaminated raw milk as the vehicle of transmission, though
C.
jejuni was not isolated from the bulk tank milk or the milk filter collected during the farm investigation. In 2007, an outbreak of enteritis was notified among people who had attended a lunch at a dairy farm where bulk tank milk was served. Of the 19 persons who had consumed raw milk, 16 (84%) had become ill. Of the persons who did not drink the raw milk, none became ill. A significant association was found between tasting the raw milk and being ill (risk difference
=
0.84,
p
=
0.0011).
C.
jejuni was cultured from four of seven cases who had submitted a stool specimen.
C. jejuni was also isolated from a sample of bulk tank milk and the isolate had an identical
flaA PCR–RFLP genotype to isolates obtained from patients. Also in this outbreak both the epidemiological and bacteriological findings support raw milk as the vehicle for the enteritis.
These two outbreaks highlight the health risks associated with the consumption of raw milk. As long as legislation allows the sale and distribution of untreated milk these risks will continue. Therefore, consumers need to be continuously informed about the dangers inherent in consuming unpasteurised milk or products made from raw milk. Farmers need to be strongly discouraged from serving raw milk to their visitors.