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Vet Advice: Will we ever learn?

Our family moved recently. During the tedium of moving and editing files, a copy of an article I wrote 10 years ago fell from a bundle of papers. “Ginny’s Sick” stared at me from the floor and brought back a flood of memories: a grandchild in Stollery Children’s Hospital on the end of a transfusion catheter carrying blood and platelets; a four-year-old on the verge of hemolytic uremic syndrome; her third trip to the emergency ward writhing in discomfort from cramps attributed to simple gastroenteritis; and the firm insistence by an old veterinarian to a young intern that they must consider things like E. coli 0157:H7.

At the time, I tried to inject logic into why things happen to innocent people and why the modern world hasn’t progressed enough to do the simple things capable of preventing needless suffering — especially why producers and retailers still sell dairy products made from unpasteurized milk with no warning about the potential danger of doing so. Small samples of Gouda cheese harbouring minuscule numbers of E. coli 0157:H7 dispensed from a farmers’ market sickened 11 people, two seriously.

Finding the article, now 10 years old, seemed surreal in light of the ongoing investigation into another case of E. coli 0157:H7 from unpasteurized cheese products. This time a person dies and 20 others are sickened by cheese sold from a family-run dairy operation outside Salmon Arm, British Columbia. Affected products had been sold at the manufacturer’s outlet, at retail stores in Alberta and British Columbia and through the Internet. People started to get sick in July, with the majority of those infected showing symptoms in late August and early September. Of the 28 victims affected in B.C., Alberta, Saskatchewan, Manitoba and Quebec, four people were hospitalized; one person died.

Despite the company’s expressed concern and sorrow for those affected by the outbreak, the fact remains: there are still companies in Canada and the U.S. producing cheese from unpasteurized milk. The practice contradicts all measures of responsible and safe production of food.

While unpasteurized (“raw”) milk by itself is prohibited from commercial sale in Canada, sales of cheese made from raw milk are allowed. To date, the Canadian Food Inspection Agency (CFIA) and more recently, the Public Health Agency of Canada (PHAC) support the fact that such cheeses are safe because they are “manufactured and produced in a way that helps eliminate harmful bacteria that may be present” in the milk. Specifically, raw-milk cheeses sold in Canada are subject to Health Canada requirements that they first be stored for 60 days at temperatures of 2 C or above. According to a video posted by the company involved in the most recent rash of illnesses, mild cheeses are stored for two months, medium cheeses for four months and aged cheeses for 12 to 24 months. According to CFIA, it’s “generally considered safe” to eat raw-milk cheese, but goes on to say it can cause “serious health effects” for children, older adults, pregnant women and people with weakened immune systems and that people in those risk groups should avoid eating raw-milk cheeses.

How many people take the time to ensure the cheese they are buying or being offered as a sample on the end of a toothpick at a farmers’ market is pasteurized by reading the label or asking the seller? How many consumers realize that beyond severe stomach cramps, diarrhea and vomiting, up to 10 per cent of E. coli 0157:H7 victims develop hemolytic uremic syndrome (HUS), and acute renal failure, which can be fatal?

Health officials have now closed their investigation into the B.C. E. coli outbreak linked to raw-milk cheese. The company has resumed selling “unaffected” products and bills what it sells as being made from milk from the farm’s grass-fed cows.

In the aftermath of a tragedy that could have been prevented, have products produced from raw milk redeemed themselves as safe food? Have consumers been made to feel safer, or do they know the questions that need to be asked when food offered for sale comes with risk? History contradicts those who purport the affirmative.

Providing or offering for sale raw-milk products runs contradictory to modern agriculture’s goal of supplying safe food to an informed public. A study by the Centers for Disease Control and Prevention (CDC) published in February 2012 indicated that when weighted for consumption the rate of outbreaks caused by raw milk and products made from it may be 150 times greater than outbreaks linked to pasteurized milk. The CDC study reviewed dairy product outbreaks from 1993 to 2006 in all 50 states. Outbreaks of diseases linked to raw-milk products were more frequent and more severe in people younger than age 20. The rate of hospitalizations was 13 times higher in outbreaks associated with unpasteurized products compared to those associated with products that were pasteurized.

There is a broad scientific consensus that raw milk is not as safe as milk that is pasteurized. There have been dozens of foodborne illness outbreaks in recent years with many hundreds of people seriously ill and some deaths clearly attributable to ingesting raw milk and raw-milk cheese even though cheese from unpasteurized milk is less risky if given time to cure. The skill and reputation of cheese makers does not eliminate risk.

There is no legal requirement to label raw-milk cheese, so most retailers are uninformed, and so are consumers. This, perhaps, lies at the heart of the debate. If Canada made labelling of raw-milk cheese mandatory, consumers could make informed choices. For those in pursuit of raw-milk cheese for whatever benefit they evoke and for those wishing to eliminate the risk of cheese made with unpasteurized milk the way forward would be much clearer. Consumers are entitled to know that some cheese is safer than others.

— Dr. Ron Clarke prepares this column on behalf of the Western Canadian Association of Bovine Practitioners. Suggestions for future articles can be sent to Canadian Cattlemen ([email protected]) or WCABP ([email protected]).

 

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Dr. Ron Clarke prepares this column on behalf of the Western Canadian Association of Bovine Practitioners. Suggestions for future articles can be sent to Canadian Cattlemen ([email protected]) or WCABP ([email protected]).

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