Scott Trautman’s planned raw milk group can’t get here soon enough for me–“an alternate – FUNCTIONAL – SAFE – system, without DATCP, without FDA,” he wrote following my previus post. “Inspect ourselves, train ourselves, have standards far above yet – SENSIBLE not ARBITRARY.”
The first thing this alternate system would need to do is send an emergency team over to Minnesota, to the Hartmann farm, and find out what the hell is wrong over there.
The news just keeps getting worse and worse from the Hartmann dairy. Three more illnesses reported, two of them children, making for a total of eight people sickened. At least one child previously had been reported with hemolytic uremic syndrome, though that child has since reportedly been released from a hospital.
In the midst of all this bad news, the Minnesota Department of Health has shown itself to be more respectful of food rights than any other public health agency I’ve ever seen.
In a Q&A on its web site, the Minnesota Department of Health raises this question:
“Are you trying to clamp down on all raw milk sales? It seems like you are trying to take away our food source, our ability to choose to drink raw milk.”
As part of the answer, the agency responds, “Like Mr. Hartmann, we wholeheartedly endorse the value of consumer choice…in this case, human disease, in the form of E. coli O157:H7 infection, has been clearly linked with consumption of milk from Mr. Hartmann’s farm… We nonetheless support the rights of consumers who wish to assume that risk, IF they do so knowingly.”
Yes, there is lots of rhetoric about the dangers of raw milk, but an acknowledgment of food choice on the part of public health professionals? That is something new and different.
I’ve read the Hartmann family’s statements and, much as I would like to believe the family’s denials that its milk hasn’t made eight people sick, I can’t. The scientific evidence is overwhelming that the dairy is the cause of the illnesses.
Beyond the problem of the Hartmann farm’s customers getting sick, this situation is creating serious problems for advocates of raw milk and food rights.
Here’s the most serious of those problems: We say we want raw milk treated the way other foods are treated in the event there are illnesses. From all I can see, that has happened here, and then some.
Some bloggers, Miguel and Deeply Concerned, in particular, want to deny the validity of genetic linkages, but the reality is that PFGE linkages have become the gold standard for identifying sources of food contamination–not just for raw milk, but for all foods. It’s fine to debate the science behind the linkages, but in the real world, where regulators and farmers operate, this is the way the system works for now.
Another problem is that this case threatens to turn our greatest asset–public opinion–against raw milk and food rights. As I said in my previous post, many people are disgusted by situations like that occurring in Wisconsin involving the harassment of the Hershberger farm.
But they can easily become outraged over something like the Hartmann situation. The latest cases indicate that people have been getting sick since the first illnesses were brought to public attention. The possibility that the dairy has been producing milk after learning of illnesses has a lot of people upset. Just read the comments following the local paper’s latest revelation that three additional people were reported ill, and see how many readers agree with which comments.
When this case first came to light, I thought the Minnesota Department of Health and a local paper were accusing Hartmann before all the evidence was in. But as I’ve reported, the department has since made the connection. Perhaps the one piece of good news out of this case is the department’s effort to educate consumers about how public health professionals handle food safety problems, and how connections are made between illnesses and particular food sources, as communicated in that Q&A I alluded to previously.
It explains how the genetic connection was made: “During May 2010, E. coli O157:H7 isolates from 5 patients sent by separate clinical laboratories to the MDH PHL were found to all have the same DNA fingerprint by PFGE testing…This particular DNA fingerprint type (which also can be called a ‘strain’ of E. coli O157:H7) had never been seen before in Minnesota.”
And it explains how failure to find the pathogen in the actual milk samples isn’t an adequate excuse. “The fact that the outbreak strain was not found in samples of product taken from the farm or homes does not mean it wasn’t in the product that sickened the individuals. In many cases, only particular batches of product may have been contaminated. The product from the contaminated batches may not be available for testing because it has already been consumed. Even if the contaminated batches are available for testing, the contamination may not be uniformly distributed throughout the product. It can be difficult to find the ‘needle in the haystack’ when only small amounts of product are able to be used for a laboratory test. The fact that some pathogen was not found in a sample taken today does not mean it wasn’t there yesterday or a week ago, or won’t be there tomorrow…”
“The outbreak strain of E. coli O157:H7 was found in the manure of some individual calves, sheep, and cattle pens. Of note, the calves were likely drinking the same milk as that consumed by the cases.
“Standard public health practice does not require finding the illness strain of pathogen in either environmental or product samples in order to determine the source of an outbreak and before intervention to prevent further illness should be initiated. In fact, it is quite rare in foodborne investigations that food product is available for testing as it is often perishable or has been completely consumed by the time the outbreak is recognized.”
A number of people, myself included, have said any number of times that raw milk can cause illness, just as any food can. The problem comes when the shit, quite literally, hits the fan. Then we need to be prepared to be true to our rhetoric, own up to problems, and push problem raw dairies to own up to problems. There needs to be introspection and self assessment as to what went wrong. The denial and pretending that a case this blatant isn’t real is a disservice to all dairies that consistently produce high-quality raw dairy products.
As Scott Trautman suggests, we need to move beyond words, to actions, to taking responsibility. If public opinion turns against raw milk, believe me, the public health and agriculture bureaucrats will lick their chops and move in for the kill.
Social responsibility is as important, if not more so, than individual responsibility in a free society.
As producers and consumers of raw milk, if we wish to have a true free market in raw milk and raw milk products, we also have to take responsibility for public health and food safety. Simply shrugging off this responsibility with constitutional rhetoric will only result in more problems, less freedom, and less democracy.
I am not trying to downplay the importance of miguel’s compelling critique of existing epidemeological techniques, or the evil in corporate agri-bussiness and their regulatory allies, trying to drive the last vestiges of sustainable family-scale farmers off the land in favor of CAFO-style farms.
What I am trying to say is that we need to create a certifying agency to deal with this issue of raw milk quality and safety in a proactive and constructive manner. It would be a grave mistake to limit our goal to merely food safety. We must attempt to elevate raw milk quality to a new level, and include artisinal value added products such as yogurt, buttter, and fresh/soft-ripened cheeses, while empowering raw milk farmers with the knowledge and tools to diversify their farms, to make them more resiliant in the face of the inevitable onslaught of state and corporate attacks.
We must begin at square one, however — identifying the heygene and microbiolgical issues of concern in raw milk production.
This post comes from the south of France. I have been drinking ( what I thought was raw milk ) raw milk sold under the brand Marguerite Fresh Lait for about a week.
I did some research on Marguerite and found that it is sold as fresh raw milk but it is not really as raw as a I thought. Margurite is a COOP of farmers that commingle their raw milk together. It is processed by microfiltration after the cream has been removed and pasteurized. The bacteria (most if any way ) is removed by microfiltration and then the pasteurized cream is added back into the raw protein and water fraction of the milk. It is semi raw milk. Something I always thought was very dangerous..?? Learn something everyday.
So it is half raw and half pasteurized. Not really OPDC 100% raw and none outsourced and artisanal and grass fed raw milk.
So I am still looking for a comparable raw milk that is sold in retail out here in the EU world. There are no raw milk vending machines in Southern France that I can find. They appear to be located in Italy and Slovenia. Switzerland did not have any that I could find.
I have not tried farms yet but I also have not found any grass fed operations. They are all confinement barn systems with seasonal access to some pastures.
As far as food safety is concerned…..
If a farmer has not deeply considered a RAMP type food safety program that includes testing and monitoring of data along all points of production…then that farmer is really not introspectively being as critical or honest as he should be with himself.
Mother nature is wonderful…..but mankind has messed with her so badly that the superbugs that did not exist in nature before now have control of her. God Move Over…GMO ( and Monsanto antibiotics etc ) is now part of nature and we must deal with it.
When Freedom collides with renewal of your farms insurance policy….a taste of reality hits you in the face….
Blissful Freedom is not real. It is a dreamy state of utopia. We have freedom when we have information and we can manage our reality and reduce risk and assure a level of acceptable safety while at the same time nourishing people. This takes investment and committment. It is not a free or primative system.
If I was at the Hartmans….I would start from scratch and establish a 100% comprehensive RAMP program and add manure testing to the protocal as well. They must grab ahold of their reality and assure that they are safe…this is an investment and deep committment.
Mark
http://www.nytimes.com/2009/08/18/science/18dna.html?_r=1
David,I don’t believe Lykke could have done a better job of defending the credibility of this epidemiological study.You even called PFGE the "gold standard" just like Lykke would have.
I have posted lots of information,not my opinion but scientific studies,that support the invalidity of PFGE’s in finding a DNA match.PFGE is the gold standard——for distinguishing between strains of bacteria.Did the MDH do 6 PFGE analysis using 6 different enzymes for each of the bacteria samples that they found were matching?If they did not the probability that the strains really match is very low.
You do live in Massachusetts.Why don’t you ask Lynn Margulis her opinion of the Minnesota dept of health epidemiological study?
http://www.geo.umass.edu/faculty/margulis/
Our greatest asset is not public opinion.Our greatest asset is the trust that we have established between the farmer and consumer.This is what is under attack.We need to stick together and support each other.We need to support the people that are sick in every way possible and we need to support the Hartmann farm too.No credible scientific evidence has been offered yet that implicates them in these illnesses.In the face of this attack by the Health Authorities we need to avoid fighting amongst ourselves over who is to blame for the illnesses.The truth is no ones knows what caused these people to become ill.The reason that we don’t know is that,going back to Steve Bemis’ 11 great thoughts, An open, collaborative, transparent and scientifically rigorous approach should be taken by producers, consumers and public health officials in all instances of disease outbreak with a common commitment both to protect public health and to protect continued viability of responsible producers."The MDH’s epidemiological investigation is none of these.
But why does this all matter?
Are these techniques believed by the public at large? Yes. Are regulators and legislators, both pro and con raw milk, guided by this science? Yes. Is our failure to address concerns and our inclination to deny sicknesses demonstrated however fitfully, by this kind of science, risks to the raw milk movement? A BIG YES. Can lawyers use these kind of correlation studies, however flawed as science, to get over the modest 51% proof standard in civil litigation? Yes.
Both Minnesota and Michigan regulators in the context of recent allegations of outbreak have SHOWN A SIGNIFICANT WILLINGNESS TO ACKNOWLEDGE THE FREEDOM OF CHOICE REGARDING RAW MILK (11GT#5) even as they attempt to hunt down the cause of illnesses. They can do more to share their methodology and their reasoning in pursuing the science in these cases. Nevertheless, in important respects, they demonstrate clear progress towards my "11 Great Thoughts" point #9 which calls for more transparent EPI: http://www.ftcldf.org/news/news-11-Great-Thoughts.html .
I prefer to look at health departments as the detectives on the case. Ideally, they are the fact-finders who will help us all get better in our efforts to produce safe and healthful raw milk and raw milk products. In the worst case, they are allies of big-ag interests and anti-raw milk forces, legislative and otherwise. I don’t see this worst case at least in Minnesota and Michigan recently. We need to seize these opportunities to work collaboratively, and positively, or risk much worse. A chorus of denials without facts (which the health departments still need to share) will not serve our cause well.
My concern is that the epidemiological investigations are biased from the beginning.They start with the search for the bacteria that caused the illness.It is not the individual people involved in the investigation that are to blame.It is our belief, as a society ,in the germ theory of disease.This all is a result of the average person’s frightening lack of understanding of bacteria.
I won’t waste my time trying to get through to epidemiologists or for that matter,even the public,what is important to me is that people who choose to drink raw milk,understand the role of bacteria in their health.
What would motivate the dept of health to falsely implicate a food source in an outbreak of illness?Who decides what the protocols are for doing an investigation?Everything is run from the top down.Someone has a list of goals that they are working on.One of the long term goals of the people at the top is to "reduce the number of states where raw milk is legal by 2020(Healthy People 2020). There is the goal. A strategy is needed to achieve that goal. The current strategy appears to be to divide the alliance between the producer and consumer by destroying the trust that has been established.
http://en.wikiquote.org/wiki/Sun_Tzu
"The art of war is of vital importance to the State."
" All warfare is based on deception."
" If his forces are united, separate them."
"to attack your enemy,attack his strategy"
Our strength,our trust ,our unity is under attack.
Our response must be to support each other in every way possible.If consumers are sick,let’s give them whatever they need to recover.If farmers are under attack let’s not join in the attack.We must question health departments about sources of bias in their investigations.We must insist that evidence is based on science and not just on convention.We must question authority.
WE need to work with the local people in charge of the health department to broaden the investigations to include sources of illness other than point sources of bacteria.
My comments attempt to address the hopeful tendency of at least two state health departments to do things a bit more openly, while at least appearing to recognize the rights we have to make private agreements to obtain the foods of our choice.
"The scientific evidence is overwhelming that the dairy is the cause of the illnesses".
I hope that you are prepared to retract these words and offer an apology to the Hartmanns. The MDofH is the only opinion that has credibility in your eyes.Do you really believe that PFGE can be used to "match" strains of bacteria?Of course if Bill Marler says so ,it must be true.
If I put the E. coli O157:H7 cultured from the Hartmann’s calf into a glass of your raw milk would you drink it? Would you give it to your child or grandchild?
I’m curious about something. David says, "A number of people, myself included, have said any number of times that raw milk can cause illness, just as any food can."
Can you, miguel, name a single example where raw milk, like any food, caused an illness? What criteria made you believe it was the source. Or, would you say that it is the customer’s fault if they are not strong enough to handle E. coli O157:H7 in a glass of raw milk or a piece of cheese.
" We’ll give him a fair trial,and hang him"
The whole tone of David’s blog was so strange.The MD of H found Hartmann farm guilty by issuing press releases,Bill Marler gleefully confirmed the guilty verdict as just,then David piled on with his agreement that Hartmanns were guilty as charged.
David says:
"Some bloggers want to deny the validity of genetic linkages, but the reality is that PFGE linkages have become the gold standard for identifying sources of food contamination–not just for raw milk, but for all foods. It’s fine to debate the science behind the linkages, but in the real world, where regulators and farmers operate, this is the way the system works for now. "
If it is fine to debate the science behind the linkages why doesn’t anyone respond to the research(not my opinion) that I posted that stated that the PFGE was NOT valid for finding matching strains of bacteria,only for distinguishing between strains of bacteria.Go ahead show me any reputable research that says that PFGE is valid when used to identify matching strains of bacteria.
I guess we are just supposed to accept injustice because it is meted out equally to everyone.
I appreciate your informative postings about PFGE. I wish all of the information (and summaries) which you post were consolidated into one document, that would make it very easy for someone to contest the validity of these PFGE test results.
I am wondering, too, if there are more accurate methods to gather and analyze epidemeological evidence that could implicate/exonerate a raw milk producer such as the Hartmanns.
http://www.cdc.gov/pulsenet/
You accuse Miguel of selectively citing information, but do you not think it is possible that the government and opponents of raw milk do the same thing? And do you not think it is possible that the public health authorities techniques for tracing diseases could be flawed?
I’m not sure what information in your link rebuts what Miguel has been saying about PFGE. Care to explain? I find Miguel’s opinions on the subject very interesting, though I’m going to keep an open mind.
Milky way
I select parts of the research because a lot of it is hard to understand and it would take up too much room to post it all.My hope is that people will find the part I post interesting enough to read the whole article.If you want to post articles that disagree with the ones I post ,I would welcome the opportunity to have a discussion about these things.Usually I post the conclusion of a research paper or the discussion that comes at the end.I do pick research that is published in peer reviewed journals much of the time.Rather that attack my credibility why don’t you join the discussion and give your viewpoint of these ideas.
You raise a number of important concerns and criticisms. You say, We need to stick together and support each other. We need to support the people that are sick in every way possible and we need to support the Hartmann farm too.
Im not sure what you have in mind to accomplish those two goals. How do you plan to support those who are ill? By denying they got sick from raw milk? I spoke with a number of those who became ill in the Midwestlong-time raw milk drinkerswho felt rejected by the denials of raw milk advocates that these individuals likely got sick from raw milk. Is this what you have in mind?
http://www.thecompletepatient.com/journal/2010/3/28/in-face-of-fda-pressure-in-dairy-ends-distribution-and-campy.html
As for supporting the Hartmanns, does support mean encouraging them to continue producing milk that appears to be sickening some drinkers, and also alienating ever more ordinary citizens? I prefer Mark McAfees approach: If I was at the Hartmanns….I would start from scratch and establish a 100% comprehensive RAMP program and add manure testing to the protocol as well. They must grab ahold of their reality and assure that they are safe…this is an investment and deep commitment.
As for your arguments that the germ theory, epidemiological evidence, and PFGE linkages are so badly flawed they are without merit, I respect your view, but I cant support recommending that raw dairy producers try to apply your arguments when confronted with the kind of crisis now facing the Hartmanns. As a related example, I feel our monetary system is deeply flawed, indeed immoral, because we went off the gold standard, and now allow our Federal Reserve to simply create money out of thin air. The current system creates endless problems. I suppose I could attempt to not participate in the monetary system, but Id have a heck of a time trying to survive. Its all we have, unless and until the existing system collapses or is adjusted, so I accept it as the will of our collective political body, and participate.
Same situation with the epidemiological evidence and PFGE linkages. I could rant and rave and say the science is flawed and tell farmers to push back till the system changes and accepts a different view about how harmful bacteria originate and create illness. Right now, the U.S. Centers for Disease Control uses PFGE linkages as key supporting evidence in all types of foodborne illness.
http://www.cdc.gov/pulsenet/index.htm
If raw dairies and other food producers want to produce and sell food, thats the system they are stuck with, the rules they have to play under. In that vein, I wonder what your answer to Milky Ways question is: Can you name a single example where raw milk, like any food, caused an illness?
You say, I guess we are just supposed to accept injustice because it is meted out equally to everyone. In a sense you could say thats the situation with any number of laws and regulations. There are people who feel our income tax laws are unjust, but they tend to be enforced equally, and those who refuse to obey them invariably wind up with severe penalties.
I, along with others who support raw milk consumption, have long been demanding that public health officials simply treat raw milk as they would any other food, not single it out for special consideration, which has consisted of either jumping to conclusions about raw milk’s role or using any illness as an excuse to ban it. Now, maybe you werent one of those who was drawn to that equal-treatment argument. But now that that approach seems to have been honored in Minnesota, I feel compelled to acknowledge the attempt at even-handedness.
Finally, you say, I hope that you are prepared to retract these words and offer an apology to the Hartmanns. I certainly am. Unfortunately, right now we only have health departments as detectives on the case, as Steve Bemis puts it. As I said in my post, I would love to see a raw dairy association send an emergency team in and do its own investigation of the Hartmann situation. Thats not going to happen any time soon, Im afraid. In the meantime, we have little choice but to accept the word of the health department detectives in charge. I believe theyve made a strong case with the tools at their disposal. Lets not beat a dead horse, as it were.
David
I’m not sure war of the literature quotes is a useful approach to this discussion, but will give thought to posting relevant links that are not "cherry picked" to avoid clogging David’s blog with laboratory details many probably don’t care about.
Miguel, your commentary on stool composition brings me back to the question you did not answer. Let me try to restate. First, suppose your hypothesis is correct, and those who became ill from Hartmann raw dairy products had an imbalance in their microbial gut community. They were raw milk drinkers, why didn’t that prevent the problem if you think raw milk fosters a balanced gut? Second, how do you predict a gut ecology out of balance in someone who otherwise looks perfectly healthy? Coming from a preventive medicine background, I am trying to understand how you translate your theories into actions that farmers and consumers can take to prevent bad outcomes from swallowing E. coli O157:H7 in a food. You want us to test the stools of patients to characterize the microbial community. But, how would we use this information, especially when the other hypothesis is that drinking raw milk promotes a healthy gut. I’d be glad to consider your thoughts on this.
Thanks.
I don’t mean to speak for Miguel, but I think there is an obvious rebuttal to the final argument you make.
Raw milk is not a silver bullet for healthy gut ecology, it is only a part of a diet of traditional nutrient dense whole foods. Someone could drink raw milk, but follow it by consuming large amounts of something bad for them, a highly processed and/or toxic industrially produced nutrient deficient and enzyme sapping food or beverage. The fact that you drank a glass of raw milk prior to eating all the bad food would not automatically mean you have a healthy gut ecology.
You ask an important question that should be pursued. For what it’s worth, I have interviewed people (or parents of children) who became sick from raw milk, and there has been a striking commonality: all of them were deeply committed to healthy diets devoid of processed foods. Raw milk was part of an overall approach in their (or their children’s) diets to promote health.
Lets call it an internal self-evaluation. Per Steve Bemis and David’s idea about doing a separate investigation into the Hartmann situation, would it be possible to query the customers who experienced illness about their dietary choices in addition to raw milk? Minnesota has already figured out that they didn’t have any other food in common. But, did they drink raw milk, then consume "large amounts of something bad for them, a highly processed and/or toxic industrially produced nutrient deficient and enzyme sapping food or beverage." This would be interesting data to add to the discussion. But, if they weren’t eating junk food, what next?
Even so, you make assumptions that we simply don’t know are true. You say we know the affected folks are raw milk drinkers so why didn’t the alleged balance it is claimed raw milk brings to the gut prevent the disease.
We do not know the folks were raw milk drinkers…we know they drank raw milk, and there is a difference. Are they longtime raw milk/nutritional eaters, in which your query is valid, or have they recently had an epiphany, turning them from living off the garbage at the Micky D’s drive-thru until very recently and simply have not had th time for their internal terrain to normalize? closer to home food, and raw milk, have been much in the news lately, and there are probably a very large number of "newbies" overly susceptible to ANYTHING outside the "normal". Hell, if you lived on Happy Meals a fresh raw carrot would probably make you ill.
Bob BUBBABOZO Hayles
I never said that the milk didn’t make those people ill.What I said is that while the farmer has been accused and pronounced guilty,I haven’t seen any CREDIBLE evidence that supports a guilty verdict.All that we can say is that there is definitely not enough evidence to point the finger of blame at anyone.PFGE profiles were the only evidence offered.Epidemiology is a very sophisticated profession.By this I mean it is all about giving the impression that there is science behind their conclusions when there isn’t any."Yes, the public expects us to track the bacteria that caused the illness,so lets at least make things as confusing and complex as possible ,maybe they won’t catch on that we really cannot do what we are expected to do".What ever happened to innocent until proven guilty?Why the rush to attack Hartmanns?
I think we should have standards for producing raw milk.But clearly no matter how high the standards, the real standard is whether or not the Health Dept can find o157:H7 on your farm.
10 cells of o157:H7 are enough to make someone ill.Close to a billion cells can fit on the head of a pin.It can survive in the soil for weeks,travel at windspeed for miles and down creeks and rivers,survive in ground water for months,it can pass it’s toxin producing DNA on to other e. coli bacteria.It can do all of this and more and we are supposed to come up with a plan that will make our milk 100% safe for anyone to drink.Oh and by the way,just because we can’t find any o157:H7 in the milk doesn’t mean it isn’t there.I can only wish that Health Departments and journalists could be held to such high standards.
I’m sure that the Health Dept could find o157:H7 on the farm I live on,and it might really even be there.Where does that leave me?Am I endangering a lot of people’s health?What would you do in my situation?When you come to the farm to pick up your milk do you have o157:H7 on your shoes or hands?Will it contaminate the farm?
Happily, for me,raw milk seems to work well as a treatment for anxiety.
I still think you should retract your guilty verdict and apologize to the Hartmanns simply because the guilty verdict was premature.Even in a court of law evidence can be thrown out if the source is obviously prejudiced and the evidence is highly subjective(needing interpretation).Courts being what they are, I realize this is unlikely.
What did I mean by saying we should take care of those who became ill ?The question is how can we turn the Health Dept’s attempt to divide the farmer from the consumer into a positive rather than choosing between the two choices we seem to face:Winning the case in court or losing the case in court.Either way we waste valuable resources and widen the divide between the farmer and consumer.Rather than collecting money to fight the case in court,why don’t we come to a settlement ,as a community of farmers and raw milk drinkers,with the people who feel they were sickened by the milk.This will deflect the attack from the individual farmer.Beyond this I would use this event to open the Health Dept’s epidemiological investigation to scrutiny and to establish a less biased way of investigating disease outbreaks in the future.I wouldn’t rule out a well researched law suit against the Health Dept for our losses due to their misrepresentation of the "science" behind their epidemiological investigation.
" "Match" is a colloquial term that really should not be used in the literature (as miguel pointed out, "indistinguishable" is the correct term). All that said, semantics are not a good reason to dismiss the power of this technology to help us learn about outbreak sources. The point is not to shut down Hartmann’s dairy. The point is to 1) stop the immediate problem so no one else gets sick and 2) try to identify what went wrong and prevent future illnesses."
"Match" is not the same as indistinguishable and so it is deceptive to substitute it for indistinguishable. The point should be to identify the cause of each illness independently.It would be interesting to know how many cases of illness were reported in people who had not consumed raw milk and did the illnesses continue to spread after the raw milk was fingered as the cause.
As stated in their Q & A, there were no illnesses with that unique PFGE pattern (never before seen in Minnesota) who had not consumed raw milk. The only food in common for the people with that strain of E. coli O157:H7 was raw milk from the Hartmann dairy.
miguel, since you reject epidemiology and laboratory tests, what criteria would you use to "finger" raw milk as the cause of an illness?
Are you saying that some people were ill that hadn’t consumed raw milk,but the PFGE profiles were distinguishable?Were these cases done in the same lab using the same enzymes?
Your willingness to answer questions like this will increase the credibility of the information about this "outbreak".
I have been drinking raw milk for over fifty years and yes I wouldnt hesitate to drink Hartmans raw milk and feed it to my children.
For those preoccupied with control then the PFGE is indeed a valuable tool notwithstanding its validity.
Ken Conrad
After this I would have one question for everyone who comes to me asking for any kind of food:Do you have faith in the Department of health’s epidemiological investigations?Will you believe whatever they say even if there is no scientific basis for it? If the answer is yes I’ll send them off to find an agent that sells health insurance,because that is what they are really looking for.Reality from my point of view is that some people expect far too much from the farmer.We have to sort those people out and let them fend for themselves.
Advocates of raw milk and food rights will ultimately eat Factory Farm food like everyone else if they don’t realize what is really going on.
It is easy for me to get defensive when you imply that the work we do is intentionally dishonest. And, I can see how it’s easy for you to get defensive when one of your fellow farmers is under investigation. I think having this conversation, even on a blog, is a positive thing and I appreciate your questions. This may surprise you, but many in the public health communityI would very much like to understand better why you and others distrust us so much.
The protocols for PulseNet are highly standardized. To answer your question, 2 enzymes are used for E. coli O157:H7 typing (Xba1 and Bln1). Only approved agencies participate in PulseNet, and the approval involves intensive training of microbiologists conducting the test. All of the agencies and individuals participating use the same protocol.optimized for the specific bacterial species http://www.cdc.gov/pulsenet/protocols.htm
PulseNet is as dynamic as the laboratory science it is based on. Each year the scientists meet to review how things are working, look at new research data, and update protocols based on the current state of the science. The PFGE methods are the same regardless of the original source of the isolate (human, food, animal, water, etc.).
Thank you for your answer.Sorry about the intentionally dishonest comment.I am mostly disappointed with David.Are you satisfied that only two enzymes were used?Why not try to distinguish with more enzymes?
http://jcm.asm.org/cgi/content/abstract/41/5/1843
" Two reasons that similarity coefficients from single-enzyme PFGE are poor measures of relatedness (and hence are poorly correlated with other enzymes) are evident from this study: (i) matching bands do not always represent homologous genetic material and (ii) there are limitations to the power of PFGE to resolve bands of nearly identical size. The findings of the present study indicate that if genetic relationships must be inferred in the absence of epidemiologic data, six or more restriction enzymes would be needed to provide a reasonable estimate using PFGE."
Maybe there was "epidemiological data" that I am not aware of.Can you tell me what it was or why you feel that two enzymes were sufficient?
http://aem.asm.org/cgi/content/full/75/17/5719
"Pulsed-Field Gel Electrophoresis Profile Changes Resulting from Spontaneous Chromosomal Deletions in Enterohemorrhagic Escherichia coli O157:H7 during Passage in Cattle"
" Instability of the PFGE patterns of EHEC O157:H7 isolates has been reported. Changes in PFGE patterns were observed among strains after repeated subculturing and prolonged storage at room temperature (11). Loss of Shiga toxin genes and a large-scale inversion within the genome were identified as genetic events generating changes in PFGE patterns in vitro (10, 13). Shifts in the genotypes of EHEC O157:H7 clinical isolates from patients and cattle have been reported (3, 14). This phenomenon was also observed in EHEC O157:H7 experimental infections of cattle. Spontaneous curing of a 90-kb plasmid resulted in the loss of two restricted fragments from the PFGE profiles of EHEC O157:H7 isolates obtained from experimentally infected cattle (2). The purpose of the present study was to identify the genetic events affecting the PFGE patterns of EHEC O157:H7 after passage through the intestinal tract of cattle, especially for restriction fragments that are >90 kb long."
"Prior to drawing a conclusion, we need to consider the use of nalidixic acid, a potent inducer of bacteriophage induction (24), for selection of the isolates. In addition, most of the EHEC O157:H7 isolates obtained on day 8 postinoculation and later were isolated from enrichment cultures (Fig. 1). The possibility that the culturing process itself affected the deletion events affecting the PFGE profiles cannot be ruled out. Taken together, the results suggest that deletions can cause a single strain to mutate into several variants while it is passing through the gastrointestinal tract of a host, provided that the culture technique used does not contribute to this process. Hence, this study may explain why EHEC O157:H7 isolates with various PFGE profiles can be isolated from a single animal. What causes the deletion mutations and why the PFGE profiles show such patterns after passage through cattle are subjects for future studies."
Aren’t they saying that e. coli 0157:H7 can change PFGE profiles as a result of being cultured or if not , then it is changing PFGE profiles as a result of passing through the host’s digestive system(implying that this could happen whether the host is cow or human) ?
How can we rely on PFGE profiles to identify matching DNA fingerprints if they can change as the result of culturing(a necessary part of PFGE analysis) or if they can change as they pass through a host’s digestive system?Doesn’t this make you question the whole process of tracking 0157:H7 from the farm to the consumer of the milk?
There are multiple reasons that many of us do not trust public health authorities.
The most obvious is because of the punitive and knee-jerk approach taken towards raw milk. No attempt is made to suggest that raw milk can be safe if produced under the proper conditions and with the proper pre-cautions. Instead, all raw milk is loudly declared a bio-hazard and consumers are not supposed to be smart enough to make their own choice. (Never mind the possibility that certified clean raw milk could actually have public health benefits!! No, no, there are NO nutritional differences between raw and pastuerized milk… do you really believe that nonsense?)
WI is an excellent example of this, where public health officials, allied with the dairy processing industry, intensively lobbied the governor to veto the recent raw milk bill, which would have regulated raw milk as a legal product. Instead, raw milk will remain an unregulated "grey market" commodity with no safety checks other than those that the producer themselves decides to take. Given the state of raw milk politics in WI, where is the incentive to produce a safe product? It seems to me that the public health authorities are just itching for an outbreak they can link to raw milk, so they can turn the screws even tighter on raw milk farms.
Since the veto, the authorities have aggressively pursued one particular farmer (Vernon Hershberger) because they know he is churning raw butter and selling it out of his farm store. Vernon has never made anyone sick, nor is there any accusation that he has ever caused any illness. Clearly it has nothing to do with food safety (making butter has an inherintly selective affect against pathogenic bacteria that may be present in the fluid milk, because of the acidification of the cream, competition from added lactic acid producing cultures, and the removal of moisture). It only has to do with control — if you don’t play by OUR rules (designed by, of, and for big dairy corporations) then we are going to shut you down.
When you add to these facts, an utter failure to address the health horrors of our modern industrial food and pharma industries — factory farms, which are breeding grounds for super-bugs like E. Coli O157:H7; the dangers of gentically modified orgranisms and the fact that there is NO labelled requirement for GMO’s (yet you still want us to put warning labels on raw milk!); American’s addictions to toxic pharmacutical drugs; forced vaccinations; poor nutritional advice, based on the profit schemes of food processing corporations… the list could go on and on.
There are serious problems with the modern western allopathic approach to health and medicine, and the public health authorities refuse to acknolwedges these problems. The result has been a loss of trust from the public. I don’t really believe any of it is about food safety or public health anymore, even if it was at one time. Maintaining corporate control by shutting out any alternatives is the name of the game.
I am not saying you personally are responsible for these problems, but as a whole the public health and food safety professions have failed to really address public health issues, and instead have just been the lackies of the powers-that-be.
I will withhold judgement on the validity of PFGE fingerprinting in tracing food-borne outbreaks, but I do think Miguel is onto something here. He makes some very compelling arguments.
I know a number of research microbiologists who abhor use of PFGE for population genetics. Indeed, they say now you need 6 enzymes to characterize the long-term (over 1,000’s of years) and global genetics of these bacteria. If you’ve ever performed PFGE, you’d abhor it too if you had to do 6 enzymes! (very laborious technology). We don’t need PFGE for that purpose. Heck, if your lab has enough money for the equipment and computers, you can sequence the entire genome of the isolate in a day (you can even sequence the entire microbial community in a rumen or raw milk sample with new technologies, though these are obviously not available in local and state labs).
Bottom line. TMI (too much information). That type of whole genome data is not useful for studying short-term events of time and place. PFGE is uniquely good at this. Interestingly, one of the reasons relates to transient "infections" of the bacteria. For example, there are viruses (phages) that can integrate into the chromosome of E. coli O157:H7. Their presence changes the PFGE pattern. Over time, they pop out and the pattern changes again. During an outbreak investigation, you get a snapshot in time of what’s going on in the bacteria’s chromosome. It isn’t necessarily useful information for population genetics, but it is very useful in combination with shoe leather epidemiology.
Regarding stability, that is an important factor that is well researched for PFGE, as well as other methods like multilocus variable tanden number repeat (MLVA) analysis, which is also used sometimes in outbreak investigations. There are small changes that happen with passage through culture or even during passage through a human. These changes are to be expected, thus having a 1 or 2 band difference (or a few tandem repeat differences in a highly variable loci for MLVA) does not rule out the isolate as part of the outbreak. Again, "match" is a poor term, though it serves the purpose to make things look simple (especially if explaining them to an agency chief, lol).
Here’s an example (not raw milk). There was a large outbreak a few years ago and the MLVA method showed identical sequences, but the PFGE pattern showed multiple band differences. We threw this case out because the PFGE is more reliable (turns out, more analysis showed that it was indeed a virus inserted in the bacteria and the other method did not pick-up this transient event in the population).
In large outbreaks, you often have the dominant pattern, then a few highy related patterns (probably due to those small biological shifts that occur during passage). If the epidemiology fits, I am very comfortable calling them all part of the outbreak. Looking at what MN has released, I would be very comfortable concluding that they linked the outbreak to the Hartmann dairy. The burning question is what went wrong at a dairy that previously had no problem with E. coli O157:H7. Did new animals come into the herd? Was there a change in the milking or bottling routine?
There are the actual lab folks who dig around in petri dishes and look through microscopes and, if they do their job right, report what they see and only what they se. While they may be personally against the general availability of raw dairy, they actually do their job with blinders on to "agenda influence" and, as Sgt Joe Friday used to say, they report ,"Just the factsm m’am, just the facts." We may disagree on just what constitutes a valid testing method, but the lab folks usually report what the tests show, period.
Then there are the OTHER regulatory folks…the ones whose STARTING point is "raw milk is bad and must be quashed". They don’t look into petri dishes for answers and solutions…they look to corporate agriculture for their answers…and for their marching orders.
Those are the SOB’s who screw things up.
Bob BUBBABOZO Hayles
Many of us have come to understand the true value of "scientific consensus." We know that when we are told to simply trust the scientific community, it usually means that there is a lack of hard evidence.
For example, we are told that while potassium-argon dating is not an exact science, it can be relied on for determining a rough age of certain types of rocks. Yet when we attempt to confirm this with rocks of known age, sending samples of the same specimen to several different dating laboratories, we receive wildly different results that are all unacceptably far from the known age.
Then there’s the surprising lack of statistical analysis surrounding certain vaccines. We are told that if one does not get these vaccines, he or she is taking a greater risk. Yet when we look at the small amount of statistical data available to the public, we find that some of the vaccines have a higher probability of death or other adverse event than the actual illnesses they are designed to prevent. When we ask for reconciliation we are told that such analyses are flawed, but no new data is provided.
Therefore, forgive me for spewing my raw milk from my nose when I see someone like you say, "the reality is that PFGE linkages have become the gold standard for identifying sources of food contamination."
(For the record, I’m not suggesting that the Hartmann Dairy is not responsible for the outbreak. I’m just explaining some of the reasons for our lack of trust in the results provided by the scientific community.)
Jeremy Johnson
I find your answers very sophisticated,in other words complex and deceptive.I guess the answer to my question about the number of enzymes used was "It’s too much trouble to do more than 2 enzymes"
The article I referenced wasn’t talking about population genetics over the long term.Maybe you didn’t read it.It is not too long so I will post the whole thing for everyone to read again.
http://jcm.asm.org/cgi/content/abstract/41/5/1843
"Evaluation of Pulsed-Field Gel Electrophoresis as a Tool for Determining the Degree of Genetic Relatedness between Strains of Escherichia coli O157:H7
Margaret A. Davis,1* Dale D. Hancock,1 Thomas E. Besser,2 and Douglas R. Call2
Field Disease Investigation Unit, Department of Veterinary Clinical Sciences,1 Department of Veterinary Microbiology and Pathology, Washington State University, Pullman, Washington 991642
Received 16 May 2002/ Returned for modification 29 September 2002/ Accepted 29 January 2003
Pulsed-field gel electrophoresis (PFGE) has been used extensively to investigate the epidemiology of Escherichia coli O157:H7, although it has not been evaluated as a tool for establishing genetic relationships. This is a critical issue when molecular genetic data are used to make inferences about pathogen dissemination. To evaluate this further, genomic DNAs from 62 isolates of E. coli O157:H7 from different cattle herds were digested with XbaI and BlnI and subjected to PFGE. The correlation between the similarity coefficients for these two enzymes was only 0.53. Four additional restriction enzymes (NheI, PacI, SfiI, and SpeI) were used with DNAs from a subset of 14 isolates. The average correlations between similarity coefficients using sets of one, two, and three enzymes were 0.405, 0.568, and 0.648, respectively. Probing with lambda DNA demonstrated that some DNA fragments migrated equal distances in the gel but were composed of nonhomologous genetic material. Genome sequence data from EDL933 indicated that 40 PFGE fragments would be expected from complete XbaI digestion, yet only 19 distinguishable fragments were visible. Two reasons that similarity coefficients from single-enzyme PFGE are poor measures of relatedness (and hence are poorly correlated with other enzymes) are evident from this study: (i) matching bands do not always represent homologous genetic material and (ii) there are limitations to the power of PFGE to resolve bands of nearly identical size. The findings of the present study indicate that if genetic relationships must be inferred in the absence of epidemiologic data, six or more restriction enzymes would be needed to provide a reasonable estimate using PFGE."
The credibility of your two enzyme results is still questionable in my mind.
There is a good short video by George Wolfe that simplifies and adds to your explanation of how phages interact with bacteria to change their DNA.
http://www.5min.com/Video/Biotechnology-Plasmids-in-Prokaryotes-151426083
So you get this "snapshot" of a bacteria’s chromosome from the stool sample and a "snapshot" of bacteria’s chromosome from a sample from the farm and you compare them ,right?Any fool can see if the look alike we have a match,right?
Are you saying that these phages add DNA to the bacteria’s chromosome and some time later that same piece of DNA pops out so that the bacteria are still close enough to the same DNA to make PFGE profiles still useful.The use of the words "transient infection" implies that the bacteria is still traceable because it reverts back to it’s original DNA.The way I understand this is that the bacteria has a relatively small amount of DNA but it is very adaptable because it has access to the DNA that is free that surrounds it and it has access to the DNA inside the other bacteria surrounding it by horizontal gene transfer.Nothing I have ever read implied that this exchange of DNA was a "transient infection".As the bacteria reacts to stress by adding DNA it can only hold onto a limited amount of DNA so it will dump some of it’s DNA that is no longer needed,not the same bit of DNA.This would change it’s PFGE profile even more.The changes are cumulative not temporary.
How many times have you performed PFGE and analyzed the gels? Until you actually work with this technology, I do not feel that you are qualified to make judgements on it’s value in epidemiological investigations. Similarly, I have never been a farmer, and would not be so arrogant as to tell someone how to run their farm. I would still like to know what went wrong at the Hartmann’s (and the other 8 dairies that had illnesses this year). The best persons to find and correct the problem would be the farmers’ themselves, not the laboratorians or the dreaded regulators. But, that would require accepting the health department’s findings and moving toward prevention instead of denial…
The argument…ANY argument that "you have to have done it" or "have to have been there" is nothing more than an excuse to not defend your position.
I’ve never dropped an atomic bomb, nor did I live in Nagasaki or Hiroshima, but I’m pretty crtain the results suck.
Scientifically, any postulations regarding dinosaurs are invalid since mno scientist was there.
What a crock. Answer, don’t avoid.
Bob BUBBABOZO Hayles
The only thing that likely went wrong at Hartmann’s farm was the flawed epidemiological investigation that took place there.Why do I have to do a PFGE analysis in order to find an article by very qualified people who have the guts to question it’s validity?If someone is in denial,you are the one who denies that PFGE could possibly be of limited value in tracking bacteria.
I do understand bacteria from the study of soil bacteria which is the study of how complex communities of bacteria work together to recycle and purify decaying organic matter into rich,fertile soil.The cow’s digestive system and our digestive system are all part of the cycle of these soil bacteria.You apparently ,come to the study of bacteria from the military point of view(the germ theory).Bacteria are dangerous to our health so we must be able to identify and kill the dangerous pathogens.
i could tell from the beginning that milky is the latest attempt to take over from the failed lykke and susan, not to be trusted in the least . good work wi rmc
Ive done quite a bit of DNA sequence analysis and a wide variety of molecular techniques from the first DNA sequencing and gel electrophoresis work in the early days to automated systems, amplifications and PFGE. The issue of limited restriction enzyme analysis of microbes that have under gone untold generations over many years for comparative purposes is acknowledged by MW and would be so by most of the scientific community. The use of two restriction enzymes with uniquely different binding/cleavage sites is another matter for the purpose we are discussing. The lower correlation coefficient of the Hancock paper, in my reading actually underscores the validity of two distinct restriction enzymes for a comparison of independent isolates that are not part of some long term evolutionary study. For example-the correlative banding patterns in the sample photo that David posted would not be disputed by any of us who have done DNA analysis. (And if there was a question-the analysis could be repeated with another set of restriction enzymes-which has already been done in countless labs to assess ambiguous results-the gel shown is not ambiguous.).
Miguel you have raised many excellent questions, raised my level of awareness on many issues, and I have looked at the references you have cited. But in this specific case, and I base this on almost three decades as a wet bench molecular biologist-MWs correct. The argument against the validity of PFGE for the specific application used here-whether in a scientific seminar (even at MIT) or in a courtroom is a loser.
I urge taking Davids words to heart and focus on the critical issues:
"we need to be prepared to be true to our rhetoric, own up to problems, and push problem raw dairies to own up to problems. There needs to be introspection and self assessment as to what went wrong. The denial and pretending that a case this blatant isn’t real is a disservice to all dairies that consistently produce high-quality raw dairy products.
As Scott Trautman suggests, we need to move beyond words, to actions, to taking responsibility. If public opinion turns against raw milk, believe me, the public health and agriculture bureaucrats will lick their chops and move in for the kill."
So it appears that your main tool for figuring the source of illnesses is invalid for the task used. And when presented with this problem you only offer deceptive answers and when those fail fall back on a silly appeal to authority. But lets think about that for a moment.
This is a classic case of how a person behaves when faced with FACTS contrary to their closely held beliefs. You were given valid scientific data showing you are misusing your tools and in a manner that would harm people if you falsely finger someone as the source of a contamination. How do you handle this? Excuses and denial. And then an appeal to your own authority, in the face of scientific evidence to the contrary. In other words you have more FAITH in your own beliefs than in the FACTS. This is not science.
You need to reconsider your response to Miguel. He is presenting a very convincing and un-rebutted case that the whole basis for these health investigations is fraudulent. If this is the gold standard then that really shows how bankrupt the whole process really is.
So what if the CDC uses PFGE, they’re also behind the push against raw milk, that doesn’t help PFGE’s credibility. The comment that "thats the system they are stuck with, the rules they have to play under." is rather silly considering we’re talking about providing raw milk, often in areas where it is supposedly illegal and these so called rules are being written by the tyrants trying to outlaw healthy giving food.
No, these health department investigations are morally and scientifically bankrupt. Whether the boots on the ground realize it or not, they are little more than the enforcement arm for Big Ag.
This doesn’t mean we should ignore people getting sick or not seek to do something about it. But it is becoming clearer every day that the regulatory agencies and health departments are too corrupt and biased to have any role. Nor do they have the proper knowledge and perspective to deal with finding problems in organic systems.
You state, I would still like to know what went wrong at the Hartmann’s (and the other 8 dairies that had illnesses this year). The best persons to find and correct the problem would be the farmers’ themselves, not the laboratorians or the dreaded regulators. But, that would require accepting the health department’s findings and moving toward prevention instead of denial….
Since you have the wherewithal to state that there is a problem then you should at least have the wherewithal to figure out how it can be solved other then to expect the farmer to get down on his knee and accept at face value the dreaded regulators conclusion based on the laboratorians ambiguous findings?
Ken Conrad
"The use of two restriction enzymes with uniquely different binding/cleavage sites is another matter for the purpose we are discussing. The lower correlation coefficient of the Hancock paper, in my reading actually underscores the validity of two distinct restriction enzymes for a comparison of independent isolates that are not part of some long term evolutionary study. For example-the correlative banding patterns in the sample photo that David posted would not be disputed by any of us who have done DNA analysis. (And if there was a question-the analysis could be repeated with another set of restriction enzymes-which has already been done in countless labs to assess ambiguous results-the gel shown is not ambiguous.)."
I agree ,the gel shown is not ambiguous ,but what information does it give us?The genetic material in the cell is cut at various places into various lengths yielding a pattern that is indistinguishable for the two samples.Do those bits of DNA that are equal in length necessarily perform the same function in the cell?Bits of DNA that are similar in length may very well be very different in function.All we know from the gel is that the PFGE profiles are indistinguishable.If we do another gel with a different enzyme and it too is indistinguishable,then we know that the probability that we are looking at similar strains is higher.The question is how high a probability should we have to have before we are satisfied to say the strains are the same? And also,very importantly,how do we calculate the probability?The authors of the study concluded that 6 or more gels with 6 different enzymes would need to be done in order for the probability to be high enough to say with confidence that the strains are closely related.
"The issue of limited restriction enzyme analysis of microbes that have under gone untold generations over many years for comparative purposes is acknowledged by MW and would be so by most of the scientific community."
Where is the cutoff.When does the number of generations that separate the two samples make the PFGE profile unreliable?We are talking about a generation length at 98.6 deg F of about 20 minutes.That is 72 generations every day.
In an earlier post MW referred to species in relation to bacteria.Species are species because they do not exchange or share DNA.DNA flows between bacteria and between a bacteria and it’s surrounding genetic material.How can these bacteria be tracked by their DNA if their DNA is not static.Do you have information that( as MW tried to say but did not support)those changes in DNA that admittedly take place are only temporary?
Milky way,
I learn as much as anyone from this back and forth,between answering Gumpert,you and Ron and keeping up with the work around here I have overlooked some questions.Please have patience and throw the most important ones back at me.
I think they want us to pasteurize the whole farm every 20 minutes if we won’t pasteurize the milk.
I’d love to see someone provide an actual answer to miguel’s clear questions, because he is challenging a premise used in the argument against the Hartmann Dairy. Logically, an argument is not sound if one of its premises are not true. If one is to arrive at such a conclusion, the onus is on him or her to demonstrate that each premise that it relies on is true. If the argument is not sound, there are a lot of people that owe the Hartmanns a big apology. (That’s not to say that the conclusion is necessarily false, but the current argument is certainly unsound at this point.)
I think that miguel is under no obligation to answer Milky Way’s or David’s questions about his personal opinions, which are irrelevant to the topic at hand, when they refuse to answer his questions that strike at the heart of the matter.
Jeremy Johnson
I attempted to answer at least one of your questions, but I do not have the expertise on this subject which Miguel does. I hope you are able to continue the dilaogue, despite the hostility from some of the other folks posting on the blog. The discussion here can get rather heated, as I’m sure you’ve gathered, because many of us have been criminalized or turned into outcasts by the state and/or dairy industry, for our choice to consume and/or produce raw milk.
Thanks for the encouragement. I didnt mean to ignore your response, it answered my trust question and I actually cut and pasted your post into a raw milk file. I thought you gave a very concise and well-written description of the political angst in the debate. I give some lectures to students and have used the raw milk debate as an example of how epidemiology and laboratory data play a role beyond the science (and how we as scientists are not automatically trusted just because we went to school for a long time and work hard in the lab). I also own a copy of David Gumperts book on the Raw Milk Revolution, and while I dont agree with everything he wrote, it is an excellent documentation of current events, and another useful teaching tool (for students or for regulators and scientists working in this arena).
Miguel, if the other bloggers havent convinced you of my lack of worth, my main questions are:
1.) Maybe youve heard this quote, or some variation of it: A microbiologist would rather use another microbiologists toothbrush than their method.
If you do not agree with PFGE, what method would you agree with? What criteria would you use to define a confirmed association between illnesses and a raw milk source? If you could, include in the answer what method you would trust in the event there was no leftover raw milk to test from the implicated batch (this is critical since you cant test something
that no longer exists, yet you can still look at the bigger picture on the farm – the animals, soil, water, equipment, etc.).
2) You suggest that the only remediation to deal with bad bugs is to sterilize the farm every 20 minutes (to satisfy the regulators). That implies that you dont believe practical and effective prevention measure exist for raw dairy. I disagree. The Hartmann farm sold raw dairy products for years without an E. coli problem, then suddenly they have a customer with a child in the hospital and multiple animals carrying the bacteria (cultures were positive regardless of what you think about PFGE). Isnt it logical to try to figure out what happened? For example, what questions would you ask as a farmer? I might ask did he bring in new animals, maybe a super shedder (see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870353/?tool=pubmed )? Did something change with the dairys milking or bottling practices?
Do you think these are reasonable questions? I acknowledged Bob Hayles and others with regard to the junk food hypothesis, and am fully supportive of asking about the diets of the raw milk drinkers who got sick. But, I kinda doubt that families who drive to a farm to get raw milk are also part of the Happy Meal and Twinkie crowd.
Thanks.
As I said before I approach these questions from a different point of view than you.For me dis-ease occurs when things get out of balance,not when some sort of outside parasite attacks the body.A lot of factors can cause things to get out of balance.Lack of sleep is one that I am particularly familiar with.Stress,did you ever get an upset stomach before a big test when you were in school?The difference we have is that your whole search for the cause of disease is focused on the search for the pathogen that attacked this normal healthy person.Other things are overlooked that can upset the balance in someone’s digestive system.Antibiotics are one of the most common causes of diarrhea.We forget that all kinds of chemicals that we encounter every day in our food, water and air and applied to our skin can upset the balance of bacteria in our gut.How do combinations of chemicals
affect us?If we look for what it was that triggered the imbalance that resulted in the overgrowth of one particular opportunistic strain of bacteria,we have to broaden our investigation to include all of these things.But more importantly when someone is out of balance ,we should recognize the situation and move quickly to reestablish the balance.If you are talking about the digestive system this means getting the right bacteria into it before the imbalance has gone so far that the patient cannot hold anything down.
I would begin the investigation of what happened by identifying the source of the imbalance in each of the ill individuals.Rather than test different foods that the ill people ate for pathogens ,I would test for chemicals or antibacterials that would depress some of the bacteria while letting others grow out of control.If I had reason to suspect the milk I would test it for the presence of antibiotics and sanitizing chemicals.These are simple tests that farmers often do themselves.
"cultures were positive,no matter what you think of PFGE"
Someday when I have more time I will tell you what I think of cultures.
You have quoted extensively from the literature, with great detail on PFGE. Can you finish your analysis with a description of a scientific alternative?
Did you know that one of the children was lactose intolerant and never drank the milk? Did you know that the one hospitalized had an adverse reaction to the antibiotic which is why the child was so sick? Did you know that one of the cases just went to school with someone who drank the milk and never consumed it?
Yes, it is a matter of the right to choose, and we choose to support a family dedicated to the health (yes, you read that right) of their consumers. We have the choice of whether to consume or not, and we choose to consume knowing all the "facts" but are not allowed to any more.
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