From: Stueve Bros. Farms
June
18, 2001
671
West Arrow Highway
Claremont, California 91711-4808
Telephone:
909.399.3560
To: James McLaren
2823 Prince of Wales Drive
Ottawa, Ontario K2C3H1
Canada
SUBJECT: Grade A Raw Milk
Dear Mr. McLaren:
The Stueve family has been selling raw milk and later raw certified milk in California, since June 1, 1945. During that time, over 56 years, our customers have consumed billions of glasses of raw milk and raw certified milk without an outbreak of illness caused by either raw milk or raw certified milk.
While all fresh foods may contain organisms that may be harmful to certain persons, raw milk is the only fresh food that actually carries a label warning the consumer of that fact.
RAW MILK CARRIES A WARNING LABEL ADVISING CONSUMERS OF THE VERY CONCERNS THAT SOME HEALTH DEPARTMENTS EXPRESS IN THEIR POSITION AGAINST RAW MILK. REMEMBER RAW MILK IS NOT PURCHASED BY ACCIDENT. IT COSTS MORE MONEY. MANY BELIEVE AS I DO THAT RAW MILK WITH ITS NUTRIENTS UNALTERED IS HEALTHIER.
The California Health Department has tried to ban raw milk for 50 years They have affected the availability of raw milk for consumers in Los Angeles County by increasing regulatory efforts to a point that any food so regulated would be difficult to purchase.
The consumer has been protected over the past fifty years by the State of California and its authority to prohibit the use, sale, disposal of raw milk when the director or, any health officer acting as an agent of the director, or milk inspection officer acting as an agent of the director determines that the oral ingestion by a human being of any raw milk supply has caused disease in a human being. California Food and Agricultural Code § 359228.
However, during the past 56 years they have never determined that oral ingestion of raw milk from Stueve Bros. Farms has caused disease in a human being!
Although not necessary since the label on the product already alerts the public that the product may contain organisms harmful to certain individuals, monthly testing of raw milk for bacteria and coliform, Salmonella, Listeria, E-coil, somatic cell, water and fat content and drugs (antibiotics) is sufficient to alert the public of any organism found.
"SOURCES OF FOODBORNE PATHOGENS ARE UBIQUITOUS, FOOD AND FOOD PRODUCTS WILL ALWAYS BE CONTAMINATED WITH LOW LEVELS OF PATHOGENS”1
It is well established that, "SOURCES OF FOODBORNE PATHOGENS ARE UBIQUITOUS" and that, "FOOD AND FOOD PRODUCTS WILL ALWAYS BE CONTAMINATED WITH LOW LEVELS OF PATHOGENS. AT LOW LEVELS PATHOGENIC MICROORGANISMS CAUSE NO PROBLEMS."2
Even though foodborne pathogens are ubiquitous, there are few food and food products, other than raw milk, that carry a warning label advising the consumers that their product may contain disease causing micro-organisms.
The statistics presented by the opponents of raw milk are incomplete, unreliable and do not lead to the conclusion that the opponents of raw milk would have you believe. See ANALYSIS OF LINE LISTINGS COLLECTED BY DR. WERNER, CALIFORNIA DEPARTMENT OF HEALTH SERVICES, attached hereto.
The studies, comments and statements, show that the efforts to date by the opponents of raw milk have been biased to scare and not to inform. Joseph L. Fleiss, Ph.D. professor and head of biostatistics, Columbia University stated,
It is appropriate for our government health department to warn the public about possible health hazards, but not to do so using biased statistics. The statistics quoted by the California Department of Health Services are meaningless. They did not adjust for confounding variables or attempt to compare like with like. They are speculating and speculations are worse than useless.
David Snydman, M.D. Hospital Epidemiologist, Associate Professor Medicine, Tufts University stated,
It is note worthy that once the pasteurization order for all milk from the dairy was handed down in April 1974, there was essentially no change in the development of Salmonella dublin infection in the California population. Therefore, certified raw milk from the dairy should not really be implicated as contributing to most of the cases of Salmonella dublin infection. This leads me to think that Salmonella dublin may be very common in other aspects of the food chain in California.
Pasteurized milk is not recalled when it is tested and found to exceed farm score card tests, coliform and/or standard plate counts. The producer is given time to correct the scoring problem and is retested.
Opponents of raw milk, in their push to ban the product, often cite Dr. Werner's California Department of Health Services ("CDHS") report on Line Listings of Salmonella cases in California between 1971 and 1975. However, the New England Journal of Medicine rejected this report because it was unscientific.3
For example, the cause of death of a woman who drowned while swimming off the coast of San Mateo was reported in Dr. Werner's statistics as a Salmonella infection death.
Another example of misleading information in Dr. Werner's statistics is found in the case of an infant who had broken his femur bone, the largest bone in his body. He was hospitalized for the broken femur bone, but also had a Salmonella infection. His hospitalization was listed as a Salmonella infection hospitalization.
A 1986 FDA Safety Initiative Preliminary Status Report issued by Jerome J. Kazak, Chief, Milk Safety Branch, reported that people with Salmonella infections have been hospitalized, yet the evidence is insufficient to conclude that they were hospitalized BECAUSE of the Salmonella infection.
When questioned under oath, Dr. Werner's own testimony confirms the unscientific nature of his "Study".
Dr. Werner testified, under oath, that:
He did not know the reason a
case listed in the line listings entered the hospital;
The case histories do
not tell him the cause of death for the Salmonella infection
cases;
He did not say that 20%
died from Salmonella infection, as some have reported;
What a person consumed was
critical determination of causation or association;
A person who consumed a
product contaminated with Salmonella would have developed symptoms close to or
as early as two days after the time the patient acquired the Salmonella
infection;
By the time an individual was identified to the county health department as having a Salmonella infection, a good three to four weeks may have elapsed before the Salmonella case history questionnaire was filled out;
In the case of Salmonella
dublin, without a laboratory isolation of the organism in the food, it is
very difficult, if not impossible, to identify in an individual case, which of
the possible risk factors caused the illness. And further, he has not
determined the source of bacteria in the majority of Salmonella dublin cases
in California; and
A person could harbor Salmonella dublin for a period of six months and one would not be able to tell when that person became infected. He could only determine the date of infection, in most cases, within a day or two of the date of exposure, but he didn't know what the date of exposure was, because people cannot generally recall what they had for supper four days ago, and “we recognize that people cannot recall specific dates of exposures".
Listeria survives the pasteurization process. 4
Listeriosis has occurred from the consumption of pasteurized milk in Boston, Massachusetts.
Listeria has been found in pasteurized milk and cheese in California but no regular effort is made to test pasteurized milk for the presence of Listeria.
Some Listeria in pasteurized milk is okay according to the World Health Organization's working group on foodborne Listeriosis. They concluded that pasteurization is a safe process that reduces the number of Listeria monocytogenes bacteria occurring in raw milk to levels that do not pose an appreciable risk to human health.
Evidence and common sense dictate that there is no way to keep pathogens from entering any food. To write that pasteurization is the only way to destroy pathogenic bacteria is sheer folly.
Pathogenic bacteria may or may not be destroyed at the time that the milk is heated in the tank. Once heated, the milk must then travel from that pasteurization tank through pipes, which may or may not be contaminated, to filters, which may or may not contain pathogenic microorganisms, to a bottle or carton, which may or may not be contaminated.
If the pasteurized milk makes it through all of these transfers without picking up pathogenic microorganisms, it then is opened by the consumer and then may or may not be contaminated by the air, other foods it comes into contact with, or even persons handling the carton.
The LARGEST OUTBREAK OF FOODBORNE ILLNESS IN MODERN TIMES RESULTED FROM THE CONSUMPTION OF PASTEURIZED MILK. The FDA estimates that over 200,000 people became ill because of an infection caused by Salmonella typhimurium in pasteurized milk. This Salmonella bacterium is the serotype of Salmonella that most often causes illness in humans, according to Dr. Werner of the California Department of Health Services.
Salmonella typhimurium occurs not only in pasteurized milk but also in many other food sources, including vegetables, fruits, meat, and poultry.
In August of 1984 approximately 200 persons became ill with a Salmonella typhimurium infection from pasteurized milk produced in a plant in Melrose, Ill. The regulators did not report this outbreak. Without evidence they concluded that the culprit was raw milk that didn't get pasteurized.
However, again in November of 1984, another outbreak of Salmonella typhimurium occurred in persons consuming pasteurized milk bottled in this same plant. Again the regulators kept it a secret!
But in March of 1985, 19,660 confirmed cases of Salmonella typhimurium illness resulted in people who consumed properly pasteurized milk bottled in the same plant in Melrose, III.
The FDA estimated that over 200,000 persons actually became ill with Salmonella typhimurium from consuming this pasteurized milk. After investigation, it turns out that raw milk was not responsible for this contamination. The milk was properly pasteurized as indicated by the bacterial and coliform counts.
Pasteurized milk responsible for outbreaks of human illness have been documented and confirmed:
1982--over 17,000 persons became ill with Yersinia enterocolitica from PASTEURIZED milk bottled in Memphis, Tenn. This pasteurized milk was shipped interstate to Arkansas and Mississippi. Tennessee, the state where the milk was produced, and Mississippi are both states that have BANNED RAW MILK!
1983--over 49 persons with Listeria illness have been associated with the consumption of pasteurized milk in Massachusetts.
1984--two outbreaks of salmonella typhimurium involving several hundred people resulted from the consumption of PASTEURIZED MILK bottled in Melrose Park, Illinois.
1985--over 16,284 reported cases (FDA estimates a total off 200,000actual cases) of Salmonella typhimurium infections in humans resulted from the consumption of PASTEURIZED MILK bottled in the same Melrose Park, Illinois where milk was bottled that caused the outbreaks in 1984.
1985--the largest number of food poisoning deaths recorded in recent history was traced to pasteurized Mexican-style cheese (142 cases, 47 deaths) contaminated with Listeria monocytogenes.
In 1987, the Regional Administration Milk and Dairy Food Branch of the California Department of Food and Agriculture reported that:
Of the 50 plants in which there was evidence of positive findings, the FDA said it found Listeria monocytogenes in FINISHED product in 19 plants, Listeria Innocua in products in 3 plants, non-pathogenic Yersinia enterocolitica in products in 21 plants, Salmonella in products in 2 plants, Aeromonas hydrophila in 3 plants, Pasteurella haemlyticus in 1 plant and Enteropathogenic E. Coli in the product in 1 plant. Listeria monocytogenes has been detected in whole milk, chocolate milk, both whole and low fat, ice cream, ice milk mix and ice cream novelties, including bars, slices, drumsticks, ice rolls and four-ounce cups.
Milk Quality Surveys in California: Surveys taken between 1974 and 1984 found that at the time people consume pasteurized milk, i.e. between the time of purchase and the pull date, the standard plate count (SPC) of bacteria per milliliter, exceeded 15,000 between 71 and 100 percent of the time AND exceeded 1,500,000 SPC in some milks 8.7 percent of the time.
Mother Nature included in some foods, such as raw milk, enzymes like Lactoperoxidase, which inhibit and in some cases eliminate pathogens like Salmonella and Listeria. This enzyme is severely altered and in many cases destroyed by heating of pasteurization.
In Los Angeles County a survey of the available records of the 1800 soft serve ice cream locations, many of them fast food outlets, indicated that one out of two milk shakes were sold illegally, i.e. they exceeded bacteria counts of 75,000 per milliliter and one out of four had over one million bacteria organisms per milliliter. Still no tests were conducted to determine if any of these organisms were pathogens such as Salmonella, Listeria, etc.
In fact, no follow-up tests were conducted to see if the bacteria counts were lowered and no action was taken to ban soft serve ice cream!
In 1985 the outbreak of Listeria was caused by contaminated Jalisco cheese. It did not contain raw milk. No Listeria was found in any raw milk supplied to Jalisco. Indeed, hundreds of tests for Listeria were performed on samples taken from Stueve's dairy plant, counters, drains and products. NO LISTERIA WAS PRESENT! Jocoque Sour Cream manufactured by Stueve's and delivered to Jalisco for distribution under the Jalisco label was '"super" pasteurized at 185 degrees. (Normal pasteurization temperature is 161 degrees).
The Jocoque found to contain Listeria was NOT taken from Stueve's dairy plant, but from a trash dumpster at the Jalisco plant. The carton of Jocoque had been damaged and opened while it was in the trash dumpster prior to testing. Indeed after an exhaustive five-week jury trial with experts from the Centers for Disease Control, State of California and County of Los Angeles and other experts from around the world, the Jury found that the milk was not the source of the Listeria!
On every occasion where a jury has heard the evidence, they have found public health officials claims to be without support and found that Stueve's raw milk did not cause disease in the plaintiff's action!
None of the Salmonella Dublin cases reported in Los Angeles County were determined to be the cause of illness in a human being.
The only outbreak of Salmonella Dublin occurred at Vandenberg Air Force base where 115 persons acquired a Salmonella dublin infection after eating roast beef, macaroni salad, ham, or beans. No raw milk was present or consumed.
UCLA reviewed data collected from faulty "investigations" by those with an agenda to ban raw milk in the State of California and others. They did not go behind the incomplete, false, inaccurate, faulty or misleading information supplied them. Their conclusions were only as good as the data they relied on. If the data relied on was false, faulty, misleading, inaccurate, incomplete, etc. then so too is their "study".
Stating that ten persons, who consumed raw milk in the week prior to illness, in California were confirmed with Salmonella typhimurium does not show causation between the raw milk consumption and Salmonella typhimurium. What else did they consume? What other foods consumed were tested for Salmonella typhimurium? Were samples taken from the batches of raw milk consumed for testing for Salmonella typhimurium or are they referring to some other raw milk in another state or country?
1998 REPORT BY CENTERS FOR DISEASE CONTROL AND PREVENTION
A 1998 Report by the Center for Disease Control and Prevention is a compilation of inaccurate and misleading data.
One example is of the reported outbreaks that occurred in Wisconsin, a state that has banned raw milk. When one learned of the facts, it was determined that when one family during a picnic, ran out of milk, they went to the neighboring farm to borrow milk. They too were out of milk, but they had milk in a barrel in the barn that horses were drinking from. They scooped a bucket of milk from the barrel in the barn the horses had been drinking from and returned to their farm to consume this horse food!
The California Department of Health Services has acknowledged that Salmonella contaminates many foods in a great number of ways. Indeed, Dr. Werner, himself, said that Salmonella typhimurium is the most common Salmonella infection in humans in California each year. Dr. Werner continued, "Salmonella typhimurium is such a large category, it receives probably half of all the cases that occur in this country and in this state..." Under oath he testified that Salmonella typhimurium "could be in any food of animal origin, it could be related to person to person transmission and other sources.”
All agencies, government or private, that have studied foodborne illness and its transmission have agreed that other pathogens, such as Listeria, Bacillus cereus, Pseudomonas aerugosa, E. coli O157:H7, Campylobacter and others are common contaminants in foods (including pasteurized milk) at the time of consumption.
Dr. Werner believes that the only foods that can be classified as safe (an absolute term) are those foods that are autoclaved (a method for sterilization by steam under pressure). According to Dr. Werner, all foods are unsafe unless sterilized. Not just cooked, but sterilized by steam under pressure!
Safe is defined as, "free from damage, danger or injury."5
Under this definition no food is always safe.
Douglas Archer and John Kvenberg of the FDA'S Division of Microbiology have estimated foodborne illness in the United States ranged between 24 and 81 million cases per year.
Research, studies and investigations into reports of sporadic cases of foodborne illness have documented a large variety of contaminated foods being sold on a daily basis. Each day, however, without incident of illness, most of the population consumes food with low levels of pathogens.
Informed investigators of foodborne illness all agree it is impossible to produce a food that is absolutely safe, i.e., without any risk, whether from pathogenic bacteria, viruses, toxic components, etc. James L. Smith, of the USDA Agricultural Research Service, and others, addressed this very issue in a study.6
"The sources of foodborne pathogens are ubiquitous. Food and food products will always be contaminated with low levels of pathogens. At low levels, pathogenic microorganisms cause no problems."7
"The following data indicates the presence of pathogens in food:
· 85% of 670 tested samples of fresh fish contained Anisakine nematodes.
· 47% of over 1000 tested samples of clams, mussels, and oysters were positive for enteroviruses (polio, echo, cossacki, reo, and hepatitis B).
· 95 to 100% of the tested samples of retail fresh raw poultry, fish, red meat and produce (lettuce, celery, kale, etc.) as cited by Palumbo et al., (1985) and Calister and Agger (1987) contained Aeromonas hydrophila.
· 100% of the tested samples of raw rice and 46-63% of raw hamburger and beef samples contained Bacillus cereus. Five out of 8 samples of dried milk powder were also found to contain Bacillus cereus.
· 45-64% of the tested samples of broiler chicken carcasses and fresh turkey wings contained Campylobacter jejuni.
· 50% of 40 samples of corn syrup contained Clostridium botulinum, type B.
· 39-45% of tested samples of pork and chicken products (both raw and cooked) contained Clostridium perfringens 1.5-3.7% of the tested retail fresh beef, pork and poultry samples were found to contain Escherichia coli O157:H7.
· 50-100% of the tested samples of raw ground beef, ground pork, ground veal and raw chicken legs were found to contain Listeria monocytogenes. Heisick, et al. (1989) found the presence of Listeria spp. in a large number of vegetables, particularly those grown in or close to the ground. For example, Listeria spp. was present on 26% of all the fresh potatoes and 30% of fresh radishes tested.
· 40-100% of the tested samples of fresh poultry, 3-20% tested samples of fresh pork, and 8-33% of tested samples of raw shellfish (clams, oysters, and crabs) indicated the presence Salmonella spp.
· 73% of tested samples of raw chicken, 13-33% of tested samples of raw pork, 26% of tested samples of raw beef and 38% tested samples of raw seafood contained Staphylococcus aureus.
· 39-46% of tested samples of seafood taken from retail operations and processing plants indicated the presence of Vibrio spp. (V.cholerae and V.parahaemolyticus).
· 49% of tested samples of raw retail pork products, 48% of raw milk taken from bulk tanker trucks and 46% of raw vegetables indicated the presence of Yersinia."8
Seafood has been associated with foodborne illness.
Seafood can carry dangerous pathogens. Scombroid fish poisoning, which causes flushing and gastrointestinal symptoms, was responsible for 15% of all reported restaurant outbreaks between 1988 and 1992 where the cause was known. Scombroid fish poisoning is caused by the decomposition of fish tissue by bacteria resulting in production of histamine, a toxin. Scombroid fish poisoning occurs when fish are not properly refrigerated, allowing bacteria to multiply.9
Meat, as well as the other foods listed on Exhibit "B", are not tested by any governmental agency on a daily basis for pathogens in finished product, that is, product ready for sale to the public. E. coli O157:H7, has been linked to beef and other foods, causing an estimated 21,000 illnesses annually and at least 450 deaths. Yet the government does not test meat daily for the presence of pathogens. It is present in beef only when the animals' intestinal contents or manure are permitted to contaminate the muscle meat during slaughter.10
Although meat contains pathogens that may be harmful, there is NO effort by CDHS or LACDHS to put a warning label on meat or other foods that may contain pathogens, much less ban them.
The U.S. Department of Agriculture in a letter regarding a warning label on meat, quoting the National Research Council:
"...the problem of controlling salmonellosis in man is greatly complicated because of the widespread distribution of the organism in the environment and the many ways by which they can reach the host."
"Recent experience has implicated a variety of processed foods and drugs (e.g., egg products, dry milk, coconut, inactive dry yeast...) in outbreaks of salmonellosis."
The Department's letter concluded that since "there are numerous sources of contamination which might contribute to the overall problem", it would be "unjustified to single out the meat industry and ask that the Department to require it to identify its raw products as being hazardous to health. Such an act would have to apply to any and all sources of salmonellae in order to be fairly administered."
Salmonella bacteria contaminate an estimated 20% of raw broiler chicken carcasses. Salmonella enteritidis, the strain of Salmonella most likely to contaminate eggs, caused between 200,000 and 1,000,000 illnesses in 1994, the last year for which such data are available.11
Indeed Nutrition Week12 reported Consumer Reports' testing of 1,000 fresh whole chickens at grocery stores in 36 cities over a 5-week period in the fall of 1997, finding that 71% of store-bought chicken contained either Salmonella and/or Campylobacter.
RESTAURANT CONTAMINATION
Food eaten in a restaurant consistently causes 40-50% of foodborne illness while food eaten at home causes 20-30% of foodborne illness. It appears that eating food in a restaurant increases one's chances of contracting a foodborne illness nearly twofold.
FDA Commissioner Frank Young reported at the National Food Policy Conference in March of 1987, that the two problem areas were imported foods and meals consumed away from home.
Harmful bacteria, including Salmonella and E. coli O157:H7, accounted for 74% of the reported restaurant-associated food poisoning outbreaks between 1988 and 1992 where the cause was known.13 The CDC reported that Salmonella caused 60% of all reported restaurant outbreaks where the cause was known.
In a survey of 45 state and local government agencies that conduct inspections of restaurants, the Center for Science in the Public Interest14 (“CSPI") found that a large majority of agencies are not following FDA's national standards for restaurants (the "Food Code").
Only 13% of the agencies surveyed enforced the FDA Food Code recommended cooking temperatures for pork, eggs, fish and poultry, and only 64% required hamburgers to be cooked to 155°F, the temperature necessary for E. coil O157:H7 to be destroyed in 15 seconds.
Only 11% of the agencies required refrigeration of food at the temperature recommended by FDA.
Only 20% of the agencies follow Food Code temperature recommendations for cooling cooked food.
Less than half of the agencies inspect restaurants twice a year.
Only 16% of the agencies require consumer warnings for raw food, like shellfish, and undercooked food, like hamburgers.
The best available national data show that, between 1983 and 1992, 42% of all reported food-poisoning outbreaks were traced to food eaten in restaurants, delicatessens and cafeterias. In comparison, only 21% of the food-poisoning outbreaks were attributed to food eaten at home.
Although there is no official estimate as to how many of the 6.5 million to 33 million food poisonings a year are caused by food eaten in restaurants, there are likely millions of such illnesses, all of which could be prevented by better food handling in restaurants and better enforcement of national food safety standards.
Both industry and government officials agree that the food safety problems linked to restaurants are substantial.
Just one food safety mistake in a restaurant kitchen can sicken large numbers of people, sometimes hundreds at a time. Some reasons for large restaurant-caused outbreaks include:15
1. Restaurants often prepare several different types of food in the same kitchen at the same time, enabling one food containing harmful bacteria to contaminate many other foods unless handled carefully;
2. Restaurants handle large quantities of food at a time, making it harder to keep food at temperatures that prevent growth of bacteria; and
3. One food handler who fails to practice good hygiene, such as proper hand washing, can contaminate food that is then served to many people.
4. A few outbreaks of restaurant food poisoning:16
Massachusetts, June 1996. Food
contaminated with Salmonella that was served in a Wendy's restaurant in
suburban Boston sickened 38 people and may have contributed to a death.
Investigators determined that employees who did not wash their hands before
handling food caused the outbreak;
Idaho, September 1995. At
least 11 cases of illness due to E. coli O157:H7 were traced to food
eaten in a Chili's restaurant in Boise. The primary source of the E. coli
O157:H7 is beef, but in this outbreak, authorities believe raw beef
carrying the bacteria probably cross-contaminated other food served in the
restaurant;
Florida, August 1995.
Salmonella newport bacteria sickened over 850 people in the largest
outbreak of foodborne illness in Florida history. Health officials who
investigated the outbreak believe that Salmonella bacteria in chicken
cross-contaminated several other foods served at Margarita y Amigos restaurant
in West Palm Beach;
Utah, January 1995. An
outbreak of 95 cases of hepatitis A was traced by the local health
department to an employee of a Taco Bell restaurant in Salt Lake City. The
hepatitis A virus is carried in human fecal matter and is spread when
food handlers do not wash their hands thoroughly;
Washington, D.C., August 1994.
Hollandaise sauce contaminated with Salmonella served at a brunch at a
hotel sickened 56 people, 20 of whom were hospitalized. According to
investigators, the sauce was prepared from raw eggs and heated over a hot
water bath. It was then held for nine hours at a temperature at least 20
degrees lower than that recommended by the FDA Food Code;
Georgia, October 1993. A
botulism-poisoning outbreak killed a customer of a delicatessen in a
small south Georgia town and sickened seven others. Their illnesses were
traced by CDC officials to canned cheese sauce, which had been left opened and
unrefrigerated for eight days, served on baked potatoes stuffed with barbecued
meat. Health officials said proper refrigeration of the sauce could have
prevented the outbreak;
Illinois, June 1993. A Mexican
restaurant in a Chicago suburb served Salmonella-tainted food that sent
25 people to the hospital and sickened 16 others. County investigators
attributed the outbreak to prepared food not being held at hot enough
temperatures, and to poor food handler hygiene;
Oregon, March 1993. In Grant's
Pass and North Bend, E. coil O157:H7 bacteria in mayonnaise served at
Sizzler restaurants sickened 48 peopled. According to data reported to CDC,
the mayonnaise was cross-contaminated by a food, most likely raw or
insufficiently cooked ground beef, that contained E. coli O157:H7
bacteria. An additional 50 cases of illness caused by E. coli O157:H7
bacteria in food served in Sizzler's restaurants in Oregon and Washington were
reported to CDC in 1993; and
The Western U.S., December 1992 to January 1993. The largest E. coli O157:H7 outbreak in the U.S. occurred in Washington, Idaho, Nevada and California and was linked to contaminated hamburgers served at Jack in the Box restaurants. At least 700 cases of foodborne illness were reported. Nearly 100 of the victims developed hemolytic uremic syndrome, a serious complication resulting from E. coli O157:H7 infection, and four children died, the oldest just six years old.
If we can be of further assistance please don't hesitate to call us.
Very truly yours,
Stueve's Natural
____________________________________________
Boyd Clarke, President
RBC/der
Enclosure
ANALYSIS OF LINE LISTINGS COLLECTED BY DR. WERNER,
CALIFORNIA DEPARTMENT OF HEALTH SERVICES
Case histories collected by various health departments and others over the last 20 years and used by the California Department of Health Services (“CDHS"), in their efforts to ban certified raw milk and certified raw milk products were not complete, were unreliable and thus do not provide valid epidemiological support for a ban on certified raw milk and certified raw milk products,17 for the following reasons:
1. The unreliability of the case histories data is established by the fact that there have been no outbreaks of Salmonella dublin associated with raw certified milk since they started collecting the case histories in 1971. An outbreak was defined as two or more cases occurring in time and place with a common source. That leaves only isolated or sporadic cases, and, according to Dr. Werner (CDHS), it is very difficult, if not impossible, to identify the source of disease in sporadic cases. As Dr. Morrison (CDHS) states, "without conclusive identification of the organism in the food, it would be unclear as to whether or not that food was the source of the infection, even in an outbreak."
2. Lawrence T. Glickman, DVM, DrPH18, an expert in Public Health, Veterinary Medicine and Epidemiology, is the only person, in all the years that the case histories have been collected, to comprehensively review all of the Case History Questionnaires that have been relied on by the California Department of Health Services and others in compiling the line listings. Dr. Glickman concluded that the case histories and the line listing summaries were not the type of data that experts in the field of Epidemiology would normally rely upon. Dr. Glickman explained that the statistics compiled by Dr. Werner of the California Department of Health Services could not serve as a basis for any correlation to determine causation. They may have been helpful for a surveillance program or to generate a hypothesis for further study, but for the reasons set forth below, Werner's statistics could not be used to support any opinion regarding causation or association between illness or death and the consumption of raw certified milk:
(a) Dr. Glickman explained that in 1963 the Surgeon General of the United States established five criteria for generally accepted methods of Epidemiology to determine causation. In epidemiological research, unlike public health surveillance in general, you must have a controlled study which utilizes a control group, so that one can begin to sort out differences between and determine whether an association even exists, and secondly, to sort out whether that association is or is not causally related to the disease in question. The only criterion met by the case histories was that Salmonella was isolated from specimens provided by the patient. No other criteria were met, especially the use of a control group. It is not surprising, then, that Dr. Werner's report, called the "Association Between Raw Milk and Human Salmonella dublin Infection" (which was based on his line listing data), was rejected by the New England Journal of Medicine because it lacked proper controls.
(b) Dr. Glickman has reported at length the numerous other inherently unreliable characteristics of the case history questionnaires. First, they were not representative of the general population, as they must be if you are trying to determine the risk regarding the consumption of raw certified milk. Secondly, the questionnaires could not have been properly used to establish an association between a suspected food item and source because the questionnaires were incomplete. Specifically, the questions as to possible source or exposure were not answered by or on behalf of all persons. Although the 697 case histories required over 76,600 responses, Dr. Glickman found only 150 to 250 usable responses in the 691 case histories that he examined in his comprehensive analysis.
(c) Another critical point, which Dr. Glickman has raised, is that the questionnaires are biased. When Dr. Glickman reviewed all of the questionnaires and their related documents, he observed that Dr. Werner had on occasion informed the public health employees who would be conducting the interviews that the information in the questionnaires was being sought for medical-legal reasons. This created a high potential for bias because the interviewers were not blinded as to why the information was being sought. This is extremely unusual in epidemiological research.
(d) According to Dr. Glickman, the case histories and line listings were also unreliable because they were incomplete and inconsistent in a variety of other ways. For example, one particular report was not marked in response to "foods eaten within three days of illness" but it was marked as to customary use of raw milk. This type of data suggested that the only food question asked might have been as to whether or not that person drank raw milk. Obviously, these types of responses considerably reduced the reliability of the data. Another example is where a case history reports that the patient "denies raw milk". This response also indicates that the interviews were biased.
(e) Of even greater significance in establishing the unreliability of the line listings as a basis for causation or association is the fact that Salmonella dublin cases occurring in California were sporadic in nature; that is, they did not occur as a result of any outbreak. Dr. Glickman opines that if a batch of raw certified milk was contaminated, and given that there were approximately 100,000 to 250,000 raw milk drinkers, you would expect to see at least more than one reported case of Salmonella occurring at any one point in time. Since the cases are sporadic, Dr. Glickman concludes that there were probably multiple sources for the Salmonella as opposed to a single source - raw milk. This conclusion is well-supported by the fact that in at least 65% of the Salmonella dublin cases reported in California during the years 1971-1984, no associations or identifications of the probable source of those persons' Salmonella infections were ever made.
(f) During the time that the various health agencies and others have been collecting these case histories, 1971-1991, the ONLY Salmonella dublin outbreak in California occurred at Vandenberg Air Force Base, affecting 115 people one afternoon in August 1975. However, these Salmonella dublin cases do not appear in any of the California statistics. The statement in the FINDING OF EMERGENCY R-5-91, that "(F)or one particular Salmonella serotype, S. dublin, 697 human cases were identified in California between the years 1971 and 1984" is false! Actually 812 cases of Salmonella dublin were identified in California for that period of time. In fact, according to Dr. Werner, those illnesses, comprising the Salmonella dublin outbreak, were either the result of the consumption of cooked roast beef, macaroni salad, baked beans or ham! Even with a point source outbreak the CDHS couldn't identify one single known source of Salmonella dublin!
3. Dr. Werner has testified that what a person consumed was critical to a determination of causation or association because a person who consumed a product contaminated with Salmonella would have developed symptoms close to or as early as two days after the time the patient acquired the Salmonella infection. However, according to Dr. Werner, by the time an individual was identified to the county health department as having a Salmonella infection, a good three to four weeks may have elapsed before the questionnaire was filled out. Incredibly, some patients (and in the case of raw certified milk, all patients) were not actually asked what they had to eat or drink prior to becoming sick because, as Dr. Werner points out, the patient usually could not recall what was consumed seven days prior to the onset of illness.
4. Dr. Werner continued his support of the unreliability of the case history questionnaires by testifying that in one case of Salmonella dublin, without a laboratory isolation of the organism in the food, it is very difficult, if not impossible, to identify in an individual case, which of the possible risk factors caused the illness, and, indeed, he has not determined the source of bacteria in the majority of Salmonella dublin cases in California; a person could harbor Salmonella dublin for a period of six months and one would not be able to tell when that person became infected; he could only determine the date of infection in most cases within a day or two of the date of exposure, but he didn’t know what the date of exposure was, because people cannot generally recall what they had for supper four days ago, two days ago, and “we recognize that people cannot recall specific dates of exposures.” He does feel that the only foods that can be classified as safe are those foods that are autoclaved (a method for sterilization by steam under pressure).
1 Snider, O.P. and Poland, D.M. "America's Safe Food", Dairy, Food and Environment Sanitation, Vol. 10, No. 12, pp. 719-724 (December 1990) and pp. 14-20 (January 1991)
2 Snider, O.P. and Poland, D.M., supra
3 Analysis of Dr. Werner's, CDHS, Line Listings by Dr. Glickman and testimony of Dr. Werner.
4 California Morbidity Weekly Report, March 31, 1989.
5 Webster's Dictionary, Unabridged, Second Edition.
6 Snyder, O.P. and Poland, D.M., Supra.
7 Snyder, O.P. and Poland, D.M., Supra.
8 Ibid., p. 719.
9 Center for Science in the Public Interest, Dine at Your Own Risk – Part III, Supra.
10 Center for Science in the Public Interest, Dine at Your Own Risk – Part III, Supra.
11 Center for Science in the Public Interest, Dine at Your Own Risk – Part III, Supra.
12 ”Chickening Out on Poultry," Nutrition Week, March 6, 1998:28(9):2, 910 17th Street N.W., Suite 413, Washington, D.C. 20006.
13 Center for Science in the Public Interest, Dine at Your Own Risk – Part III, Supra.
14 Center for Science in the Public Interest, Dine at Your Own Risk – Part I, The Failure of Local Agencies to Adopt and Enforce National Food Safety Standards for Restaurants, Caroline Smith DeWad, Director, Food Safety Program, Elizabeth Dahl, Staff Attorney, Food Safety Program, November 1996.
15 Center for Science in the Public Interest, Dine at Your Own Risk - Part III, The Failure of Local Agencies to Adopt and Enforce National Food Safety Standards for Restaurants, Caroline Smith DeWaal, Director, Food Safety Program, Elizabeth Dahl, Staff Attorney, Food Safety Program, November 1996.
16 Center for Science in the Public Interest, Dine at Your Own Risk - Part IlI, Supra.
17 Analysis of Dr. Werner's Line Listings on Salmonella dublin cases between 1971 and 1975.
18 See attached Curriculum Vitae for Lawrence T. Glickman, DVM, DrPH.