Detection & Investigation of a Large Campylobacter Outbreak - - PowerPoint PPT Presentation

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Detection & Investigation of a Large Campylobacter Outbreak - - PowerPoint PPT Presentation

Jul 29, 2023 487 likes •703 views

Detection & Investigation of a Large Campylobacter Outbreak Associated with Raw Milk Cindy Burnett, MPH Utah Department of Health One Health Conference, 10/1/15 Campylobacter jejuni Reportable in Utah Gram negative bacteria Outbreaks:

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Detection & Investigation of a Large Campylobacter Outbreak Associated with Raw Milk

Cindy Burnett, MPH Utah Department of Health One Health Conference, 10/1/15

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Campylobacter jejuni

Reportable in Utah Gram negative bacteria Outbreaks: poultry, contaminated water, raw milk Incubation: 2-5 days Symptoms: fever, diarrhea Stringent survival/growth requirements

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Campylobacter sources

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Outbreak - Background

In May 2014, three Campylobacter isolates with indistinguishable PFGE patterns

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Investigation

All 3 reported drinking raw milk

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Nothing new here….

14 outbreaks of Campylobacter due to raw milk since 2009

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Raw Milk Laws in Utah

Permit issued by UDAF

  • Milk sold directly by farm
  • Labeling requirements
  • Record keeping
  • Regular testing
  • If illness – permit may be suspended until milk

tests negative for pathogen

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UDAF Dairy Inspection

June 16

  • 10 cases identified
  • No violations found
  • Bulk tank samples negative for Campylobacter

June 20

  • Problem with cooling bulk tank
  • Bulk tank samples negative for Campylobacter
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Cases Continue

2 4 6 8 10 12 14

Number of Outbreak Cases Reported Through July 29, 2014

Investigation Began

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Collaborative Inspection

July 29, 2014

  • UDAF, Epi and UPHL
  • Milk neutralized onsite
  • Sample positive for C. jejuni
  • Dairy’s license suspended Aug. 4
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2 4 6 8 10 12 14

Number of Outbreak Cases Reported Through October 1, 2014

Investigation Began Raw milk permit suspended Raw milk permit reinstated

Success?

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Permit Revoked

2 4 6 8 10 12 14

Number of Outbreak Cases Reported Through July 29, 2014

Investigation Began Raw milk permit suspended Raw milk permit reinstated Raw milk permit revoked

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Exposures of All Cases (n = 99)

Exposure

  • No. (%)

Dairy A Raw Milk 53 (54%) Mexican-style Cheese (Queso Fresco) 21 (21%) Unknown Source 25 (25%)

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Exposures of All Cases (n = 99)

Exposure

  • No. (%)

Dairy A Raw Milk 53 (54%) Mexican-style Cheese (Queso Fresco) 21 (21%) Unknown Source 25 (25%)

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Demographics of Cases (n = 99)

Characteristic

  • No. (%)

Male 58 (59%) Hispanic 31 (31%) Age (years) 0-5 11 (11%) 6-18 32 (32%) 19-64 44 (44%) ≥65 4 (4%)

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Demographics of Cases (n = 99)

Characteristic

  • No. (%)

Male 58 (59%) Hispanic 31 (31%) Age (years) 0-5 11 (11%) 6-18 32 (32%) 19-64 44 (44%) ≥65 4 (4%)

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Demographics of Cases (n = 99)

Characteristic

  • No. (%)

Male 58 (59%) Hispanic 31 (31%) Age (years) 0-5 11 (11%) 6-18 32 (32%) 19-64 44 (44%) ≥65 4 (4%) Hospitalized 10 (10%)

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Demographics of Cases (n = 99)

Characteristic

  • No. (%)

Male 58 (59%) Hispanic 31 (31%) Age (years) 0-5 11 (11%) 6-18 32 (32%) 19-64 44 (44%) ≥65 4 (4%) Hospitalized 10 (10%) Died 1 (1%)

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Conclusions

Routine testing of raw milk does not ensure safety Proper pathogen testing is essential for regulatory efforts during outbreaks Raw milk is an important source of Campylobacter infections in Utah Raw milk consumption should be discouraged

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Questions?

cburnett@utah.gov www.igotsick.health.utah.gov