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Dr. Purnedu Vasavada - Current and Emerging Organisms in Raw Milk that Affect Public Health
 

Dr. Purnedu Vasavada - Current and Emerging Organisms in Raw Milk that Affect Public Health

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Current and Emerging Organisms in Raw Milk that Affect Public Health - Dr. Purnedu Vasavada, University of Wisconsin-River Falls, from NIAA's One Health: Implications for Animal Agriculture, March 15 ...

Current and Emerging Organisms in Raw Milk that Affect Public Health - Dr. Purnedu Vasavada, University of Wisconsin-River Falls, from NIAA's One Health: Implications for Animal Agriculture, March 15 - 17, 2010, Kansas City, MO, USA.

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    Dr. Purnedu Vasavada - Current and Emerging Organisms in Raw Milk that Affect Public Health Dr. Purnedu Vasavada - Current and Emerging Organisms in Raw Milk that Affect Public Health Presentation Transcript

    • Current and Emerging Organisms in Raw Milk that Affect Public Health Dr. Purnendu C. Vasavada Animal and Food Science Department University of Wisconsin - River Falls River Falls, WI 54022 Presented at 2010 NIAA Annual Meeting Kansas City, MO. March 15-17, 2010 © Dr. P.C. Vasavada.2010 All Rights Reserved. 1
    • Main Objective   To review current and emerging pathogens in raw milk, including the “less recognized” and “presumptive” pathogens in the context of safety and public health risk associated with consumption of raw milk and in milk products manufactured from unpasteurized milk © Dr. P.C. Vasavada.2010 All Rights Reserved. 2
    • Milk Mustaches… What, Me Worry? Raw Milk: = Alfred E. Newman © Dr. P.C. Vasavada.2010 All Rights Reserved. 3
    • Outline   Introduction   Microorganisms in milk   Sources of microorganisms   Pathogens in Milk – Historical aspects   Current and Emerging Pathogens   Less recognized and presumptive pathogens   Summary © Dr. P.C. Vasavada.2010 All Rights Reserved. 4
    • UW River Falls UW River Falls  30 th UW River Falls  Food Microbiology Symposium and Rapid Methods in Food Microbiology Workshop  River Falls, WI.USA , October 17-20, 2010 © Dr. P.C. Vasavada.2010 All Rights Reserved. 5
    • Significance of Microorganisms in Milk   Quality and shelf life   Regulatory and vendor compliance   Fermentation, starter cultures, flavor organisms, adjunct flora, probiotic organisms   Safety - Pathogens, toxins, biosecurity © Dr. P.C. Vasavada.2010 All Rights Reserved. 6
    • Microorganisms in milk   Bacteria   Yeast and molds   Viruses/Bacteriophages   Rickettsiae © Dr. P.C. Vasavada.2010 All Rights Reserved. 7
    • Important spoilage microorganisms- Bacteria   Bacillus*   Achromobacter*   Corynebacterium   Acinetobacter*   Clostridium   Alcaligenes*   Enterococcus   Enterobacter   Lactobacillus   Escherichia   Listeria*   Flavobacterium   Microbacterium   Moraxella*   Micrococcus   Proteus   Pediococcus   Weisella   Schewanella  Psychrotrophic   Zymomonas © Dr. P.C. Vasavada.2010 All Rights Reserved. 8
    • Important spoilage microorganisms - Yeast and Molds Yeasts Molds   Candida   Alternaria   Cryptococcus   Aspergillus   Debaromyces   Aureobasidium   Rhodotorula   Botrytis   Torulopsis   Cladosporium   Yarrowia   Geotrichum   Mucor   Penicillium   Rhizopus   Thamnidium © Dr. P.C. Vasavada.2010 All Rights Reserved. 9
    • Sources of microorganism in Raw Milk   Milk from the healthy animal is usually sterile   Contamination may occur from   Cow (Mastitis, Systemic disease (Bovine Tuberculosis)   Skin microflora   Environmental contamination (air, soil,dus), water, manure, bedding material (sawdust), silage   Equipment (milking equipment, pipe-line, utensils, drains, transportation trucks   Vector ( insects , flies)   Humans ( personnel: milkers and milk handlers © Dr. P.C. Vasavada.2010 All Rights Reserved. 10
    • Raw Milk and Public Health Threat   Raw milk recognized since early 1900s as a significant source of diseases   Pasteurization introduced in 1906, PMO developed in 1924   Milkborne outbreak constituted 25% of all disease outbreaks due to contaminated food and water, today, less than 1% of all outbreaks attributed to contaminated milk and milk products.   Raw milk sales controlled or banned in over 40 states.   87% of raw milk outbreaks during 1973-1992 in states that permit intrastate sale   Position statements and scientific consensus about public health risk of raw milk © Dr. P.C. Vasavada.2010 All Rights Reserved. 11
    • Public Health, Regulatory and Educational Organizations’ Position on Raw Milk Issue   American Veterinary Medical Association (AVMA)   Association of Food & Drug Officials (AFDO)   Health Canada   National Association of State Departments of Agriculture (NASDA)   National Association of State Public Health Veterinarians (NASPHV)   National Conference on Interstate Milk Shipments (NCIMS) program   State regulatory agencies   University cooperative extension programs © Dr. P.C. Vasavada.2010 All Rights Reserved. 12
    • Raw Milk and Public Health Threat   Raw milk demand growing   Political pressure on relaxing/overturning milk pasteurization regulations/allowing sale of raw milk   Less then 0.5% of U.S. milk is consumed unpasteurized.   Yet, raw milk and cheese result in approximately twice the outbreaks as conventional products © Dr. P.C. Vasavada.2010 All Rights Reserved. 13
    • Growing Demand for Raw Milk and activism © Dr. P.C. Vasavada.2010 All Rights Reserved. 14
    • Hearing Held About Legalizing Raw Milk Mar 10, 2010 EAU CLAIRE, Wis. (AP) -- Hundreds of people packed a legislative hearing in Eau Claire Wednesday on legalizing the sale of unpasteurized milk. The proposed legislation would allow consumers to buy raw milk directly from a farm and give dairy farmers immunity from liability if someone got sick drinking the unpasteurized product. © Dr. P.C. Vasavada.2010 All Rights Reserved. 15
    • © Dr. P.C. Vasavada.2010 All Rights Reserved. 16
    • Milkborne disease outbreaks by Food category, United States, 1973-2005 © Dr. P.C. Vasavada.2010 All Rights Reserved. 17
    • Pathogens identified in unpasteurized dairy Products associated illness outbreaks, U.S., 1990-2006 • Source: SCPI Outbreak Alert! Database, 2008. © Dr. P.C. Vasavada.2010 All Rights Reserved. 18
    • Bellingham company recalls raw milk due to E. coli fears Posted on February 24, 2010 by Drew Falkenstein a Bellingham, Washington company called Jackie's Jersey Milk recalled raw milk product due to possible contamination by E. coli O157:H7. The contamination was detected during routine sampling and testing of the company's products by the Washington State Department of Agriculture. © Dr. P.C. Vasavada.2010 All Rights Reserved. 19
    • © Dr. P.C. Vasavada.2010 All Rights Reserved. 20
    • Tuesday, March 16, 2010 • WALWORTH COUNTY, WI State orders Elkhorn farm to stop raw milk sales through cow-share program ELKHORN — State agriculture officials have ordered an Elkhorn farm to stop selling raw milk through a cow-share program after more than two dozen people fell ill. The order against Zinniker Farm Inc., says 35 people from Walworth, Waukesha and Racine counties have been diagnosed with campylobacter jejuni since Aug. 13. That’s a bacterial infection that causes diarrhea, cramping and vomiting. All the victims said they had consumed raw milk. Thirty of them said they got it from the Zinniker farm. Tests matched campylobacter jejuni found in 29 victims’ feces to campylobacter jejuni found in cow feces on the farm. © Dr. P.C. Vasavada.2010 All Rights Reserved. 21
    • © Dr. P.C. Vasavada.2010 All Rights Reserved. 22
    • © Dr. P.C. Vasavada.2010 All Rights Reserved. 23
    • © Dr. P.C. Vasavada.2010 All Rights Reserved. 24
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    • E. Coli in raw milk sends kids to the hospital December 13, 2005 By Brian Barker and KATU Web Staff VANCOUVER, Wash. - If you or your children have been drinking unpasteurized milk or been experiencing diarrhea, you might want to get checked out by a doctor. The Clark County Health Department says they have confirmed six cases of E. coli have in children between the ages of 5 and 19. © Dr. P.C. Vasavada.2010 All Rights Reserved. 26
    • FDA Warns Consumers to Avoid Drinking Raw Milk E coli outbreak in Washington blamed on raw milk Raw milk distributors targeted by regulators © Dr. P.C. Vasavada.2010 All Rights Reserved. 27
    • © Dr. P.C. Vasavada.2010 All Rights Reserved. 28
    • E. coli 0157:H7 infection associated with Unpasteurized Goat’s Milk © Dr. P.C. Vasavada.2010 All Rights Reserved. 29
    • UK: Threat of E-coli contamination spreads 23 Dec 2005 Source: just-food.com Fears that certain brands of camembert may be infected with the dangerous strain of E-coli, 026, have spread to include other raw milk products imported from France, the Food Standards Agency (FSA) announced yesterday (23 December). © Dr. P.C. Vasavada.2010 All Rights Reserved. 30
    • © Dr. P.C. Vasavada.2010 All Rights Reserved. 31
    • Pathogens in Raw Milk - Historical aspects  M. tuberculosis  C. diptheriae  C. burnetii  Staph. aureus  Salmonella  Streptococci  Brucellae © Dr. P.C. Vasavada.2010 All Rights Reserved. 32
    •   Pasteurization statutes - 1906/ PMO adoption   “TB Free” and “Brucella Free” status of dairy herds   “Certified” milk movement   Refrigeration of milk   On-farm hygiene and milk quality programs © Dr. P.C. Vasavada.2010 All Rights Reserved. 33
    • Current and Emerging Pathogens   Salmonella spp. Emerging Pathogens are infectious   E. coli 0157:H7 agents whose incidence in humans has increased dramatically within the past two   Listreia monocytogenes* decades, or one that has the probability   Yersinia enterocolitica* of increasing in future   Staphylococcus aureus CDC (1994)   Clostridium spp.   Bacillus cereus* * Pyschrotrophic   Campylobacter jejuni © Dr. P.C. Vasavada.2010 All Rights Reserved. 34
    • Pathogens in raw milk   Several well designed studies to assess incidence of pathogens in raw milk   Steel et al. 1997 Ontario Bulk Tank Raw Milk   Jayarao and Henning 2001. Bulk tank milk in SD and Western Mn   Waak et al. 2002. Listeria monocytogenes in raw milk in Swedish dairy   Karns et al 2005. Salmonella enterica in bulk tank milk by PCR © Dr. P.C. Vasavada.2010 All Rights Reserved. 35
    • Pathogens in Bulk Tank Milk Pathogen % Campylobacter 2 – 9.2% E. coli O157:H7 0 - 0.75% Listeria monocytogenes 2.8 - 7.0% Salmonella spp 0 – 11% Shiga-toxin E. coli Oliver et-al (2009 2.4 3.96% Yersinia enterocolitica 1.2 – 6.1% Oliver et al (2009) © Dr. P.C. Vasavada.2010 All Rights Reserved. 36
    • Pathogens in raw milk* Pathogen % positive Campylobacter jejuni 0.4 – 12.3 % E. coli 0157:H7 0.8 – 3.8% Salmonella spp. 0.2 – 8.9% L. Monocytogenes** 1.0 – 12.6 % Y. enterocolitica 11.3 - 89% •  Compiled from Several International studies, Oliver et al. 2005. ** Incidence of L.M. in raw milk varies from 0 %- 45.3 % © Dr. P.C. Vasavada.2010 All Rights Reserved. 37
    • Yersinia enterocolitica in Raw Milk Larkin et al. 1991 © Dr. P.C. Vasavada.2010 All Rights Reserved. 38
    • Campylobacter jejuni in Raw Milk Larkin et al. 1991 © Dr. P.C. Vasavada.2010 All Rights Reserved. 39
    • Less Recognized and Suspected Pathogens Changing Paradigm – Microorganisms: The Good Bad and Ugly   Beneficial Organisms   Spoilage Organisms   Recognized and emerging pathogens New category: Less recognized/ presumptive /opportunistic pathogens © Dr. P.C. Vasavada.2010 All Rights Reserved. 40
    • Less Recognized and Suspected Foodborne Pathogens   Enterobacteriaceae   Helicobacter and Arcobacter   Spore forming organisms   Lactic acid bacteria   Coryniform and Mycobacteria   Zoonotic organisms © Dr. P.C. Vasavada.2010 All Rights Reserved. 41
    • Less Recognized and Suspected Foodborne Pathogens   Enterobacteriaceae   Citrobacter spp., 5 outbreaks 3 attributed to milk   Klebsiella. Isolated from milk, milk products, water, vegetation   Spore forming organisms   Bacillus cereus, B. brevis, B.licheniformis   Clostridium perfringens © Dr. P.C. Vasavada.2010 All Rights Reserved. 42
    • Enterobacter sakazakii   Linked to deaths of premature infants in neonatal intensive care units   Reconstituted infant formulae   Several recalls of infant formulae   Environmental contamination C. sak © Dr. P.C. Vasavada.2010 All Rights Reserved. 43
    • E. Sakazakii   Necrotizing enterocolitis, sepsis, meningitis in neonatal infants   Powdered milk-based infant formulae recognized as a vehicle for infection   Outcome poor (fatality rate 40 - 80%)   Wide spread in environment   Variable heat resistance   Biofilm production © Dr. P.C. Vasavada.2010 All Rights Reserved. 44
    • E. sakazakii - Heat Resistance Thermal Death Time Curves for 2 E. Sakazakii Heated at 58°C D = 591.9 sec D = 30.5 sec E. sakazakii- Biofilm Formation Stainless Steel: Adherent Micro-Colonies Hoescht Stain of ES after attachment (1:10 TSB – 4 h, RT), rinsing and Incubation (TSBReserved. and 48 h at 37oC) © Dr. P.C. Vasavada.2010 All Rights – 24 h 45
    • Less Recognized and Suspected Foodborne Pathogens Zoonotic pathogens   Mycobacterium paratuberculosis   Brucellosis   Q fever   Leptospirosis © Dr. P.C. Vasavada.2010 All Rights Reserved. 46
    • Mycobacterium paratuberculosis (MAP)   Johne’s and Crohn’s disease   Detection and isolation of M. paratb.   Heat inactivation of MAP © Dr. P.C. Vasavada.2010 All Rights Reserved. 47
    • Other Mycobacterium spp.   M. bovis   M. scrofulaceum   Associated with infected lymph nodes in children   isolated from raw milk   M. gordonae   “tap water bacillus”   Isolated from raw milk and water © Dr. P.C. Vasavada.2010 All Rights Reserved. 48
    • Brucellosis   Zoonoses affecting farmers, Vets   Undulant fever, Malta fever   B.abortus, B. melitensis, B.suis   Brucellosis outbreak associated with soft cheese from unpasteurized sheep and goat’s milk and travel to endemic areas   Trends in Raw milk/Cheese consumption   Disease making a come back? © Dr. P.C. Vasavada.2010 All Rights Reserved. 49
    • Less Recognized and Suspected Foodborne Pathogens:”LAB” Streptococci S.pyogenes, S. agalactiae S. zooepidemicus Enterococci E. durans, E, feacium, E. fecalis Lactobacillus, Lactococcus, Leuconostock & Pediococci All isolated from human infection © Dr. P.C. Vasavada.2010 All Rights Reserved. 50
    • Less Recognized and Suspected Foodborne Pathogens   Streptobacillus moniliformis   Pleomorphic Gram negative rods   Acute illness associated with rat- bite fever   1926 Haverhill fever traced to raw milk consumption   Coryniform bacteria   C. diptheriae, C. bovis, C. ulcerans   © Dr. P.C. Vasavada.2010 All Rights Reserved. 51
    • Less Recognized and Suspected Foodborne Pathogens   Protozaon parasites   Cryptosporidium   Giardia   Toxoplasma gondii – Raw Goat’s milk © Dr. P.C. Vasavada.2010 All Rights Reserved. 52
    • Coxiella burnetii © Dr. P.C. Vasavada.2010 All Rights Reserved. 53
    • Q Fever in The Netherlands   December 16, 2009 An outbreak of Q fever   2,293 human cases have been confirmed in 2009, including 6 deaths   Part of the ongoing outbreak of Q fever in the Netherlands since 2007   190 cases (2007)1,000 cases in 2008. © Dr. P.C. Vasavada.2010 All Rights Reserved. 54
    • Coxiella burnetii   a highly infectious agent   resistant to heat, drying, and many common disinfectants, allowing it to survive for a long time in the environment.   can become airborne and inhaled by humans.   could be developed for use in biological warfare and is considered a potential terrorist threat. © Dr. P.C. Vasavada.2010 All Rights Reserved. 55
    • Q Fever - Recommendation-   Eat only milk and dairy products that have been pasteurized.   Do not drink raw milk or eat raw milk products. © Dr. P.C. Vasavada.2010 All Rights Reserved. 56
    • Summary   Raw milk is a recognized source of pathogen   Inadequate Some organisms pose special challenge due to their slow growth, low occurrence or special characteristics   Detection challenges and approaches   Education, awareness and implementation of preventative strategies (HACCP) © Dr. P.C. Vasavada.2010 All Rights Reserved. 57
    • Emphasis on Dairy Products Quality and Safety   Quality Control   Quality Assurance TQM   Quality Systems HACCP   TQM GMPs   HACCP Hygiene   On-Farm HACCP ? Microbes play a significant role in food quality and safety © Dr. P.C. Vasavada.2010 All Rights Reserved. 58
    • Detection Challenge   Many suspected pathogens are :   Slow growing fastidious organisms   VNC   Similar to other contaminating flora   Do not grow readily on microbial media ….and hence the need for novel approaches and methods © Dr. P.C. Vasavada.2010 All Rights Reserved. 59
    • Detection Challenge: MAP, Parasites and viruses   On-farm “quick tests” in most cases have not been tested or approved for use in milk   Assays typically do not have the sensitivity or specificity to detect/indentify pathogens such as E. coli O157:H7   Multiplex detection not possible   Molecular methods? © Dr. P.C. Vasavada.2010 All Rights Reserved. 60
    • PCRs, Biosensors and Microarrays: MAP, Parasites and viruses detection Rapid Progress made in and characterization methods and approaches Symposia, workshops worldwide for research dissemination and training © Dr. P.C. Vasavada.2010 All Rights Reserved. 61
    • UW River Falls Food Microbiology Symposium 30 th UW River Falls You are invited!!! Food Microbiology Symposium and Rapid Methods in Food Microbiology Workshop River Falls, WI.USA October 17-20,2010 © Dr. P.C. Vasavada.2010 All Rights Reserved. 62
    • Conclusion   Raw milk and unpasterurized milk product consumption continues to cause illness and outbreaks   Inadequate regulations restricting raw milk and unpasterurized milk product   Unpasteurized product outbreaks are more common and cause more severe illness than pasteurized product outbreak   Educate consumers, public health partners and legislators about health risks of consuming unpasteurized products © Dr. P.C. Vasavada.2010 All Rights Reserved. 63
    • Raw Milk Safety : Control of Pathogens   “First priority in producing dairy foods: produce safe foods.” “To produce safe dairy products, it is vital to understand the causes of foodborne illness and the peculiarities of the organisms involved” Elmer H. Marth, Emeritus Professor , UW- Madison   ‘It is very difficult to get a person to understand something when his/her salary depends on not understanding it.’ Upton Sinclair from The Jungle   © Dr. P.C. Vasavada.2010 All Rights Reserved. 64  
    • Acknowledgement Thank You !! Any Questions ??? © Dr. P.C. Vasavada.2010 All Rights Reserved. 65
    • See you in Wisconsin !! © Dr. P.C. Vasavada.2010 All Rights Reserved. 66