Even under the best circumstances, unpasteurized milk can make people sick, a new report concludes.

In one of the biggest outbreaks of campylobacter bacteria seen nationally in recent years, raw milk from a Pennsylvania dairy farm sickened 148 people in four states in January 2012, according to the report. Most campylobacter outbreaks involve a dozen or fewer people.

The report, which details what happened during the outbreak, said the dairy that sold the milk had a permit for selling unpasteurized milk, and had passed all inspections. The farm was among the largest sellers of unpasteurized milk in the state.

The dairy also tested its own milk for E. coli bacteria more often than was required. The vast majority of the sick people drank the milk before its "best by" date.

The only deficiencies that investigators found were that a mechanical milk bottle capper was broken, so employees had capped the bottles by hand, and that the water used to clean equipment was cooler than recommended (110 to 120 degrees Fahrenheit, instead of 160 to 170 degrees F).

But these issues were "minimal," and this campylobacter outbreak demonstrates "the ongoing hazards of unpasteurized dairy products," according to the report authors from the Centers for Disease Control and Prevention and state health departments. The findings were detailed online April 26 in the journal Clinical Infectious Diseases.

"Raw milk is riskier than most foods," said Douglas Powell, a professor of food safety at Kansas State University. While certainly a larger number of people get sick yearly from eating tainted tomatoes or lettuce, there are many more consumers of those foods than consumers of raw milk, he said.

Bacteria commonly found in the digestive tracts of farm animals, including campylobacter and E. coli O157, can easily find their way into milk as it is pumped and bottled on a farm, Powell said.

"Fecal matter just ends up in the milk — it's not like you can see it," he said. "No inspectors can see it — this isn't CSI, where the bacteria just magically line up."

Nearly a third of those sickened in the outbreak were children, the report said. Children, along with pregnant women and people with compromised immune systems, are at high risk of complications from campylobacter infections.

Powell said he advises that raw milk not be given to children. "As adults, you're free to choose," he said. "But don't give it to your kids."

The people sickened in the outbreak ranged in age from 2 to 74, the report said. Typically, campylobacter infections cause diarrhea, abdominal pain and fever that last about a week, and most people get better on their own. In the outbreak, 10 people were hospitalized.

The dairy immediately suspended unpasteurized milk sales when it was informed of the outbreak.

The researchers recommended that state officials consider more regulation of unpasteurized milk, such as monthly pathogen testing.

However, consumers can never be certain that unpasteurized milk is free of pathogens, even it is certified and from a dairy that seems to be functioning well, the report said.

"The only way to prevent unpasteurized milk–associated disease outbreaks is for consumers to refrain from consuming unpasteurized milk," the researchers wrote in their report.

The number of dairies with permits to sell unpasteurized dairy products in Pennsylvania grew from 26 in 2002 to 153 in 2013, according to the report. The increase was driven by consumer demand and the higher prices that unpasteurized milk producers can get for their products, the report said.

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By Carey Gillam
Reuters

Dangerous antibiotic-resistant bacteria has been found in ground turkey on U.S. grocery shelves across a variety of brands and stores located in 21 states, according to a report by a consumer watchdog organization.

Of the 257 samples of ground turkey tested, more than half were found to be positive for fecal bacteria and overall, 90 percent were contaminated with one or more types of disease-causing organisms, many of which proved resistant to one or more common antibiotics, Consumer Reports found.

The non-profit, independent product-testing organization said in the June issue of its magazine that the sampling marked the first time it had conducted a laboratory analysis of ground turkey, a popular consumer alternative to hamburger. It was alarmed by the results.

"Some bacteria that end up on ground turkey, including E. coli and staph aureus, can cause not only food poisoning but also urinary, bloodstream, and other infections," said a Consumer Reports statement on its findings.

The group said it samples ground turkey from 27 different brands including major and store brands.

Turkeys, like other livestock in the United States, are commonly given repeated low doses of antibiotics in an effort to keep the animals healthy and help promote growth. But there has been growing concern that widespread use of antibiotics in animals that are not sick is speeding the development of antibiotic resistance. 

The National Turkey Federation said the findings were sensationalized on a sampling that was "extremely small," and said that blaming use of antibiotics in animals was "misleading."

"There is more than one way they (harmful bacteria) can wind up on food animals," said National Turkey Federation vice president Lisa Picard. "In fact, it's so common in the environment, studies have shown that generic E.coli and MRSA (Methicillin-resistant Staphylococcus aureus) can even be found on about 20 percent of computer keyboards."

The U.S. Food and Drug Administration also found widespread contamination, discovering antibiotic resistant E coli, salmonella and other harmful bacteria in turkey, ground beef, pork chops and chicken in sampling done in 2011.

The food safety regulator says resistance of bacteria to antibiotics is "a major public health threat," and last year issued voluntary guidelines for animal health and animal agriculture industries aimed at limiting the antibiotic use in livestock. The agency has rebuffed efforts to mandate reduced usage, however.

U.S. Rep. Louise Slaughter, a New York Democrat, last month reintroduced legislation that would ban non-therapeutic uses of eight types of antibiotics in food animal production.

The Centers for Disease Control and Prevention also has issued a warning about antibiotic resistance infections, saying they are becoming increasingly difficult to treat and more infected people are likely to die.

"Humans don't consume antibiotics every day to prevent disease and neither should healthy animals," said Dr. Urvashi Rangan, Director of the Food Safety and Sustainability Group at Consumer Reports. "Prudent use of antibiotics should be required to stem the public health crisis generated from the reduced effectiveness of antibiotics."  

At least 73 people in 18 states have been sickened with salmonella poisoning after eating cucumbers imported from Mexico, government health officials said Thursday.

The potentially tainted cukes have been removed from the market and the two firms involved -- Daniel Cardenas Izabal and Miracle Greenhouse of Culiacan, Mexico -- were placed on import alert Thursday, according to the Centers for Disease Control and Prevention. The cucumbers were distributed by Tricar Sales Inc. of Rio Rico, Ariz.

Cucumbers from the firms will be denied access to the United States until the suppliers show that they are not contaminated with salmonella, including the salmonella Saintpaul strain detected in the current outbreak.

The biggest concentrations of victims were clustered in Western states, including 28 from California and nine from Arizona. Fourteen people have been hospitalized. Reports show that illnesses occurred between Jan. 12 and April 6, though more could still be detected.

Most people infected with salmonella bacteria develop diarrhea, fever and abdominal cramps within one to three days of eating contaminated food. The illness typically lasts four to seven days, and most people recover without treatment. However, some people may require hospitalization. Most at risk are children younger than 5, older adults and people with weakened immune systems.

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This story was originally published on Mon Apr 8, 2013 7:23 PM EDT

Paul Sakuma / AP file

Members line up for registers at a Costco warehouse store in Mountain View, Calif. Purchase records are being used more frequently by public health officials investigating outbreaks of foodborne illness.

If you have a warehouse membership card in your wallet or a supermarket shopper tag on your key chain, you might regard it as a good way to save money. But public health officials say it may be an even better way to save lives.

More local health departments -- along with state and federal investigators -- are relying on the detailed information about what went in consumers’ shopping carts to track down outbreaks of foodborne illness, experts say.

Take the outbreak of E. coli O157:H7 bacteria in organic spinach and spring mix salad greens that sickened 33 people in five states last fall, including new mother Erica Duerr, 32, of North Tonawanda, N.Y., and her mother-in-law, Beth Duerr, 60.

Erica Duerr already had been sick for nine days when Beth Duerr was struck with gastrointestinal symptoms so severe she had to be rushed to a local emergency room. That’s when local health department officials called, seeking her shopper card numbers.

“They went to the hospital and they got her info,” says Erica Duerr, a nurse who had just given birth to her second child. “They were actually able to track down where it came from.”

Data from Beth Duerr and others pointed to contaminated greens sold by Wegmans, a small Northeast grocery chain, but produced by State Garden of Chelsea, Mass. Seattle food safety lawyer Bill Marler sued the firm on the Duerr families' behalf. 

Identifying exactly which products were purchased by victims of food poisoning has become a standard tool for public health investigators, said officials with the Centers for Disease Control and Prevention.

“We are definitely supportive of the use of shopper cards during these outbreak investigations,” said Casey Barton Behravesh, deputy chief of the CDC’s outbreak and prevention branch of the division of foodborne, waterborne and environmental diseases. “The product, the flavor, the lot code, the best by date: That is all tracked with these purchases.”

The CDC estimates that 48 million Americans get foodborne illnesses every year, 128,000 of them are hospitalized and 3,000 die.

Store cards are a rich trove for epidemiologists, who often are trying to track down suspect food a month or so after it was consumed because of the lag between when an illness strikes and when it gets reported, said Bill Keene, a senior epidemiologist with the Oregon Public Health Division. His state has been a leader in using shopper card data, along with Minnesota, but others are joining in, Keene said. 

“We rely on people’s memories, which are quite fallible, and on our interviews, which are quite fallible,” Keene told NBC News. “Shopper club cards are a good source of finding out what people ate.”

Identifying the source of an outbreak early and accurately can get product off the shelves faster and point doctors toward the best treatment for victims, experts said.

The push appears to have begun back in 2009, when investigators were stumped after an outbreak of salmonella linked to salami and other deli meats sickened 272 people in 44 states. It was only when officials with Costco warehouse stores cooperated with health officials to review membership data that the source was pinpointed: pepper-crusted Italian-style meats made by Daniele International Inc.

Costco has been notifying consumers about food and other products recalls for safety reasons since the late 1990s, said Craig Wilson, the company’s vice president for food safety and quality assurance. But now, they’re being called on by public health officials at every level.

“It happens a couple times a week,” said Wilson. “It’s getting to be more of a norm.”

Most recently, CDC officials say they have been using shopper cards to investigate an outbreak of salmonella Heidelberg that has sickened at least 128 people in 13 states since June. The illnesses appear to be tied to poultry products from Foster Farms, a West Coast poultry producer. 

The reasons may be obvious. About 80 percent of U.S. consumers belong to a shopper loyalty card program, and the average household now participates in more than six shopper programs, according to a report by the Food Marketing Institute.

Nearly 60 percent of retail grocery stores now offer shoppers cards, said Hilary Thesmar, vice president for food safety programs at FMI. The group's members go out of their way to cooperate with public health officials.

“The hardest ones are when they are looking for that food and they have the illnesses and they’re finding it’s hard to detect the source of the illnesses,” Thesmar said. “I know our members receive a lot of requests and they frequently comply with those requests.”

But it’s not always easy, Keene says. Stores provide data only with the permission -- usually written consent -- of the consumer and a verified shopper card or membership number. And disclosure rules vary from state to state, making some information more difficult to obtain.

“We won’t just release data,” said Wilson.

Those concerned about the potential for privacy violations say it’s not nearly tough enough, however. Shopper cards and membership stores that track your groceries are essentially creating a “food registry” of every meal you eat, said Katherine Albrecht, founder and director of CASPIAN, Consumers Against Supermarket Privacy Invasion and Numbering.

She worries that the information one day could be used to control consumers’ health decisions, particularly once federal health care reforms take full effect.

“Once the federal government is paying for your health, it becomes a public health issue what you put in your mouth,” she said, adding later: 

“Public health officials want to know exactly what’s on your shelf. Today it’s salmonella, but tomorrow it might be cholesterol, or ice cream.”

In the meantime, though, health officials like Keene say they safeguard the data carefully and use it only as a tool to keep more people from getting sick.

“We are the government, but we aren’t that part of the government,” he said. “We’re the good guys.”

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A federal grand jury indicted four employees of a peanut company linked to a 2009 salmonella outbreak that killed nine people and sickened hundreds.

The indictment was unsealed Wednesday in federal court in Georgia and charges four employees with Virginia-based Peanut Corp. of America. The charges include conspiracy, wire fraud, obstruction of justice and others related to contaminated or misbranded food.

Named in the indictment were company owner Stewart Parnell, his brother and company vice president Michael Parnell, Georgia plant manager Samuel Lightsey and Georgia plant quality assurance manager Mary Wilkerson.

The recall of Peanut Corp.'s peanut products was one of the largest in history. FDA inspectors found remarkably bad conditions inside Parnell's processing plant in Blakely, Ga., including mold and roaches.

The indictment accused the Parnells and Lightsey of conspiring to defraud customers and obtain money through false and fraudulent pretenses. Wilkerson was charged with obstruction of justice.

The U.S. attorney's office declined to comment until after a news conference later Thursday.

The indictment alleged the conspiracy lasted from about June 2003 through February 2009. The indictment said peanut products were shipped after it tested positive for salmonella, and the company failed to inform customers.

Stewart Parnell, who invoked the Fifth Amendment to avoid testifying before Congress in February 2009, once directed employees to "turn them loose" after samples of peanuts had tested positive for salmonella and then were cleared in a second test, according to e-mails uncovered at the time by congressional investigators.

The indictment cited emails sent between defendants talking about the contamination in the product.

A federal judge in 2010 approved a $12 million insurance settlement for more than 100 salmonella victims.

Even President Barack Obama expressed concern at the height of the product recalls, noting that his daughter Sasha eats peanut butter for lunch as often as three times a week.

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