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ARS Home » Plains Area » Lincoln, Nebraska » Agroecosystem Management Research » Research » Publications at this Location » Publication #401652
Research Project: Managing Manure as a Soil Resource for Improved Biosecurity, Nutrient Availability, and Soil Sustainability

Location: Agroecosystem Management Research

Title: Shiga toxin-producing escherichia coli linked to raw milk consumption associated with a cow share agreement — Tennessee 2022

Author
item THOMAS, CHRISTINE - Tennessee Department Of Health
item MARR, JACK - Tennessee Department Of Health
item Durso, Lisa
item GOLWALKAR, MUGDHA - Tennessee Department Of Health
item IRVING, DJ - Tennessee Department Of Health
item OREJUELA, KELLY - Tennessee Department Of Health
item RASNIC, ROBIN - Tennessee Department Of Health
item RIPLEY, DANNY - Tennessee Department Of Health
item RUE, BRENDA - Tennessee Department Of Health
item THOMAS, LINDA - Tennessee Department Of Health
item VIRUEZ, JULIE - Tennessee Department Of Health
item FILL, MARY-MARGARET - Tennessee Department Of Health
item GARMAN, KATTIE - Tennessee Department Of Health
item DUNN, JOHN - Tennessee Department Of Health

Submitted to: Meeting Abstract
Publication Type: Abstract Only
Publication Acceptance Date: 4/20/2023
Publication Date: N/A
Citation: N/A

Interpretive Summary:

Technical Abstract: BACKGROUND: On August 9, 2022, the Tennessee Department of Health (TDH) identified 2 cases of Shiga toxin-producing Escherichia coli (STEC) infections in 2 infants, each aged 10 months. One infant developed hemolytic uremic syndrome (HUS). Both lived in households that consumed raw milk from the same cow-share program. To determine STEC source and prevent additional illnesses, TDH initiated epidemiologic and environmental investigations of the cow-share dairy farm. METHODS: We attempted to contact listed cow-share participants and did an environmental assessment of the cow-share dairy farm. We defined a case as diarrheal illness in a person with access to raw milk from the cow-share. If laboratory-confirmed STEC infection was identified, we considered the case confirmed, otherwise considered it probable. We tested available human stool samples for STEC O157:H7 using selective media culture and polymerase chain reaction, and environmental samples from the dairy farm using brilliant green agar, anti-O157 immunomagnetic beads, and CHROMagar 0157. RESULTS: Of 125 listed cow-share participants, we reached 50 households with a total of 112 persons and identified 3 additional probable cases. In total, 5 cases were identified with 2 confirmed in hospitalized infants; no deaths were reported. The environmental assessment found possible routes of fecal contamination during milking and that temperature abuse might occur during milk storage. Laboratory testing identified 1 isolate of STEC O157:H7 from a human stool sample and 2 isolates from a cow manure sample taken from the milking barn. These isolates were highly related, with zero allele differences by whole genome sequencing. We provided education to the dairy farm and cow-share participants about reducing raw milk health risks. CONCLUSIONS: This outbreak highlights the risk for significant illness associated with cow-share arrangements, especially among young children at increased risk for HUS. Policies increasing awareness of raw milk product health risks could prevent further morbidity.