Campylobacter outbreak associated with raw drinking milk, North West England, 2016

Abstract

In December 2016, Public Health England investigated an outbreak of campylobacteriosis in North West England, with 69 cases in total. Epidemiological, microbiological and environmental investigations associated the illness with the consumption of unpasteurised cows' milk from Farm X, where milk was predominantly sold from a vending machine. Campylobacter was detected in milk samples which, when sequenced, were identical in sequence type as pathogens isolated from cases (Clonal Complex ST-403, Sequence Type 7432). The farm was served with a Hygiene Emergency Prohibition Order to prevent further cases. To our knowledge, this is the first outbreak of campylobacter associated with unpasteurised milk in England since 1996. Our findings highlighted several important lessons, including that the current testing regime in England for unpasteurised milk is not fit for purpose and that the required warning label should include additional wording, underscoring the risk to vulnerable groups. There has been a substantial increase in both the volume of unpasteurised milk consumed in England and the use of vending machines to sell unpasteurised milk over the last 10 years, making unpasteurised milk more readily accessible to a wider population. The evidence generated from outbreaks like this is therefore critical and should be used to influence policy development.

Why knowledge is the best way to reduce the risks associated with raw milk and raw milk products

“…It is important to highlight that all samples came from health and vaccinated herds and the selling vending machines were in accordance with the enactment of an Italian law that allows the sale of unpacked and unpasteurised cows milk on the farm and at markets. More recently (2016), an outbreak with 69 cases of campylobacteriosis was linked with raw milk from vending machines in England (Kenyon et al ., 2020). These findings raise the question of whether some national regimes for unpasteurised milk are fit for purpose.…”

Advanced Methods for Isolating from and Confirming Campylobacter spp. in Milk and Dairy Products: Review

“…However, other types of food such as ground beef, water, oyster, egg, vegetable and milk have also been reported as a cause of Campylobacter illness [2,4,5]. Above all, unpasteurized raw milk is a well-known cause of Campylobacter outbreaks, with numerous reported outbreaks from the UK, Poland, and elsewhere [5][6][7]. Raw milk may is contaminated with the Campylobacter spp.…”

“…are ubiquitous in cow and dairy farms [5]. For example, uncleaned milking machines, mastitis (cow's udder disease), and fecal contamination of the reservoir could directly affect the outbreaks of Campylobacter infection [5][6][7]. Also, cross contamination of ready to eat foods during food preparation as well as direct contact with animals have been identified [6,7].…”

Evaluation of culture‐based and molecular detection methods for Campylobacter in New Zealand raw cows’ milk

“…2019; Kenyon et al . 2020). Molecular methods for the detection of Campylobacter in dairy samples and raw milk reported in the literature varied between publications and no standardized methodology is currently available.…”

“…2020; Kenyon et al . 2020). In New Zealand, raw milk was a suspected vehicle in nine of the 29 foodborne Campylobacter spp.…”