In August 2016, local and state public health and agriculture agencies investigated an outbreak of E. coli O157 linked to consumption of unpasteurized or “raw” milk purchased through the Dairy Delight Herd Share Program. The investigation was triggered by reports from the Michigan Department of Health and Human Services (MDHHS) Bureau of Laboratories (BOL) that two 12-year-old boys residing in different counties (Wayne County and Oakland County) had been laboratory confirmed with an indistinguishable genetic strain of E. coli O157:H7. The strain was identified as PulseNet Pattern Combination EXHX01.6470/EXHA26.4727. This strain had never been seen in Michigan and there were no other case-patients diagnosed with this strain nationally.
Local public health investigators in each county interviewed the parents and ill boys about symptoms and risk factors for infection with E. coli O157. Investigators learned that each child had experienced symptom onset on August 8. The boys, who are friends, spent the night together on August 5 at home of the Wayne County case patient. Both boys consumed chocolate milk made with raw milk supplied by the Dairy Delight Herd Share Program. The parents of the Wayne County case patient were members of the program.
A third person who resided in Shiawassee County was a genetic match to the outbreak strain of E. coli O157. This person denied consuming raw milk but admitted that family members residing in his household belonged to the Dairy Delight Herd Share Program and that they consumed raw milk. Public health investigators attempted to contact the individual for additional information but were not successful. He was classified as “lost to follow-up.” Additionally, a fourth person was diagnosed with E. coli O157 strain EXHX01.6470/EXHA26.4727. This person was also described as being “lost to follow-up” and could not be interviewed.
On August 26, 2016, inspectors from the Michigan Department of Agriculture and Rural Development (MDARD) and the Livingston County Department of Public Health went to the Dairy Delight Cow Boarding establishment located at 11341 Killin Road in Howell Township, Michigan. Their intent was to inform Dairy Delight property owners, Kristal and Gary Unger, of illnesses linked to consumption of Diary Delight Herd Share raw milk and to ask for a list of herd share members and the products they receive from the farm. They were met at the gate by two individuals who denied entry and refused to provide a list of herd share members.
On September 1, the inspectors returned to Dairy Delight with a court approved Administration Inspection Warrant issued by the 53rd District Court. The warrant ordered property owners, Kristal and Gary Unger, to allow Livingston County Public Health inspectors to enter the premises for the purpose of conducting activities necessary to investigate E. coli infections that occurred after ingestion of raw milk from Dairy Delight Cow Boarding. The warrant also provided authorization for MDARD inspectors to enter the property to conduct activities necessary to determine compliance with the Grade A Milk Law, the Manufacturing Milk Law, and the Food Law. The warrant ordered Kristal and Gary Unger to produce all records, contracts or other written or electronic records pertaining to their operation of Dairy Delight Cow Boarding.
Inspectors observed several issues of concern. Notably, the short section of the pipeline/swingline that goes into the bulk tank was dirty. Medications were stored in an uncovered container. A chicken and chicken feathers were found in the milk barn. The chicken was lying in an uncovered storage container of what appeared to be cattle feed. The walls, ceiling and exterior of pipelines were dirty. During the inspection MDARD inspectors observed a variety of food items held and offered for sale including gluten free oatmeal cookies, apple muffins, honey, shell eggs, Kombucha tea, kraut, and frozen chicken. These products were not properly labeled and not from regulated sources, requirements for foods being offered for retail sale. MDARD seized these items from Dairy Delight Cow Boarding pursuant to MCL 289.2105(1). Additionally, MDARD obtained samples of raw milk from the bulk tank for laboratory analysis. Tests of raw milk were negative for the presence of Salmonella, Listeria species and Shiga Toxin E. coli.
Local health departments contacted Dairy Delight Cow Share members by email, telephone or US mail informing them of recent E. coli O157 illnesses among people who drank raw milk obtained from Dairy Delight Cow Boarding. They asked members to provide information about additional illnesses. No other herd share members reported illness. This was not the first time inspectors in Michigan had been denied access to Dairy Delight property. In 2011 the raw milk from the farm was implicated in an outbreak of Q fever that occurred among members of the cow share program.
The outbreak involved 5 individuals. One person was hospitalized. Farm owners did not cooperate with local and state investigators in their efforts to conduct an outbreak investigation.See: https://academic.oup.com/cid/article/55/10/1387/322724