Missouri’s Lawrence County Health Department (LCHD) was notified of a case of HUS in a child with a history of bloody diarrhea in early May of 2008, and began an investigation into the case. LCHD subsequently learned that additional cases of E. coli O157:H7 had been reported in other Missouri counties, and that all cases had a common exposure to raw goat’s milk sold at Herb Depot, and produced by Autumn Olives Farm.
Epidemiologic and environmental investigations by LCHD revealed four E. coli cases associated with the consumption of raw goat’s milk in April of 2008. Three culture-confirmed cases shared a common, indistinguishable genetic strain of E. coli O157:H7 that had a unique subtype, and had never been reported before in Missouri. LCHD reported that “no other plausible sources of exposure common to all four cases were identified [other than the milk.]” LCHD ultimately concluded that “the epidemiological findings strongly suggest the unpasteurized goat’s milk from Farm A [Autumn Olives] was the likely source of infection for each of the cases associated with this outbreak.”