Got Milk Microbes?

A Guide to Milk-borne Infectious Diseases

Its the first food we taste. Its sweet and delicious and good for you too. Its in pasta sauces, candies, pastries, custards, and ice cream. Milk is arguably one of the most versatile ingredients among cooks and a staple in most households. However, as an animal product that is full of nutrients, there are several infectious diseases associated with microbe-contaminated milk and milk products. The good news is that most of these microbes are killed by pasteurization, and so in reality, infections due to milk and cheese are pretty rare -- but still possible.

How Does Cows Milk Get Contaminated?

Dairy cows spend much of their time grazing in pastures, where they come in contact with a variety of environmental microbes. In addition, many microbes that are commensal organisms (that co-exist with cows without causing disease) may be considered human pathogens. Dairy processing facilities have many routes for the entry of contaminating microbes. First, as a nutrient-rich liquid, milk provides an ideal environment for microbial growth. Second, dairy processing plants are full of areas where foot traffic from employees can be accompanied by microbes.

Infectious Microbes Found in Cows Milk

Bacillus cereus: These bacteria produce a toxin that can cause diarrhea and another that causes vomiting. Bacillus cereus spores are heat-resistant and may survive pasteurization. There have even been very rare cases linked to dried milk and dried infant formula. Brucella: Brucella is a bacterial microbe that is found in unpasteurized dairy products. Brucella infection, or Brucellosis, has also been called Undulant Fever because of the regular recurrence of fever associated with the disease. Campylobacter jejuni: Campylobacter jejuni is the most common bacteria to cause diarrheal disease in the U.S. and is found in raw milk and poultry. It has an increased chance of causing disease when consumed in milk, because the basic pH of milk neutralizes the acidity of the stomach. Coxiella burnetii: Coxiella infects a variety of animals, including livestock and pets. The microbe can be found in cows milk and is resistant to heat and drying. Infection by Coxiella results in Q fever, a high fever that may last up to 2 weeks. E. coli O157:H7: This particular strain of E. coli has been associated with a number of food-borne outbreaks and is the cause of bloody diarrhea. Frequently associated with dairy cattle, microbial contamination of raw milk and soft cheeses can result in disease.

Listeria monocytogenes: Listeria is a common bacterial pathogen that is found in soft cheeses and unpasteurized milk. It can even survive below freezing temperatures and can therefore withstand refrigeration. It is particularly dangerous to individuals who have weakened immune systems, including pregnant women, AIDS patients, and the very young and very old. Mycobacterium avium subspecies paratuberculosis: This strain of mycobacteria can withstand pasteurization and has been associated with the development of Crohns disease, also known as inflammatory bowel syndrome. However, whether or not these bacteria can actually infect humans remains controversial. Mycobacterium tuberculosis: The cause of consumption, a horrific wasting disease that first affects the lungs, Mycobacterium bovis is associated with consumption of raw milk and was one of the most common contaminants prior to the practice of pasteurization. M. bovis causes tuberculosis in cows and can be passed to humans via unpasteurized cow's milk, causing a disease that is very similar to M. tuberculosis. Salmonella: Salmonella contamination of raw milk and milk products has been the source of several outbreaks in recent years. Symptoms include diarrhea and high fever. Staphylococcus aureus: Staph aureus produces a toxin that causes explosive vomiting. The disease may be considered a consequence of actual food poisoning from simply consuming the toxin, rather than from an actual infection. Yersinia enterocolitica: Associated with raw milk and ice cream, among other foods, contamination is believed to be a consequence of a breakdown in sanitization and sterilization techniques at dairy processing facilities.

What about Mad Cow Disease?

Mad Cow Disease, also known as bovine spongiform encephalitis (BSE), is a disease that affects the nervous system and is caused by an infectious protein called a prion. Consumption of meat from cattle with BSE can result in transmission of the disease. In humans, the disease is called transmissible spongiform encephalopathy or variant Creutzfeldt-Jakob disease. Fortunately for the dairy industry and milk consumers, the infectious prion has not been found in milk from infected cows, nor has transmission through drinking of cows milk been reported. In short, you cant get Mad Cow Disease from milk.

How to Prevent Milk-borne Infectious Diseases:

1. Dont drink raw milk. 2. Keep dairy products refrigerated within the expiration date marked on the package. 3. Be careful when you travel to developing nations, follow the recommended sanitary precautions for the country you are in and do not eat raw dairy products.
Sources:

Boor, KJ. Fluid Dairy Product Quality and Safety: Looking to the Future. J. Dairy Sci. 84:1-11 (2001)

Foodborne Illness. US Food and Drug Administration. Center for Food Safety and Applied Nutrition

Rowan NJ et al. Putative virulence factor expression by clinical and food isolates of Bacillus spp. after growth in reconstituted infant milk formulae. Appl Environ Microbiol. 2001 Sep;67(9):3873-81.

MILK BORNE DISEASES

The importance of milk in our diet is well established as it is considered as the best, ideal and complete food for all age groups. However, in spite of being so, milk can also serve as a potential vehicle for transmission of some diseases under certain circumstances. Moreover, by virtue of possessing almost all the essential nutritional factors, milk can also serve as an excellent source and protective medium for certain microorganisms, which may include potential pathogens capable of causing various health problems to the consumers.

In this way, milk may serve not only as a potential vehic transmission of disease causing organisms, but it can als pathogens to grow, multiply and produce certain toxic m thereby making itself an extremely vulnerable commodi public health point of view.

A variety of pathogenic organisms may gain access into products from different sources and cause different type illnesses. Milk and milk products may carry organisms a toxic metabolites (poisons) called toxins to the suscep consumers. Ingestion of toxins already synthesized in th formed brings about poisoning syndromes in the consum

This is called food intoxication and the toxins affectin intestinal tract are called enterotoxins. Whereas the inge pathogenic bacteria along with the food leads to their im establishment in internal organs. This is called food inf are yet other types of organisms, which can infect intest ingested along with the food and produce toxins in situ t symptoms of poisoning. This situation is called toxi-inf These three categories are better covered by the term food-borne infections and intoxications. Apart from these food-borne illnesses, a number of other types of diseases whose etiological agents may be bacteria, fungi, rickettsiae and viruses can also be spread through milk and milk products. The microbiological health hazards arising from the consumption of contaminated high risk foods like milk has grown in recent years and has resulted in national and international intensification of food hygiene programs.

Although the occurrence of incidences of food-borne illnesses has been considerably reduced in most of the developed countries chiefly due to adoption of strict microbiological quality control and sanitary practices during the production, processing and distribution of milk and milk products, the situation continues to be grim in developing countries where such practices can not be followed. This problem is aggravated when heavy expansion of dairy industry in the third world countries and this increases the risk of milk-borne intoxications and other illnesses. Common milk-borne infections, intoxications and toxi-infections Sl. No. 1 Type of milk borne disease Food infection Causative agent Salmonella typhi and related species Shigella dysenteriae Streptococcus sp. (enterococci) 2 Food intoxication Bacterial Staphylococcus aureus Clostridium botulinum Escherichia coli Vibrio cholerae Aspergillus flavus Disease/disorder Typhoid, Salmonellosis (food poisoning) Shigellosis (dysentery) Septic sore throat, Scarlet fever, food poisoning Food poisoning Botulism (food poisoning) Summer diarrhea Cholera Aflatoxicosis

Fungal

Toxi-infection

Other toxigenic mold sp. Mycotoxicosis Bacillus cereus Food poisoning Clostridium perfringens Gas gangrene Aeromonas sp. Food poisoning Proteus sp. Food poisoning Food poisoning Food poisoning Food poisoning Diarrhoeal diseases Diarrhoeal diseases Diarrhoeal diseases Listeriosis

Other milk-borne disorders (uncertain pathogenesis)

Klebsiella sp. Pseudomonas sp. Citrobacter sp. New emerging pathogens Yersinia enterocolitica Campylobacter jejuni Vibrio parahaemoyticus Listeria monocytogenes Other milk-borne diseases: Bacterial Mycobacterium

Tuberculosis

tuberculosis 7 Milk-Borne Diseases : Infections, Intoxications and Toxi-infections Bacterial diseases Brucella abortus Corynebacterium diphtheriae Bacillus anthracis Rickettsial diseases Coxiella burnetti Viral diseases Entero viruses

Brucellosis Diphtheria Anthrax Q fever Enteric fever

Infectious hepatitis virus Infectious hepatitis Tick-borne Encephalitis Tick-borne Encephalitis Virus Foot and Mouth Disease Foot and Mouth Disease virus (FMD-virus) (FMD) The pathogenic organisms may be derived chiefly from: (1) Dairy animals (2) Human handlers (3) Environment (1) The health of dairy animals is a very important consideration because a number of diseases of cattle including Brucellosis, Q fever, Salmonellosis, Staphylococcal and Streptococcal infections and Foot and Mouth Disease (FMD) virus may be transmitted to man through the consumption of milk. The organisms of most of these diseases may be transmitted to milk either directly from the udder or indirectly through the infected body discharges, which may drop, splash or be blown into milk. (2) The diseased persons may transmit disease like typhoid fever, scarlet fever, diphtheria, septic sore throat, and infantile diarrhea by contaminated hands or by coughing, sneezing and talking. (3) Dairy and farm environment may also introduce a variety of pathogens into milk and milk products at different stages of production and processing. Some common air-borne pathogens include Group A streptococci, Corynebacterium diphtheriae, Mycobacterium tuberculosis, Coxiella burnetti and some viruses of respiratory origin. Water, fodder and unhygienic conditions at farm and plant level may also contribute pathogens to milk. Prevention of milk-borne diseases is one of the most important problems of public health. Success in controlling a disease can be maintained only by the constant vigilance over the health of the cow udder until it reaches the mouth of the consumers.