Federal health officials on Friday, Sept. 25, announced an outbreak of E. coli O26:H11 tied to Graziers raw milk cheese, a day after the maker, Sierra Nevada Cheese Company, recalled all of the cheese line. Here is what matters most for a parent checking the refrigerator or freezer: which product the recall covers, which symptoms call for a doctor right away, and that one possible complication, hemolytic uremic syndrome, is what the CDC calls a medical emergency.
What was recalled and how to tell
The Food and Drug Administration says it contacted Sierra Nevada Cheese Company on Sept. 24, and the company “that same day agreed to and initiated a recall of all Graziers Raw Milk Cheeses.” The recalled line includes grass-fed medium cheddar, sharp cheddar, jalapeño jack and Monterey jack, sold in 8-ounce and 16-ounce retail packages and in 5-pound loaves for food service, and according to the FDA it was “sold at retailers nationwide and online.” Because the recall covers the whole line, there is no code or date to match — any of the cheese is included.
The CDC warns that “these products have a long shelf life,” so cheese bought weeks ago could still be sitting in a refrigerator or freezer. If it was frozen or re-wrapped and can no longer be identified as a Graziers product, the FDA advises throwing it away rather than eating it. Refunds are available at the place of purchase, according to the FDA and the company’s own recall notice, which tells customers to “DO NOT CONSUME” any Graziers cheese and lists a company phone number, 530-934-8660, and email, info@sierranevadacheese.com.
Who has gotten sick
Thirteen people across nine states — California, Colorado, Georgia, Kentucky, Michigan, Nevada, Oregon, Tennessee and Utah — have gotten sick, the CDC says, with illnesses beginning between July 7 and Aug. 26. Ages range from 1 to 58, with a median age of 5, and “over half of the sick people in this outbreak are children 5 years old and younger,” according to the CDC. Eight of the 13 people with information available (62%) have been hospitalized, and three developed hemolytic uremic syndrome, a serious kidney complication; no deaths have been reported. Of nine people interviewed, all nine reported eating the cheese, compared with just 4.9% of respondents in the CDC’s FoodNet Population Survey who reported eating any raw milk cheese. The county of San Diego, citing its own case count, says two of California’s three cases are San Diego County children under 5.
Symptoms and when to seek care
Symptoms can start “anywhere from a few days after consuming contaminated food or up to nine days later,” the FDA says. Call a doctor right away for diarrhea with a fever above 102 degrees, diarrhea lasting more than two days without improvement, bloody diarrhea, vomiting so severe that liquids cannot be kept down, or signs of dehydration, the CDC advises. For hemolytic uremic syndrome specifically, the CDC lists a warning sign parents should not wait out: “urinating (peeing) less often or not at all.” The CDC calls HUS “a medical emergency” and says to call a doctor or go to the emergency room immediately if it appears.
Why raw milk cheese carries this risk
Under 21 CFR 133.113, the federal standard for cheddar cheese says that if the dairy ingredients used are not pasteurized, the cheese must be “cured at a temperature of not less than 35 °F for at least 60 days.” The CDC’s general guidance is to choose pasteurized milk and dairy products, advice it says is “especially important for children under 5” because they are more likely to get a severe foodborne illness.
What happens next
The FDA says its investigation “is ongoing to determine the source of contamination and if there are any other products potentially affected.” The true number of sick people “is likely much higher” than reported, the CDC says, because many people recover without medical care and are not tested for E. coli; in addition, recent illnesses may not yet be counted because it “usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.” This is general information, not medical advice; anyone with symptoms should contact a health care provider.