1. Tracy D. Murphy, MD State Epidemiologist/Deputy State Health Officer Wyoming Department of Health

2. Foodborne Illness in WY Foodborne illnesses do indeed occur in WY 1,012 cases of Campylobacter, E. coli, Salmonella, Shigella reported to WDH 2003-2008 In 2008 WDH epidemiologists investigated 12 outbreaks with food as likely source, and 11 outbreaks in 2009

3. Foodborne Illness Where does foodborne illness originate? Majority of illness that is likely due to contaminated food occurs sporadically (not part of larger outbreak) Of the 1,012 cases of Campylobacter, E. coli, Salmonella, Shigella reported 2003-2008, approx. 70% were sporadic Significance? The illness results from something relatively isolated that occurred on an individual basis, such as their own hygiene or food handling practices. Most not from restaurants or large commercial producers

4. Foodborne Illness Most cases of foodborne illness occur as a result of the food handling and preparation practices of persons in their own kitchens Well documented outbreaks of foodborne illness due to botulism, other Clostridium species, Salmonella, Campylobacter, others, from consumption of home produced food, including commercial sales of home produced food

5. Foodborne Illness Unlicensed South Dakota home-based caterer responsible for 180 Salmonella cases, 2009 Unlicensed Wyoming caterer linked to at least 25 cases of Clostridium perfringens toxin-mediated illness, Dec 2009 Improperly refrigerated product (preliminary report guacomole, salsa) at Iowa farmer’s market responsible for at least 16 Salmonella cases, July 2010

6. Foodborne Illness Restaurants (contaminated food, infected food handlers) Mass produced, commercially available food

7. Foodborne Illness Of the 11 outbreaks in 2009 investigated by WDH with food as likely source: Caused by original contamination of mass produced, commercially available food, or food obtained in restaurants = 5 outbreaks, 22 ill WY residents Caused by food handling of individuals = 4 outbreaks, 92 ill WY residents Unclear = 2 outbreaks, 17 ill WY residents

8. Foodborne Illness Virtually any food or drink can become contaminated with disease causing organisms and cause illness It is FALSE that only certain hazardous foods can spread disease 179 documented outbreaks resulting in 4,904 illnesses linked to breads, cakes, pies, other bakery items in U.S. 1990-2006 (Center for Science in the Public Interest, Dec 2008)

9. Foodborne Illness Raw (unpasteurized) milk leading cause of Campylobacter outbreaks in WY WDH investigated 3 outbreaks, resulting in 18 illnesses, of Campylobacter associated with raw milk 2003-2008

10. Foodborne Illness More isolated cases identified that were likely due to raw milk or milk products Laramie Co, Ecoli, child with severe disease (HUS), exposure of raw goat’s milk (2009). Lincoln Co, Campylobacter, exposure of raw cow’s milk (2010). Campbell Co, Campylobacter, exposure of raw cow’s milk; consumed with a group, epi unable to identify the others or supplier of milk (2010). Campbell Co, Salmonella, exposure of raw milk while traveling to other state.

11. Foodborne Illness Longmont, Colorado, June 2010 - Thirty (30) people ill with Campylobacter and Ecoli from unpasteurized goat’s milk through “share” program. Minnesota, May 2010 – Four cases of Ecoli from unpasteurized milk. Utah, May 2010 – Nine Campylobacter and six Salmonella cases from unpasteurized milk purchased at local vendors licensed to sell raw milk. Milk samples positive Salmonella, other coliforms, despite being licensed.

12. Foodborne Illness Michigan, March 2010 – at least 18 cases of Campylobacter from unpasteurized milk through “cow share” program. Mostly young children. April 2009, cluster of Campylobacter illness associated with “cow share” program, CO

13. Foodborne Illness 29 cases Salmonella caused by raw dairy products, PA, 2007 (Lind L, et al. MMWR 2007;56:1161-4) 18 cases E. coli O157:H7 in WA, OR caused by raw milk, 2005. Most cases <14 years old. (Denny J, et al. Foodborne Pathog Dis 2008;5:321-8) U.S. 2006, 10 outbreaks linked to raw milk, caused by Campylobacter, E. coli, Salmonella, Listeria (CDC MMWR 2009;58:609-15)

14. Foodborne Illness Not restricted to microorganisms U.S., 2006, outbreaks due to Natural toxins Cleaning agents Other chemicals Outbreak resulting in 11 illnesses due to contamination of baked goods with floor sealant