Raw-milk cheese implicated in 35 TB cases

Mar 17, 2005 (CIDRAP News) – This week's health warnings about soft cheeses made from unpasteurized milk were based on 35 recent cases of tuberculosis in New York City that are believed to have been linked to raw-milk products.

The cases occurred from 2001 to 2004 and were caused by Mycobacterium bovis, which can be found in raw milk from infected cattle, the New York City Department of Health and Mental Hygiene (NYCDH) said in a Mar 15 statement. In one case, a 15-month-old child died of complications of M bovis infection.

The New York cases prompted the Food and Drug Administration (FDA) this week to warn against consuming raw-milk soft cheeses, especially those imported from Mexico, Nicaragua, and Honduras.

NYCDH Commissioner Thomas R. Frieden stated, "As a rule, people should not eat food products that are unlabeled or not labeled in English, as is required by law. Illegally imported food products may not be manufactured or packaged in compliance with the FDA's strict regulations; consuming these products may endanger your health."

Consumers should not eat cheese that is not clearly labeled as pasteurized, the NYCDH statement added.

The 35 people who apparently contracted tuberculosis from contaminated unpasteurized dairy products include 22 adults and 13 children, according to a Mar 16 New York Times report. All the adults were born abroad, most of them in Mexico.

The report said health officials began an investigation 4 months ago after determining that all the younger children were American-born, raising the possibility that contaminated products were coming from abroad.

The NYCDH said it is working with federal and state agencies to find the source of products linked with the illness in the city. The department is testing unlabeled or improperly labeled cheese obtained from some Mexican grocers in Brooklyn and Queens.

The common form of tuberculosis is a lung infection caused by Mycobacterium tuberculosis. M bovis accounts for less than 1% of tuberculosis cases in the United States and other countries where few cattle are infected and milk is pasteurized, according to the NYCDH. M bovis is more likely than M tuberculosis to cause tuberculosis in organs other than the lungs, such as the lymph nodes or intestinal tract, officials said.

General symptoms of M bovis tuberculosis include fever, night sweats, and weight loss, the department said. Lymph node infection may cause neck swelling, and gastrointestinal infection may lead to abdominal pain and swelling, officials said.

The statement said symptoms usually don't appear until months to years after infection. Frieden told the Times that the illness often goes unrecognized when it does not affect the lungs. The illness is treatable with a combination of antibiotics. If it is not treated, it can be fatal in rare cases.

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