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  • Michelle Ebtia 7:27 pm on October 16, 2015 Permalink | Reply
    Tags: E. coli, , Leafy Green Vegetables, , PHAC Outbreak Timeline   

    No Surprises in E. coli Outbreaks of Eastern and Central Canada: The Usual Food-Source, and PHAC’s Anticipated Race against Time! 


    The Public Health Agency of Canada (PHAC) , the institute in charge of responding to public health emergencies and infectious disease outbreaks, published a final update on the E. coli outbreak that occurred between July 6 and September 4, 2015, in Alberta, Ontario, Quebec and Nova Scotia. Of the 29 cases reported, seven were hospitalized.

    According to PHAC, investigators identified E. coli O157 to be responsible for this outbreak, “with the use of enhanced techniques”, that enabled them to rule out 2 other reported cases with similar gastrointestinal symptoms, as not being related to the outbreak strain. The food-source associated with the outbreak has not been identified yet, but further investigations are underway.

    This is the second E. coli outbreak of 2015 in Eastern Canada, with the first occurring between March 13 and March 31 in Alberta, Saskatchewan, Ontario, and Newfoundland and Labrador; all the 13 cases that were reported had a matching genetic fingerprint of E. coli O157:H7.
    According to PHAC report, exposure to contaminated leafy greens (including all varieties of lettuces, in addition to other green leafy vegetables such as kale, spinach, arugula, or chard) was identified as the possible source of the outbreak. However, CFIA could not identify a specific food product as the single source of the pathogen, which illustrates the challenges associated with food-source attribution in outbreaks.

    Escherichia coli O157:H7, a Shiga toxin–producing E. coli (STEC) is the strain most commonly associated with outbreaks of bacterial gastrointestinal disease in the North America. The subpopulation most severely affected by the outbreaks have historically been young children, and the elderly, whereas in the latest Canadian outbreak discussed in this report, the majority of patients were young males (average age of 23); however, the report does not disclose the age distribution of the patients who were hospitalized due to the severity of their condition.

    The most common routs of transmission of E. coli pathogen, leading to outbreaks are generally identified to be contaminated food, water (drinking, irrigation or swimming), and environment, as well as person-to person and animal-to-person contact (Turabelidze et al. 2013).

    Analysis of outbreak data suggest that foods most frequently implicated in outbreaks in North America are ground beef, leafy green vegetables, and unpasteurized dairy products, as well as sprouts, unpasteurized apple cider, melons and other fruits, and salami (Neil et al. 2009). Therefore, the suggested association of the earlier outbreak to leafy green vegetables, is in line with the characteristics of outbreak food-sources in general.

    guiltyNumerous studies have specifically examined the survival and growth of E. coli on leafy vegetables. For instance, Parker et al. (2011) demonstrated E. coli’s “ability to multiply in the phyllosphere of whole lettuce plants” on shredded and intact harvested lettuce leaves, due to an up-regulation of genes involved in oxidative and osmotic stress, which also make the bacteria more resistant to antimicrobials commonly used in the fresh-cut produce industry. Therefore, the food industry needs to implement more effective strategies in handling raw vegetables.

    Examining the timeline of PHAC’s report on E. coli outbreaks, reveals that in both occasions, it took the agency over two months from the time of the first reported case, to come to a final conclusion about the strain and possible food source. A similar timeline can be observed in E. coli outbreaks from previous years as well (2012 and 2013). The use of new and improved methods, such as Matrix-Assisted Laser Desorption/Ionization Time-of-Flight (MALDI-TOF)-Based Peptide Mass Fingerprinting, as suggested by Chui et al.(2015) can contribute to a more rapid identification and fingerprinting of the pathogen, which can in turn, reduce the burden of outbreaks by early targeting of the attributed food source.

    How can we, as consumers, prevent outbreaks from happening? How do you evaluate the effectiveness of communication methods, and timeliness of response to outbreaks by PHAC?


    Works Cited:

    Neil, K. P., Biggerstaff, G., MacDonald, J. K., Trees, E., Medus, C., Musser, K. A., … & Sotir, M. J. (2012). A novel vehicle for transmission of Escherichia coli O157: H7 to humans: multistate outbreak of E. coli O157: H7 infections associated with consumption of ready-to-bake commercial prepackaged cookie dough—United States, 2009. Clinical infectious diseases54(4), 511-518.

    Parker, C. T., Kyle, J. L., Huynh, S., Carter, M. Q., Brandl, M. T., & Mandrell, R. E. (2012). Distinct transcriptional profiles and phenotypes exhibited by Escherichia coli O157: H7 isolates related to the 2006 spinach-associated outbreak. Applied and environmental microbiology78(2), 455-463.

    Turabelidze, G., Lawrence, S. J., Gao, H., Sodergren, E., Weinstock, G. M., Abubucker, S., … & Tarr, P. I. (2013). Precise dissection of an Escherichia coli O157: H7 outbreak by single nucleotide polymorphism analysis. Journal of clinical microbiology51(12), 3950-3954.

    • Jasmine Lee 8:01 pm on October 17, 2015 Permalink | Reply

      In my opinion, I believe that our nation’s food safety system has come a long way to reduce the outbreaks of E. coli O157:H7, bringing the incidence rate per 100,000 people down from 3.8 to 1.4 in nine years (PHAC’s graph from lecture notes). Regardless, we can and will continue to do better. I agree that two months is a considerably long time for PHAC to identify the causative agent and contaminated food source. However, this may be due to many factors that hinder the efficiency of the investigation, such as under-reporting, method availability and instrument sensitivity. Under-reporting from patients’ reluctance to visit the doctor may be the ‘rate limiting step’ in identifying the outbreak. I strongly believe more emphasis could be placed on educating the public about foodborne illness. While the food industry is doing its best to minimize the risk of transmissible foodborne pathogens, consumers need to be better informed about practicing proper hygiene and reporting their symptoms to their healthcare practitioners so that it would be on record. PHAC should work closely with the provincial health agencies, e.g. HealthLink BC, to deliver outbreak information to the public through posters, community workshops, public service announcements and social media. Consumers should also ensure that their produce are washed thoroughly prior to consumption, stored under refrigeration and discarded if the quality is doubtful. Outbreaks are inevitable unless policymakers, food producers and consumers all do their part.

      • Michelle Ebtia 9:52 am on October 27, 2015 Permalink | Reply

        Hi Jasmine,
        Thanks for your very thoughtful comment. I specially agree with your suggested methods of reaching the public through the use of community workshops and social media, and think they have a higher potential in raising awareness than what is being used now!

    • flyingsquirrel 8:41 pm on October 18, 2015 Permalink | Reply

      This is most concerning because the consumption of whole/raw leafy green vegetables is on the rise as people become more aware of health and weight balance. Common ingredients such as kale, lettuces, arugula, and spinach are often found in salad mixes sold to the masses on a daily basis. I agree with Jasmine that public education about how to handle foods to prevent illness is definitely one of the best ways to prevent outbreaks. Aside with working with provincial health agencies,I think a point of target that PHAC should address soon with provincial sectors, is how small-scale organic farms will be handled in terms of safety inspections, practices, and certificates. Although they are small compared to the big corp farms,they are essential in the Canadian market as popularity is increasing for pro-local and organic foods. Small-scale organic farmers do not completely follow the rigors of inspection due to financial issues and this topic is still being debated. How can all producers follow a standard guideline in inspection and safety of foods without financial restrictions?

      • Michelle Ebtia 9:57 am on October 27, 2015 Permalink | Reply

        Thanks for your interesting comment! That is definitely a concern which needs to be addressed, considering on a greater scheme, the cost of illness for these outbreaks may well outweigh the expenses required for thorough testing and ensuring the safety of these food items.

    • meggyli 9:22 pm on October 25, 2015 Permalink | Reply

      Very interesting article! We often associate E. coli with under-cooked beef or meat products but many people seem to forget about the leafy greens component that’s also a major part of our diet. In my opinion, as food practitioners we should also emphasize the importance of proper handling and cleaning of ready-to-eat or fresh foods in addition to the potentially hazardous or high-risk foods because not only are leafy greens a source of E. coli they are prone to causing Salmonella spp. as well! From the course notes we also saw that in the United States produce cause the most foodborne-associated illnesses, whereas meat and poultry causes the most foodborne associated deaths.

      • Michelle Ebtia 10:05 am on October 27, 2015 Permalink | Reply

        Hi Meggy,
        I agree that meat and poultry seem to be regarded by the general public as the major source of contamination with food-borne pathogens, which calls for a more effective strategy to be adopted in order to raise awareness about risks associated with produce! I think as Jasmine pointed out, community workshops and social media might be effective tools in educating the public about the topic.

  • MichelleLui 7:02 pm on October 16, 2015 Permalink | Reply
    Tags: , E. coli, , South Africa   

    E. coli found in South Africa drinking water 

    South Africa drinking water

    In March 2015, AfriForum, a South African civil-right organization, found E. coli in the drinking water of four local South Africa municipalities: Molteno-Inkwanca, Tarkastad-Tsolwana, Coligny-Ditsobotla and Vryheid-Abaqulusi. Under the South African National Standard for Drinking Water (SANS 241:2011) and the World Health Organization (WHO) guidelines, E. coli must not be detected (count per 100 ml) in any drinking water samples. Local communities were notified not to drink the water. The non-compliance municipalities’ water authority was told to investigate the source of contamination and implement corrective actions. Follow-up samples were taken and tested clean.

    E. coli is found in the intestines of human and animal. While most E. coli strains are harmless, some are pathogenic and can cause severe human illnesses. According to the study undertaken by WHO’s Foodborne Disease Burden Epidemiology Reference Group (FERG),enteropathogenic E. coli was one of the top three enteric disease agents responsible for most deaths globally in 2010. Enteropathogenic E. coli associates with infantile diarrhea and it is the major cause of infant mortality in developing countries. Enterotoxigenic Escherichia coli (ETEC), the most common cause of travel-associated diarrhea, can be found in less-developed countries. ETEC can also cause mortality for children under the age of 5.

    In Inkwanca Municipality: Integrated Development Plan 2012-2017, one of the remarks made on Molteno water supply concern was the need to upgrade the monthly raw water treatment system. Molteno raw water source is abstracted from Molteno Dam, the Jubilee Dam and a borehole in Denekruin Township. As the dams are open water sources, it may carry more of a risk for E. coli contamination than closed water sources. Precautionary measures such as restricting domestic, livestock or wild animals access to these dams should be taken. Surface water should also be in adequate distance from untreated manure and human sewage waste system. Borehole water can also be contaminated by agricultural livestocks effluent. It is important for the municipality to maintain and upgrade the raw water source treatment and purification work as recommended in the development plan.

    Both Ditsobotla and Abaqulusi have experienced water shortages due to the growth demand outstripping the water supply. The National Treasury advises that all municipalities should ensure that the water tariffs can cover the cost of maintenance and renewal of purification plants, water networks and water infrastructure expansion. To prevent low income households from opting for unsafe water sources due to the water tariffs, Free Basic Water Policy and water subsidies are implemented in some municipalities. To prevent reoccurrence of E. coli detection in drinking water, South African municipalities must put in a sustainable water supply budget plan in order to supply high quality potable water for households of all income levels.

    • ColleenChong 5:42 pm on October 18, 2015 Permalink | Reply

      Hi Michelle this article connects nicely with the Escherichia Coli topic we learned in class, particularly with Enterotoxigenic Escherichia coli, which causes up to 30% mortality in infants. This specific microorganism is a major concern in developing countries, such as Africa. This article explains that raw water carry a high risk of being contaminated with E.coli since the water may have been in contact with livestock and wild animals. I agree with you that the government should create a better plan in providing a safe water source for citizens across the nation. This is a great plan, however, it is costly and will require sometime before everyone is able to receive safe water. In the meantime, I think it is important to educate the people ways to obtain safe water. For example by treating it with chlorine or boiling water to kill off pathogenic organism that maybe in raw water.

    • carissarli 9:56 pm on October 23, 2015 Permalink | Reply

      Hi Katrina, I think you made a great emphasis on how E. Coli influence mortality rate in South Africa greatly. As Colleen mentioned, the use of chlorine can kill pathogenic organisms in raw water since it is a disinfectant. However, the use of chlorine can cause cancer due to the byproduct it produces. I suggest using ozonation instead since it does not produce any byproduct and it is very effective. There are several other disinfectants too which I found from a website: http://www.prominent.co.za/Applications/Disinfection.aspx.

    • kathykim 2:03 am on October 24, 2015 Permalink | Reply

      As I read this posting, I immediately thought of the infant formula/milk feeding. The water shortage is problematic by itself, but if contaminated water is used to make infant formula, the result would be infections involving diarrhea, and this could be heavily contributing to the high infant mortality rate in developing countries. When there is no choice but to consume water that is available, I feel like the people would still drink the water even after they are advised not to do so. So I guess this all connects with poor living conditions and environments that make them more vulnerable to such infections…

    • BarbaraCorreiaFaustino 11:35 am on November 2, 2015 Permalink | Reply

      I liked your article! I believe that South African authorities should try to correct this problem as soon as possible, and try to provide potable water to the population to avoid contamination with E. coli, with can lead to very serious consequences, especially in children. As said by the other commenters, it will take some time to build a good water infrastructure capable of providing drinkable water to people, so campaigns should also be made to teach the population how to make the water potable, boiling it for example. One very important point that you wrote is the availability of free potable water to low income populations, and I’m glad to read that there are a Free Basic Water Policy and water subsidies, and I hope they are implemented in other places as well.

  • KristinaRichmond 5:22 pm on October 16, 2015 Permalink | Reply
    Tags: , E. coli, EHEC, , Japan, Naha   

    E. coli 0121 Outbreak Naha, Japan 

    E. coliOn October 2nd, an E. coli outbreak was reported at a childcare facility in Naha, Japan. The strain implicated in the infection was Enterohemorrhagic E. coli 0121. The first case identified was from a nurse who worked at the childcare center. Ten people in total became ill with mild gastrointestinal symptoms. Seven of the cases were children. The source of the infection is still unknown.

    Japan may be particularly sensitive when it comes to E. coli outbreaks, especially among school-aged children. Back in 1996, one of the worst E. coli outbreaks ever seen worldwide occurred in Sakai City Japan. Ultimately, an astonishing 9,451 people became ill from the bacteria, and 12 people died. Most of those affected by the outbreak were school children.

    The causative strain was identified as E. coli O157:H7; however, the source of E. coli was not identified until three years later when scientists conducted studies aimed at tracing the source. In their report they concluded that radish sprouts from a single farm were responsible for the outbreak. The sprouts had been shipped to various schools to be included in the children’s lunches.radish sprout

    This extreme example, and the more recent outbreak show the difficulties in attributing an E. coli outbreak to a particular source. Without knowing the origin of an outbreak, it is more difficult to get it under control, and can quickly get out of hand as seen in 1996 incident. This is an important idea to consider as last year alone Japan experienced 4153 cases of EHEC (according to the National Institute of Infectious Disease).

    Despite current conditions, there may be good news for future improvements to Japan’s E. coli testing. According to a study reported in Food Safety News, the global market for E. coli testing is predicted to increase by nearly one billion dollars by 2022, with Asia being the region expected to see the most growth. Technologies are being developed to make E. coli testing quicker and more cost effective.

    It will be interesting to see if faster, and more frequent testing can have any significant impact in preventing or minimizing future outbreaks. It is easy to wonder if Japan had had more funding or technology devoted to testing for E. coli back in 1996 if the outbreak would have reached the staggering number of cases that it did. Even now, this recent outbreak shows the continued difficulty in tracking the spread of E. coli infections. Luckily, this time the outbreak stopped at 10 cases.


    What do you think?

    Could faster and more effective methods of testing help prevent infections and stop major outbreaks?

    Also, even though the market is showing an increasing demand for E. coli testing should resources go to developing these technologies, or should money go to other areas along the food safety/disease prevention chain?


    • shinnie 6:12 pm on October 16, 2015 Permalink | Reply

      Hi Kristina, interesting article! I know that E. coli O157:H7 is said to be one of the most common serotype implicated in foodborne illness in Japan (as well as North America) but it is quite shocking to learn that the Big Six established by the U.S. also cause many foodborne illnesses in other parts of the world. Aside from the O121 strain that you mentioned, I found through Dr. Wang’s slides that O111 has also caused an outbreak in Japan with 56 cases and 4 deaths– both of these strains belong to the Big Six! Granted, the O111 outbreak happened largely because of the patients eating a raw beef dish called “yukhoe” and we all know that not cooking food properly enables microbes to obtain “cross-protection” as well as thrive in mild environments. I think it would be interesting to see how much beef (huge E. coli reservoir) the Japanese population consumes on average, and maybe compare that number to Canada who is a gigantic beef producer and consumer (I think they mostly eat sea food?) and then we can establish whether or not it is worth the money to invest in these technologies. I also wonder what strains Japan health government tests for, and if the procedures they use are similar to the ones we employ in North America? I know currently Canada only tests for O157, but U.S. has already started testing for the Big Six in many beef products. I am thinking that Canada will start to adopt the same policies. To answer your questions, I definitely think that faster and more effective methods of testing will help prevent infections and prevent major outbreaks, but at the same time this requires a lot of resources and knowledge. If E.coli is one of the major pathogens causing illness, hospitalization, and deaths in Japan, I fully support implementing better technology for disease prevention for that purpose, but if another type of bacterium or toxin is at work, maybe it will be better to invest money on the technologies that test for those pathogens instead. All in all, I don’t think this will be difficult for Japan to do since the country is one of the most technologically developed!

    • csontani 7:21 pm on October 17, 2015 Permalink | Reply

      it’s definitely not a big surprise that E. coli can contribute to such an extreme outbreak. I personally think that Japan now has more fund to improve their food safety since they are more developed as a country. If they found a case of E. coli again in the future, they will definitely stop the spreading much faster if they have figured out a more efficient and faster way to detect the source for E. coli. Not only in Japan, but other countries should also consider improving their detection methods for E. coli since the Big Six is becoming more of a concern and not only O157:H7.

    • WinnieLiao 9:29 am on October 21, 2015 Permalink | Reply

      It seems like other E. coli strains has “moved out” of the North American zone and starting to become an issue also in Asia. As Shinnie mentioned above, cattles are a main reservoir for E. coli. This can gradually become a concern for not only Japan but also US and Canada. Canada has large beef industry, and if E. coli problems are not resolved and taken into precaution, this may lead to an economic and reputation loss for Canadians in the future. Also we note that Japanese consume a lot of raw meats, from raw fish to raw beef. To me this means that many other pathogens other than E. coli can also make their way to the tables, causing protruding food safety issues. In the short term, I would consider faster and more effective methods of testing a good way of investigating food borne outbreaks in order to obtain the results faster and develop a coherent database. However, the result of preventing infections and stopping major outbreaks can only be accomplished in the long term, when resources become more available and preventive steps can fully be developed. I would also agree to the fact that funding should be put into the food safety/disease prevention program, especially in the training and education sector; food safety training for those working in the food plant, and public education for safe handling of foods purchased.

    • ayra casuga 10:15 am on October 24, 2015 Permalink | Reply

      Very intriguing article! This case definitely illustrates the severity of having an outbreak source directly linked to a vulnerable group for E.coli. More specifically, the fact that the E.coli infested radish sprouts were directly sent to schools for children’s lunches has caused the large amount of people becoming infected. Although this incident was terrible, the positive outcome is the fact that Japan is starting to pay more attention to food-borne illnesses and how to prevent another case similar or worse from happening again.

      As what Winnie had mentioned, I do believe that a good portion of their funding should go towards improving their food safety/disease prevention as a whole because of their reputation of eating a variety of their products raw. For example, the raw seafood they consume could easily be contaminated with seafood toxins. Therefore, the funding should not all go primarily to better E.coli control, but better standards towards all food products that are high risk for the majority of the population. Specifically for the case of children, I do believe more stringent cooking procedures are needed. Perhaps the school lunch program must ensure that all food products being served to children are properly cooked rather than left raw.

    • EmilyChow 7:29 pm on October 24, 2015 Permalink | Reply

      Great post! I find it interesting how it took 3 years for an advanced nation such as Japan to identify the source of the E. coli outbreak. Since Japan has such a large population density, many people can get sick every time there is an outbreak incident so I do think there is importance in developing fast testing methods to quickly identify the source in order to prevent any more people getting infected. On the other hand, I believe there would be a more significant impact if resources and funding went towards food safety and disease prevention. If more people were educated, especially those who handle foods in the processing industry or restaurant business, many incidences of food poisoning would not occur. Overall I believe both are important but it’s better to prevent infections from happening in the first place.

    • cvalencia 12:26 pm on November 3, 2015 Permalink | Reply

      Very informative article! I don’t know how big the population is in that area of Japan (if it’s like how it is in Tokyo), but the number of those who became ill is staggering. And we all know that children are very vulnerable in becoming ill from foodborne pathogens. This just shows how extra precautions should be taken to ensure the food is safe, especially if the food is going to be served to vulnerable populations, such as children, pregnant women and the elderly. It is also quite surprising that it took them a long time to discover the source of the illness. I guess with the rapid detection systems that we recently learned in class, it will be faster now to determine the source of illness. Do you know if E. coli has been a big problem in Japan? Or is this one the worst case that they encountered?

    • teewong 12:03 am on December 15, 2015 Permalink | Reply

      Wow, I am surprised by the fact that they even found out the source of contamination after 3 years! I am glad though, because even though more than 9000 people were infected with the O157:H7, very little people died from this outbreak. However, it must have impacted and raised awareness in a lot of people that even fresh produce can cause tremendous harm! I feel that more technologies should be developed in testing pathogens in the producer side, so that they could eliminate the risk before they even reach the consumers. Consumers should also be educated with the food safety practices so the chances of getting infections could be minimized!

    • JorgeMadrigalPons 11:58 am on December 15, 2015 Permalink | Reply

      It’s surprising that more than 9000 people got infected with sprouts from a single farm. With the technology nowadays, some new effective detection systems have been created. Hopefully, these new systems can detect outbreaks more rapidly, to prevent the spreading of outbreaks like the one discussed in your blog.

    • DeniseZhang 8:24 pm on December 15, 2015 Permalink | Reply

      I don’t think an outbreak can that easily be controlled without finding out the source of contamination. As long as the contamination is not eliminated, there are always chances for the outbreak to occur again. Fortunately that we have learned more about E.coli now. Now we know how to avoid and control its transmission, things will become much easier than before.

  • angel519 11:00 pm on October 15, 2015 Permalink | Reply
    Tags: breast milk, E. coli, ,   

    Breast Milk: a potential source of Escherichia coli 

    “Liquid gold” as known as breast milk is the natural way of providing energy and nutrients to young infants for healthy growth and development. World Heath Organization (WHO) recommends breastfeeding particularly colostrum (breast milk produced at the end of pregnancy) to new born within the first few hours of birth. Unfortunately, there are mothers with extremely vulnerable hospitalized babies (preterm birth, birth defects) are unable to provide adequate amount of breast milk to support their babies; or there are mothers that generally cannot produce enough breast milk. With the increase of Internet usage and online shopping, people have started to sell breast milk online.


    source: http://hamptonroads.com/2013/10/chkd-begin-work-breast-milk-bank-next-month

    An investigation done by the “BBC Inside Out” program took 12 samples of online bought breast milk around Europe for microbiological tests at Coventry University. The results showed that four of the samples contained pathogenic Escherichia coli, two of samples contained candida and one contained pseudomonas aeruginosa, which lead to death of four infants in neonatal units in Belfast in 2012. Even though the investigation had very small sample size, the test result indicated that online breast milk has the potential of containing pathogenic bacteria. Infants have immature immune system and devoid of natural gut microflora, which make them the most vulnerable population that has the highest risk of being infected by pathogenic bacteria. Small amount of pathogenic bacteria can cause severe illness or death of infants. Thereby, online breast milk from unauthorized websites should be banned to prevent foodborne illness from happening on those fragile babies.


    In Europe and other parts of the world, there are many authorized Milk Banks that offers pasteurized breast milk for premature babies or babies recovering from surgeries. To ensure the safety of donor milk, serological screening, medical history and lifestyle are done and checked before receiving donor milk. According to the European Milk Bank Association (EMBA), there are 210 active milk banks around Europe to support infants that need safe breast milk. A study on nutrients and bioactive factors in human milk indicated that heating process like pasteurization does have a certain degree of destruction on the functionality of bioactive protein components. However, it is not worth the risk of feeding infants with unknown source breast milk that is potentially pathogenic.

    Despite there are no outbreaks caused by E.coli in online sold breast milk, preventions should be done to avoid such incidence from happening.

    The following video shows a clear procedure on how milk bank handle donated breast milk. (Video from the Mother’s Milk Bank Northeast)

    Click link to see the video: http://milkbankne.org/for-healthcare-professionals/

    Angel Chen

    • yichen25 1:55 am on October 16, 2015 Permalink | Reply

      I personally think that it is not a wise choice to purchase breast milk online as the milk source is not known and you have no idea if the breast milk is properly processed and pasteurized. With online shopping nowadays, it is difficult to determine the authenticity of the item and this applies to breast milk as well. Food fraud is more likely to happen online as the buyers are convinced based on the description and pictures given without seeing the real product. Also, even with proper pasteurization, breast milk still stands a chance of being contaminated with improper packaging, storage and delivery. Therefore, to avoid infants risking their lives for breast milk that might endanger their lives, it is best for local authorities to restrict the sales of breast milk on an online platform unless it is properly authorized.

    • CandiceZheng 1:39 pm on October 16, 2015 Permalink | Reply

      I’d say this is a brilliant angle for the food safety issues! As online shopping is becoming increasingly popular and everyone enjoys its convenience, lots of home prepared food come to the market without proper processing method, which might lead to lots of potential food safety issues. Nowadays the inspection agency should pay their attention to those online sources as well.

    • CandiceZheng 2:02 pm on October 16, 2015 Permalink | Reply

      Online shopping is a new angle for the food inspection agency to consider. Online shopping is becoming increasingly popular currently and we all enjoy the convenience. However, this also bring about a lot of home processed food and even things like breast milk, which poses a significant threat to food safety. Although it might be hard to regulate the selling of all those types of food online, the authorities should pay more attention to the food that potentially have more significant impact and probably ban the sales. For example, online breast milk are used to feed infants, who do not have a complete immune system yet. While by consuming contaminated foods normal individuals might only get mild symptoms, infants are very fragile and might get very severe problems.

    • catherine wong 5:38 pm on October 16, 2015 Permalink | Reply

      I also agree that purchasing breast milk online from an unknown stranger is very dangerous. If they were purchasing or receiving the breast milk from an authorized source such as a milk bank then it would be different because it technically should be treated and handled by professionals hopefully. I understand that some new mothers are unable to give their newborns enough breast milk and decide that the only way their babies can get benefits of colostrum is from other new mothers, but they have to understand that there are lot of risks associated with this. The mothers selling the breast milk may not even know that the milk contains harmful pathogens and since they are not trained on ways to keep breast milk safe through the packaging, handling and storage process, they really should not be selling it.

    • elaine chan 3:29 pm on October 18, 2015 Permalink | Reply

      Interesting article! Since breast milk comes from our own human body as a natural source of food for our babies, it’s understandable how some people can overlook the safety factor. Majority of the population may assume that since it’s a natural source, and under normal conditions, it would be fed straight to the baby, there will be no health hazards associated with purchasing breast milk from another source. I also agree that even though there are no reported outbreaks, preventative measures should be implicated to avoid its occurrence. Setting out regulations for the sale of breast milk would be a good solution to manage its distribution. However, regulations can only manage so much and the distribution of breast milk can still occur in secrecy. I think it will be important to educate mothers that are planning to either buy or sell breast milk. This will allow both sides to understand the risks associated and be more cautious about the breast milk they’re handling with for babies.

    • TamaraRitchie 9:00 pm on October 18, 2015 Permalink | Reply

      Really interesting article. I had never thought about breast milk being a possible source of bacterial contamination as it usually goes directly from mother to baby, therefore minimizing the risk of cross contamination. I think it is great what is being done in Europe with having the Milk Banks that supply safe and fresh milk to babies who are in need. It is a great alternative for Mothers who want to supply breast milk to their babies but cannot do so for a number of reasons. I think it is very unsafe for breast milk to be sold online without any regulations or screening. I agree with Elaine Chan that it would be a great idea to educate mothers that are considering buying breast milk online. I believe if many of these mothers knew the health dangers associated with infants and bacterial contamination of foods that they would reconsider the purchase of breast milk from an online source.

    • RainShen 10:26 pm on October 18, 2015 Permalink | Reply

      I think purchasing human breast milk from unauthorized online stores is not wise at all. Newborns’ immune system is not nearly as effective as an adult’s or even an older child’s, and that it takes many months before a newborn can fight off infection as well as someone whose immune system is fully matured. Breast milk provides the babies with an added level of immune protection, because it contains large numbers of antibodies and other infection fighting cells, but it must be not pathogenic in the first place. It is very nice that these authorized Milk banks can provide safe breast milk, but if the breast milk has already been pasteurized, is it still providing those unique antibodies for the baby? Comparing to the commercial formula, is the pasteurized breast milk still much more beneficial for the newborns? I’m thinking that during the transportation or storage, there might be other contamination.

    • amreenj 7:01 pm on October 19, 2015 Permalink | Reply

      A really interesting article! Taking into consideration that breast milk is highly recommended as the primary food source for infants and that infants have a unestablished microflora it seems counterintuitive that breast milk would be a source of illness/death. However, purchasing dairy products online, seems rather unwise. We have learnt the importance of proper sanitation/ processing at various stages of the food processing/distribution continuum and that failing to do so can lead to serious harm. When buying products online, especially with low shelf-life foods, it is critical that they be stored (before/after/ during transport) at the correct temperature and treated appropriately. In knowing this, it should raise a red flag to potential consumers that plan on buying such products online (unauthorized online stores). On the other hand, the presence of Milk Banks, serve as a safer alternative, and make breast milk more accesible to those who perhaps can’t provide this to their infants.

    • MarinaMoon 2:28 am on October 20, 2015 Permalink | Reply

      In my opinion, I would never risk my baby to consume breast milk from another unknown source even if breastfeeding has many positive benefits to a baby. I think it is better to provide baby formulas which ensure of containing all of the nutrients that a baby needs as well as safety of the baby. Even if the breastmilk to be sold had been free of bacteria may become contaminated through out the process of transportation to handling of the milk. There is so many other factors that needs to be supervised which cannot be done online. On the other hand, the milk bank that provides pasteurized breastmilk that confirms safety seems like a better approach in allowing women who lack the ability to breastfeed to be able to give breastmilk to their child. However, as mentioned in the summary of article, the first thing that came to my mind was nutrient content of the pasteurized milk. I remember one of the article on this blog talked about raw milk to be more nutritious and beneficial to the body than pasteurized milk although it does have negative consequences such as presence of bacteria. Nevertheless, this evidence indicates that pasteurizing milk does in fact reduce the nutrient content of the product. This being said, I would rather feed baby formulas which compensates women who cannot breastfeed to be able to give their children the nutrients that they need.

    • YaoWang 2:56 pm on October 20, 2015 Permalink | Reply

      The article is really interesting! As online shopping is becoming more and more popular and convenient, people can buy almost whatever they can think of via the internet. However, I won’t buy food from any unauthorized sources online especially for vulnerable populations such as babies. I think in order to prevent people from risking their babies’ lives, it is more important for the government to make the authorized Milk Banks more available rather than just regulate online shopping environment.

    • cheryl lau 6:05 pm on October 21, 2015 Permalink | Reply

      This article about breast is brings up interesting concerns as there is an increasing demand for these types of products. Whether or not people feel that selling breast milk is controversial does not take away from the fact there should be some sort of system to ensure the safety of these products. Since the breast milk is supposed to benefit babies, there should even more emphasis on ensuring that these products are not contaminated with foodborne pathogens. Breast milk sold online are sold at higher prices because of its claimed benefits and limited supply, therefore it should go without saying that consumers of these products would not mind if they paid a little more to have the milk tested before going on the market.

    • laurenrappaport 4:45 pm on October 22, 2015 Permalink | Reply

      This is such an interesting post! I had never considered breast milk to be a potential source of foodborne pathogens before reading this. As babies have not developed any sort of immune system or gut microflora this is something that should be of major concern. Selling un-testing breast milk online creates a huge risk factor for the health of the baby and I dont think it should be done without pasteurization techniques and testing. For mothers who cannot produce their own breastmilk the milk banks are an amazing alternative to providing their baby with the nutrients and introduction of microflora compared to the alternative of formula. Although there is a degree of uncertainty when you use the milk from the banks as the milk is coming form an unknown source, with the proper use of sanitation, preparation and storage it provides a great opportunity to babies to get the all the benefits even though it is not coming from their mother directly.

    • Stephanie Chen 1:37 pm on October 23, 2015 Permalink | Reply

      This article gives an interesting insight to the issue of breast milk banks online. While the intentions may be good, buying breast milk from online sources really is a flashing red light to me. Multiple dangers may come with breast milk purchased from the internet, most importantly, health and safety risks for your baby. Each step of the collection, processing, testing (if any), and storage of breast milk may introduce a route of entry for pathogen contamination. Even if they are said to be pasteurized, you have no way of ensuring the process will eliminate all pathogenic factors in the breast milk. Moreover, the FDA recommends against feeding babies with breast milk acquired directly from individuals or through the internet. While understanding the need for alternative sources of milk for those who cannot breastfeed, personally, I believe the risks to infants’ health and safety outweigh any benefits that they may get from breast milk. Many types of formula are available for babies with medical conditions and may be the better alternative.

    • Silvia Low 4:50 pm on October 23, 2015 Permalink | Reply

      I think it is absolutely disgusting that people would purchase breast milk ONLINE for their infants. What is wrong with people? This activity should be completely banned and illegal. To me, this is equivalent to purchasing blood, kidneys, and other miscellaneous organs online. Why would people want this? I’m flabbergasted. “Recommendations” to not purchase online break milk from the FDA and other authorities are not enough. They should make this a criminal act. Especially if one day, by chance, death does occur from consumption of this product. Because, killing someone is a crime! Intentional or not!

    • EmilyLi 11:51 pm on October 23, 2015 Permalink | Reply

      In my opinion, since breast milk is considered to be the “gold standard” for infants, the intention and the availability of breast milk banks is wonderful. However, because the breast milk from the the milk banks are for vulnerable infants, milk bank facility should be run by under government authorities to ensure tight regulations. The facility should be able to provide health information of the donor mother for the safety of the consumer. I think breast milk bank provided another option for very vulnerable infants who are not taking formula well, but something like breast milk shouldn’t be order online and have it mail to you. The process of shipping may introduce more risk factor of the breast milk which can be life threatening to infants.

    • Mandy Tam 8:48 pm on December 1, 2015 Permalink | Reply

      Great article and I remember we discuss this in class. I think nothing is better than breast milk to infant, however, food safety is very important as well. Like local farm market, I think government will have a hard time to control online selling as they are too “scatter” to track unlike large industrialize production.

      I think starting a register program and also recommend people to provide milk to such program are a great start since breast milk becomes more and more popular over formula.

      Anyway, I learn a lot from this post!

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