COLUMBIA — Four more cases of E. coli have been confirmed in Missouri since Friday morning, bringing the total number of cases in the state to 13.
Three of the 13 cases were reported from Boone County, said Gena Terlizzi, public information officer for the Missouri Department of Health and Senior Services. The remaining cases were split up between Cooper and Howard counties with three each and Camden, Clark and Jackson counties with one each. The location of the most recent case, for which information was released around 6 p.m., has not yet been disclosed.
E. coli refers to a group of bacteria that can be found in drinking water and certain foods, which have been contaminated by small amounts of animal or human fecal matter, according to the Centers for Disease Control and Prevention.
According to the CDC, certain foods are considered high risk for an E. coli infection, such as raw milk, unpasteurized apple cider and cheese made with raw milk. Terlizzi and the department thinks one possible cause of E. coli's presence in Missouri might be from the consumption of raw milk, but no conclusions have been finalized.
All 13 cases have led to an onset of illness, according to a health advisory issued by the health and senior services department. Seven of the 13 people with the bacteria have been tested and found to have matching strains, and three more have pending results, expected next week.
Of the seven cases with matching patterns, five people have reported the consumption of raw dairy products from the same farm. Three additional cases are under investigation for which laboratory reports are not available.
Symptoms of the infection include severe stomach cramps, bloody diarrhea, vomiting and possible fever, according to the health advisory. Most symptoms improve after five to seven days from the onset of diarrhea. Some patients go on to develop hemolytic uremic syndrome, which is a life-threatening condition that can result in permanent kidney damage, according to the advisory.
A 2-year-old girl has reportedly developed the syndrome. Another 1-year-old child, previously reported as possibly having the syndrome, was tested and did not have the correct pattern for it.
A longstanding debate rages on about the health advantages and concerns of raw milk. Proponents argue that its freshness and longevity surpass any pasteurized milk sold in grocery stores and that precious nutrients are lost in the pasteurization process, according to a previous Missourian article. Opponents counter that the nutrients lost during pasteurization are minimal and that the quicker expiration dates are worth it for the security of knowing E. coli won't be consumed.
The health advisory states that there is no proof of any benefits that raw milk offers. It also states that the major nutrients in milk are not affected by pasteurization and that raw milk can actually grow harmful bacteria.
Missouri currently has one permitted facility, located in Galena, that has obtained the proper permit for retail sale of raw dairy products, according to the Missouri Department of Agriculture.
Terlizzi could not be reached again to comment on which farm five of the cases are reportedly connected to.
Only certain jurisdictions permit sales, and producers and processors wishing to sell raw milk or cream at farmers' markets have to first apply to the Missouri State Milk Board for a permit. Only after complying with regulations pertaining to proper bottling, capping and labeling can they then sell raw milk products, according to the Department of Agriculture's code of state regulations.
Graded raw milk may not be sold in retail stores under these regulations. Missouri law specifically allows an individual farmer to sell raw milk or cream in Missouri if it's purchased at the farm where it was produced or if delivered to the customer for his or her own personal use, according to the health advisory.
The regulations also state that each local health department should follow its own discretion with regard to selling raw milk at farmers' markets. Many local health departments follow the Food and Drug Administration Food Code.
The state health department has been working closely with the local public health agencies to look for trends or patterns to narrow down the cause of the E. coli outbreak.