Table.'Outbreaks'from'Unpasteurized'(Raw)'Milk'and'non<Mexican'Style'Raw'Milk'Cheeses,'United'States,' 1998<2011.*'

Table.'Outbreaks'from'Unpasteurized'(Raw)'Milk'and'non<Mexican'Style'Raw'Milk'Cheeses,'United'States,' 1998<2011.*' Year' Month' State' Etiology' No.' Ill' No.' Hosp.' Source' Comments/References' 2011 Aug( Nov WA E.coliO157:H7 3 Rawmilk Retailsale;WDOH2011 2011 Aug( Oct CA E.coliO157:H7 5 3 Rawmilk Retailsale;CDFA2011 2011 Jul NC Campylobactersp. 8 Rawmilk Retail;FDA2011 Parentbroughtmilktoschool;DATCP/DHS 2011 Jun WI Campylobacterjejuni 18 Rawmilk 2011 2011 Jun MI Coxiellaburnetii 3 Rawmilk Cowshare;FSN2011 2011 May( Jul AK Campylobacterjejuni 18 Rawmilk Cowshare;AKDOH2011 2011 Sep NY Campylobactersp. 5 Rawmilk Farmsale;NYDOH2011 2010 Apr UT SalmonellaNewport 10 Rawmilk Retailsale;CDC2010a 2010 Apr UT Campylobactersp. 15 Rawmilk Retailsale;FSN2010 2010 Dec e E.coliO157:H7 8 1 Agedrawmilkcheese Retailsale;FDA2010 2010 Feb WA Shigatoxin(producingE.coli 6 RawMilk Retailsale;WDOH2010 2010 Feb e Campylobactersp. 12 Rawmilk Cowshare;FDA2010 2010 Jan NY Campylobactersp. 5 Rawmilk Farmstore;NYDOH2010 2010 Jun CO Campylobacterjejuni;E.coli O157:H7 30 2 Rawgoatmilk Hershare;BCPH2010 2010 Mar PA Campylobacter 10 1 Rawmilk Retailsale;PDA2010 2010 May WA E.coliO157:H7 2 Rawmilk Retailsale;WDOH2010 2010 May MN E.coliO157:H7 8 1 Rawmilk Farmsale;MDA/MDH2010a 2010 Nov e E.coliO157:H7 38 15 Agedrawmilkcheese Retail;CDC2010b 2010 Nov TX Salmonellasp. 4 2010 Oct MN Campylobacter;Cryptosporidium 7 1 Rawmilk Rawmilk Farmsale;DCDOH2010 Farmsale;MDA/MDH2010b

DATA'EXTRACTED'FROM'CDC S'FOODBORNE'OUTBREAK'ONLINE'DATABASE,'1998<2009' 2009 Aug WI Campylobacterjejuni 52 1 Rawwholemilk 2009 Jan PA Campylobacterjejuni 9 1 Rawwholemilk 2009 Mar CO Campylobacterjejuni 81 1 Rawwholemilk CDPHE2009 2009 May PA Campylobacterjejuni 2 0 Rawwholemilk 2009 Sep WA E.coliO157:H7;O121 3 0 Rawwholemilk 2008 Apr MO E.coliO157:H7 4 2 Rawgoatmilk 2008 Apr MA Campylobacterjejuni 8 0 Rawmilk 2008 Apr OH Campylobacterjejuni 3 1 Rawmilk 2008 Apr UT Campylobacterjejuni 4 0 Rawmilk 2008 Aug MN Campylobacterjejuni 2 2 Rawmilk 2008 Aug PA Campylobacterjejuni 65 1 Rawmilk 2008 Aug MN Campylobactersp. 2 0 Rawmilk 2008 Aug VT E.coliO157:H7 6 3 Rawmilk 2008 Jun CT E.coliO157:NM(H() 14 5 Rawmilk Guh2011 2008 Mar ID Campylobactercoli 5 Rawmilk 2008 May CA Campylobacterjejuni 16 1 Rawmilk Cowshare;CDPH2008b 2008 Nov ND Campylobacterjejuni 3 0 Rawmilk Campylobacterjejuni;Salmonella 2007 Apr SC Give 11 4 Rawmilk 2007 Apr NY Campylobactersp. 2 1 Rawmilk 2007 Dec WA Campylobacterjejuni 18 0 Rawmilk 2007 Jul GA Campylobacterjejuni 8 0 Rawmilk 2007 Jun PA SalmonellaTyphimurium 13 1 Rawmilkcheese On(farmsale;CDC2007b 2007 Nov CA Campylobacterjejuni 11 0 Rawmilk/colostrum Retailsale;CDPH2008a 2007 Oct KS Campylobacterjejuni 16 0 Rawmilkandcheese Dontationtofairbylocaldairy;CDC2009 2007 Sep PA Campylobacterjejuni 4 0 Rawmilk ' 2

2006 Aug KS Brucellasp 5 3 Rawmilkgoat/chevre cheese 2006 Feb NY Campylobactersp. 2 0 Rawwholemilk 2006 Jan IL Campylobacterjejuni 18 0 Rawwholemilk 2006 Jan OH Campylobactersp. 3 1 Rawwholemilk Homemaderawmilk 2006 May WI Campylobacterjejuni 58 2 cheese 2006 May VA Campylobacterjejuni 9 0 Rawmilk 2006 Nov ID E.coliO157:H7 4 0 Rawwholemilk 2006 Sep CA E.coliO157:H7 6 3 Rawmilk/colostrum Retailsale;CDC2008a 2006 Sep CO Campylobactersp. 5 4 Rawwholemilk 2006 Sep WA E.coliO157:H7 2 1 Rawwholemilk Retailsale;WDOH2006 2005 Apr OK Campylobacterjejuni 11 3 Rawgoatmilk 2005 Dec CO Campylobacterjejuni 22 0 Rawwholemilk 2005 Jul WY Campylobacterjejuni 11 2 Rawwholemilk 2005 Mar WY Campylobacterjejuni 3 0 Rawmilk 2005 May IA Campylobacterjejuni 33 0 Rawwholemilk Church/temple 2005 May KS Campylobacterjejuni 4 0 Rawwholemilk 2005 Nov CO Campylobacterjejuni 5 0 Rawwholemilk 2005 Nov e E.coliO157:H7 18 5 Rawwholemilk Cowshare;CDC2007a;Denny2008 2005 Sep UT Campylobacterjejuni 11 0 Rawwholemilk 2005 Sep AZ Campylobacterjejuni 13 1 Rawwholemilk 2004 Feb IA Campylobacterjejuni 32 0 Rawwholemilk 2004 Jul WY Campylobactersp. 6 1 Rawwholemilk 2003 Apr VT Campylobacterjejuni 18 0 Rawmilkcheese 2003 Mar WI Campylobacterjejuni 2 0 Rawmilk Campylobacterjejuni;E.coli 2003 May WA O157:H7 3 0 Rawmilk 2003 Oct MI Campylobacterjejuni 6 0 Rawmilk Church/temple 2002 Apr KS Campylobacterjejuni 46 1 Rawmilk 3

2002 Jan UT Campylobacterjejuni 13 0 Rawwholemilk Highschoolathleticteamdinner;Peterson 2003 2002 Jan WA Campylobacterjejuni 2 0 Rawwholemilk 2002 Nov OH SalmonellaTyphimurium 107 6 Rawmilk Dairy(restaurant;CDC2003;Mazurek2004 2002 Sep CA Campylobactersp. 12 0 Rawmilk 2001 Apr e SalmonellaNewport 27 12 Rawmilkcheese Homemaderawmilk 2001 Jul CA Brucellasp 4 cheese 2001 Mar MN Campylobacterjejuni 4 0 Rawwholemilk 2001 Nov NC E.coliO157:H7 202 11 Rawmilk School 2001 Nov WI Campylobacterjejuni 75 0 Rawwholemilk Cowshare;CDC2002 2000 Apr e Campylobacterjejuni 18 0 Homemaderawmilk cheese 2000 Feb OK Campylobacterjejuni 21 2 Rawmilk 2000 Feb TX Campylobactersp. 2 Rawmilk 2000 Feb ID Campylobacterjejuni 4 0 Rawwholemilk 2000 Jun ID Campylobacterjejuni 42 1 Rawmilk Camp 2000 Jun OK Campylobacterjejuni 11 1 Rawmilk 2000 Jun MN Campylobactersp. 8 1 Rawmilk 2000 May WI Campylobacterjejuni 19 0 Rawmilk 2000 Sep NY Campylobacterjejuni 39 Rawwholemilk Fair/festival 1999 JUN WA Campylobactersp. 2 Rawmilk 1998 JUL NY CampylobacterSP. 3 Rawmilk 1998 JUL SD Campylobacterjejuni 6 1 Rawmilk 1998 JUL ME E.coliO157:H7 2 2 Rawmilk 1998 JUN WI E.coliO157:H7 63 24 Rawmilkcheesecurds CDC2000 1998 Oct MA SalmonellaTyphimurium 47 2 Rawmilk *Tabledoesnot'includeoutbreakslinkedtoMexican(stylerawmilkcheese,orpasteurizeddairyproductscross(contaminatedwithrawmilk duringprocessing. REFERENCES' 4

AKDOH.2011.OngoingRawMilkCampylobacter-Outbreak SouthcentralAlaska,July2011Availableat: http://www.foodsafetynews.com/2011/06/raw(milk(in(michigan(causes(q(fever(outbreak/ BCPH.2010.Publichealthinvestigatesrawmilkoutbreak.EpiConnection,September2010.Availableat: http://www.bouldercounty.org/find/library/help/epiconsep10.pdf CDC.2000.OutbreakofEscherichia-coliO157:H7InfectionAssociatedWithEatingFreshCheeseCurds Wisconsin,June1998. MMWRMorbMortalWklyRep49:911(3. CDC.2001.FromtheCentersforDiseaseControlandPrevention.OutbreakofListeriosisassociatedwithhomemadeMexican(style cheese NorthCarolina,October2000(January2001.Jama286:664(5. CDC.2002.OutbreakofCampylobacterjejuniinfectionsassociatedwithdrinkingunpasteurizedmilkprocuredthroughacow( leasingprogram Wisconsin,2001.MMWRMorbMortalWklyRep51:548(9. CDC.2003.eoutbreakofSalmonellaserotypetyphimuriuminfectionsassociatedwithdrinkingunpasteurizedmilk Illinois, Indiana,Ohio,andTennessee,2002(2003.MMWRMorbMortalWklyRep52:613(5. CDC.2007a.Escherichia-coliO157:H7infectionassociatedwithdrinkingrawmilk WashingtonandOregon.November December 2005.MMWRMorbMortalWklyRep56:165(7. CDC.2007b.Salmonellatyphimuriuminfectionassociatedwithrawmilkandcheeseconsumption Pennsylvania,2007.MMWR MorbMortalWklyRep56:1161(4. CDC.2008a.Escherichia-coliO157:H7infectionsinchildrenassociatedwithrawmilkandrawcolostrumfromcows California,2006. MMWRMorbMortalWklyRep57:625(8. CDC.2008b.Outbreakofmultidrug(resistantSalmonellaentericaserotypeNewportinfectionsassociatedwithconsumptionof unpasteurizedmexican(styleagedcheese Illinois,March2006(April2007.MMWRMorbMortalWklyRep57:432(5. 5

CDC.2008c.OutbreakofListeriamonocytogenesinfectionsassociatedwithpasteurizedmilkfromalocaldairy Massachusetts, 2007.MMWRMorbMortalWklyRep57:1097(100. CDC.2009.CampylobacterjejuniInfectionAssociatedwithUnpasteurizedMilkandCheese Kansas,2007.MMWRMorbMortal WklyRep57:1377(9. CDC.2010a.Notesfromthefield:SalmonellaNewportInfectionsAssociatedwithConsumptionofUnpasteurizedMilk(((Utah, April((June2010.Availableat:http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5926a6.htm CDC2010b.InvestigationUpdate:eOutbreakofE.-coliO157:H7InfectionsAssociatedwithCheese.Availableat: http://www.cdc.gov/ecoli/2010/cheese0157/ CDC2011.FoodborneOutbreakOnlineDatabase(FOOD).Availableat:http://wwwn.cdc.gov/foodborneoutbreaks/Default.aspx# CDFA.2011.OrganicPasturesrawmilkrecallannouncedbyCDFA.Availableat: http://www.cdfa.ca.gov/egov/press_releases/press_release.asp?prnum=11(064 CDPH.2008a.ClusterofCampylobacterinfectionspossiblyassociatedwithrawdairyproducts.Availableat: http://www.marlerblog.com/cluster%20of%20campylobacter%20infections.pdf CDPH.2008b.Campylobacteriosisamongpersonsconsumingunpasteurizedmilkfromacowleasingprogram,DelNorteCounty, May(June2008.Availableat:http://www.marlerblog.com/uploads/file/CDPH%20Report%20%28Tardiff%29.pdf CDPHE.2009.CampylobacterOutbreakAssociatedwithConsumptionofUnpasteurizedMilkfromaCowShareOperation,Montrose County2009.Availableat:http://www.thecompletepatient.com/storage/Montrose%20raw%20dairy%20report%20Final.pdf DATCP/DHS.2011.RacineCountyoutbreaktiedtorawmilkconsumption;16peoplesickened.Availableat: http://wisbusiness.com/index.iml?article=239824 DCDOH.2010.DallasCountysalmonellacasetiedtoconsumptionofrawmilk.Availableat: http://www.dallascounty.org/department/hhs/press/documents/041911rawmilk.pdf 6

Denny,J.,M.Bhat,andK.Eckmann.2008.OutbreakofEscherichia-coliO157:H7associatedwithrawmilkconsumptioninthePacific Northwest.FoodbornePathogDis5:321(8. FDA.2010.Publichealthageniceswarnofoutbreaksrelatedtodrinkingrawmilk.Availableat: http://www.fda.gov/newsevents/newsroom/pressannouncements/ucm206311.htm FDA.2010.ConsumersshouldnoteatSallyJacksoncheeseduetoriskofEscherichiacoliO157:H7.Availableat: http://www.fda.gov/newsevents/newsroom/pressannouncements/ucm237381.htm FDA2011.FoodborneOutbreakAssociatedWithRawMilkFromTuckerAdkinsDairyofYorkS.C.Availableat: http://www.prnewswire.com/news(releases/foodborne(outbreak(associated(with(raw(milk(from(tucker(adkins(dairy(of(york(sc( 125693908.html FSN.2010.UtahCampylobacteroutbreaktracedtorawmilk.Availableat:http://www.foodsafetynews.com/2010/05/campy( outbreak(in(utah(traced(to(raw(milk/ FSN.2011.RawmilkinMichiganlinkedtoQfever.Availableat:http://www.foodsafetynews.com/2011/06/raw(milk(in(michigan( causes(q(fever(outbreak/ Guh,A.,Q.Phan,R.Nelson,K.Purviance,E.Milardo,S.Kinney,P.Mshar,W.Kasacek,andM.Cartter.2010.OutbreakofEscherichia colio157associatedwithrawmilk,connecticut,2008.clininfectdis51:1411(7. MacDonald,P.D.,R.E.Whitwam,J.D.Boggs,J.N.MacCormack,K.L.Anderson,J.W.Reardon,J.R.Saah,L.M.Graves,S.B.Hunter, andj.sobel.2005.outbreakoflisteriosisamongmexicanimmigrantsasaresultofconsumptionofillicitlyproducedmexican(style cheese.clininfectdis40:677(82. Mazurek,J.,E.Salehi,D.Propes,J.Holt,T.Bannerman,L.M.Nicholson,M.Bundesen,R.Duffy,andR.L.Moolenaar.2004.A multistateoutbreakofsalmonellaentericaserotypetyphimuriuminfectionlinkedtorawmilkconsumption Ohio,2003.JFoodProt 67:2165(70. 7

MDA/MDH.2010a.InvestigationintoE.coliO157:H7illnessesandRawMilkConsumptionfromHartmannfarm.Availableat: http://www.health.state.mn.us/foodsafety/alert/ecoli0610.html MDA/MDP.2010b.Minnesotahealthofficialsidentifymoreillnesseslinkedtorawmilk.Availableat: http://www.health.state.mn.us/news/pressrel/2010/milk102810.html NYDOH.2010.CampylobacterContaminationFoundinRawMilk.Availableat: http://www.health.ny.gov/press/releases/2010/2010(01(29_campylobactor_contamination_in_raw_milk.htm NYDOH.2011.CampylobacterContaminationFoundinRawMilk.Availableat:http://www.health.ny.gov/press/releases/2010/2010( 01(29_campylobactor_contamination_in_raw_milk.htm PDA.2010.PennsylvaniaAgricultureDepartmentSuspendsRawMilkSalesPermitofPastureMaidCreameryinLawrenceCounty. Availableat:http://www.prnewswire.com/news(releases/pennsylvania(agriculture(department(suspends(raw(milk(sales(permit(of( pasture(maid(creamery(in(lawrence(county(90216057.html Peterson,M.C.2003.Campylobacterjejunienteritisassociatedwithconsumptionofrawmilk.JEnvironHealth65:20(1. WDOH.2006.E.colioutbreakconnectedtorawmilkdairyinWhatcomCounty(pressrelease).Availableat: http://www.doh.wa.gov/publicat/2006_news/06(154.htm WDOH.2010.E.coliupdate:newillnessespointoutpotentialrawmilkhazards.Availableat:E.coliupdate:newillnessespointout potentialrawmilkhazards WDOH2010.FoodRecallsandSafetyAlerts(Jackie sjerseysdairy).availableat:http://www.doh.wa.gov/ehp/food/recall.htm WDOH.2011.CozyValeCreameryrecallsrawmilkproductsbecauseofpossiblehealthrisk.Availableat: http://www.doh.wa.gov/ehp/food/rawmilk(cozyvale.pdf 8