The Illinois Department Of Health has confirmed what we have been saying on this website for years:
1) Cronobacter Sakazakii or Enterobacter Sakazakii can cause infant memingitis resulting in long term complications or death.
2)Powdered infant formula (PIF) can be contaminated in the manufacturing process or through the raw ingredients used.
3)While the organism has been found in other foods, “Only PIF Has Been Linked To Disease Outbreaks”.
4)Premature, low weight and immune compromised infants are at a higher risk to get this infection.
5)Sterile liquid formula is better choice for these infants than NON STERILE PIF.
Please see full article below and tell all of your friends to never use PIF with infants.
Monthly Archives: January 2012
Questions and Answers about Cronobacter sakazakii and the Use of Powdered Infant Formula
Provided by Illinois Department of Public Health
If you are concerned about your infant’s health or the infant is experiencing symptoms of meningitis or septicemia, which include fever, fussiness, vomiting, lethargy, not eating, listlessness or spine arching, immediately contact your pediatrician or local health care provider.
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What is Cronobacter sakazakii? What diseases can the bacteria cause?
Cronobacter sakazakii, formerly known as Enterobacter sakazakii, is a bacterium. Illness from this organism is rare, but infection can cause meningitis and septicemia in infants. The infection can be fatal or result in long-term complications.
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Where does the bacterium come from? Where can it be found?
The bacteria are everywhere in the environment and have been found in the intestinal tract of healthy humans and animals. Ingestion of food contaminated with the bacteria or the presence of the bacterium on surfaces, such as kitchen countertops, does not always result in illness.
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How does powdered infant formula get contaminated with Cronobacter sakazakii? Can it be found in other foods?
The way powdered infant formula becomes contaminated with these bacteria is not well understood. Contamination can occur from the raw ingredients used in the formula, during the manufacturing process or during the preparation/reconstitution process. Contamination also may occur through blenders, feeding bottles and utensils used to cleanse feeding bottles. Contamination may be more likely when reconstituted formula is kept at improper temperatures prior to use or for a longer duration than suggested by manufacturers. The organism has been found in other foods, but only powdered infant formula has been linked to disease outbreaks.
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Who is at risk for getting this infection?
Those at elevated risk for infection are premature and low birth-weight infants, infants with immune system problems or babies born to mothers with immune system problems.
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How can this risk be minimized or reduced?
Commercially sterile liquid formula is less frequently associated with illness and can be used in instead of powdered infant formula, where possible. If powdered infant formula is chosen, remember it is not a sterile product and the use of boiled water can reduce the risk of infection. This includes tap water, bottled water or water specifically indicated for use in infant care.
Powdered infant formula should be prepared/reconstituted immediately before feeding time, according to package instructions and cooled appropriately before giving to the infant.
Additional tips to reduce infection risk
Clean utensils
- Wash hands, forearms and fingernails thoroughly before handling any feeding materials or preparing formula.
- All bottles, nipples, caps and rings should be washed in hot, soapy water with thorough rinsing.
Preparing formula
- Before use, powdered formula should be kept dry in an airtight container with a firm cap or lid and stored in a cool, dark area. Make sure the expiration date has not passed.
- During formula preparation, bring water to a bubbling boil for two minutes and allow the water to cool before mixing.
- Avoid reheating formula and do not use a microwave oven to warm the formula.
Storing formula
- Formula should be prepared in small amounts immediately before feeding time to minimize the need for storing prepared/reconstituted formula.
- Prepared/reconstituted formula should not be stored at room temperature for more than one hour or more than four hours in the refrigerator.
- Throw out any formula left in a bottle after feeding.
Posted from idph.state.il.us
Update on Enfamil, Infants and Cronobacter Infections
Posted from healthmap.org
Jan 5, 2012
By Anna Tomasulo
In mid December of 2011, four infants were diagnosed with a rare bacterial infection. Two died. The infecting agent was Cronobacter sakazakii, formerly known as Enterobacter sakazakii. The US Centers for Disease Control and Prevention typically see four to six cases a year; however, in 2011 twelve cases were recorded. These most recent cases were found in four different states: Missouri, Illinois, Oklahoma and Florida.
As a precautionary measure, retailers recalled a powdered infant formula, Mead Johnson’s Enfamil, due to supposed association with the C. sakazakii infections. Two of the infected infants consumed Enfamil brand powdered baby formula, while the other two reportedly drank several different brands.
Tests conducted by the CDC revealed that the C. sakazakii found in Missouri and Illinois are genetically different, suggesting that the cases are not related. While tests from Missouri show presence of the bacteria in an open container of Enfamil as well as in an open container of nursery water (a distilled water used to prepare infant formula), no traces of the bacteria were found in other sealed containers of the powdered formula tested from the same lot. How the water and powder were contaminated remains unclear and the investigation continues.
In a joint statement released Dec. 30, the FDA and the CDC stated that there is no need for a recall of Enfamil formula.
Currently, the CDC is asking that public health officials nationwide be vigilant for other cases of Cronobacter infection among infants.
Symptoms of C. sakazakii infection include fever, poor feeding, and listlessness. Infection can lead to meningitis and septicemia. Infants with low birth weight or immune system problems have an increased risk of infection. Despite the rare occurrence of this illness, its severity should not be misjudged as it can result in long-term complications or death. The CDC recommends that any infant with C. sakazakii infection be brought to a physician for treatment.
Further, the CDC recommends breastfeeding over formula use. However, when breastfeeding is not feasible, the CDC and FDA provide the following recommendations for infant formula use:
- Wash hands and all feeding utensils with soap and water before beginning preparations.
- Water used in infant formula should be boiled first and then cooled quickly to serve to the infant.
- Only prepare enough formula for one feeding and discard any leftovers.
- Read “use by” date, storage information and preparation methods very carefully.
Resources:
Reporting a problem to the FDA:
fda.gov/Safety/ReportaProblem/ucm2005658.htm
FAQs and helpful hints from FDA on infant formula:
fda.gov/Food/FoodSafety/Product-SpecificInformation/InfantFormula/ConsumerInformationAboutInfantFormula/ucm108079.htm
fda.gov/ForConsumers/ConsumerUpdates/ucm048694.htm
Photo credit: Preston Smalley
Emerging pathogen, enterobacter sakazakii in powdered infant formula
Posted from vwmcclain.blogspot.com
A Reuter’s article dated December 30, 2011 states: “U.S. health officials said they found no trace of potentially deadly bacteria that killed two infants in recent weeks in sealed cans of Enfamil baby formula, and a recall was unnecessary, providing relief for the product’s manufacturer, Mead Johnson Nutrition Co.” Providing relief… we seem to be only concerned about the relief for the infant formula company.
Later the article states, “Mead Johnson’s name may be cleared, but the company will likely take some time to fully heal…” Fully heal from the falling of their stock shares by 10%.
Then the even sadder news for Mead Johnson, “negative publicity has already damaged Enfamil’s brand equity and could have cost the company one cycle of new parents.” One whole cycle of new parents. I think we are a sick society,when our public concern is for an industry that loses its market shares over parents whose infants have died or been maimed by a product. A product that is considered a safe “choice” in our developed countries. Mead Johnson has become a person in the heart and minds of this PR campaign to protect an industry. As a corporation in the USA, it is a person. It must heal, it must be offered relief. What about the parents of those dead and maimed infants? Will they get relief? Will they fully heal from their grief?
This article adds a little surprise. “The death of a second baby, in Florida, was not known until an update from the US Food and Drug Administration and the Centers for Disease Control and Prevention late on Friday following the testing of samples taken from the infected babies’ homes and company facilities.” What about the other baby girl, 25-day old Ivyionna Marie Pinnix of Grant City, Missouri who died? What is the explanation for her death? She is not mentioned in most articles I have read. And the Florida death, I live in Florida and I never heard about this. Weird, its like there is a campaign of minimization of this tragedy. Who does this protect? Parents who might get upset that powdered infant formula is not necessarily a safe “choice.” Or are we protecting industry from lost profits?
I found an interesting article dated April 20, 2011 from the Ottawa Public Health, an alert on Cronobacter Sakazakii. “Two infant cases of Cronobacter sakazakii meningitis were recently reported to the US Centers for Disease Control and Prevention (CDC) with onset dates March 25, 2011 and March 26, 2011. These cases originate from Michigan and Ohio. Typically, the CDC is aware of four cases annually.” Well, 2011, is beating this average, because just by my count this brings it to 6 cases (not including the infant from Grant City), two deaths and 4 infants hospitalized. Infants who survive meningitis from enterbacter sakazakii often are brain damaged with long term health issues.
Today I found an article in Antara News (Jakarta, Indonesia) dated July 8, 2011 entitled, “All milk brands in RI found sakazakii-free.”
“Six months after mothers made a public fuss about formula milk tainted by Enterobacter Sakazakii, the Health Ministry has once again announced that all milk brands in circulation were free from the dangerous bacteria.” This article states how rare this pathogen is and that tests conducted in 2003 and 2006 found 20% percent of the samples were contaminated by Sakazakii bacteria…”the brands of the tainted milk have never been made public.” I am impressed that mothers made a public fuss in Indonesia. Interesting that this organism cannot be found in powdered infant formula in 2011. Yet it was found in 20% of the samples back in 2003 and 2006. It’s a miracle this organism that supposedly is everywhere in the environment can’t be found in powdered infant formula anymore. I guess they have figured out a way to sterilize the powder (although that is not possible). So what’s up with this? Maybe its the range of difficulty of testing this organism in samples. Maybe its the samples they get? Maybe its reclassifying the organism–strange how industry itself (Nestle) can set the guidelines for classifying a pathogen implicated in the contamination of their product. Rather interesting conundrum, the experts state that it is everywhere in the environment. Yet it is no longer residing in powdered infant formula. Can’t be found. So we are left in confusion other than telling parents that make the choice to use infant formula, that they should probably use either liquid or ready-to-feed formula for their newborns (much more expensive) or be more careful about boiling water when using the powder (and making up formula one feeding at a time, since long holding times are risky). An article in a medical journal, Surgical Infections dated October 2008 entitled, “Enterobacter sakazakii: An Emerging Pathogen in Infants and Neonates,” by Catherin J. Hunter et al. comes to an interesting conclusion, “We recommend a focus on simple preventative strategies such as the promotion of breast milk feeding, inclusion of warnings on powdered infant formula packages that they may be contaminated with ES [Enterobacter Sakazakii], and abstinence from the practice of re-warming of reconstituted formula.” Hm…that’s a problem. Promoting “breast milk feeding?” How about promoting breastfeeding? This organism that is in the environment, probably adheres to equipment used in feeding infants. It would seem far better to promote breastfeeding (even with premature infants). I am quite sure that no formula company will allow a label that states it’s powdered formula may be contaminated with a pathogen.
I continue to read news articles that state that the risks of enterobacter sakazakii in powdered infant formula are small. Yet are we looking at the tip of the iceberg? We continue in the USA to promote “choice” because of a good PR system that makes the public believe that it is a balanced even choice between baby formula and breastfeeding. But when you are the parent of a baby that died from powdered infant formula or was brain damaged or has life-long disabilities, your perceived risk was not small, it was 100%. The parent lives with it for a life time. And while a industry will whine about lost profits and brand equity, a parent will have a life-time of sorrow, regret, and unanswered questions.
Copyright 2012 Valerie W. McClain
**12 known cases in the USA of enterobacter sakazakii in 2011
foodsafetynews.com/2011/12/cronobacter-fda-and-cdc-find-no-connection-to-formula/
Testing, testing, testing for Cronobacter sakazakii in powdered infant milks
Posted from vwmcclain.blogspot.com
According to an article written by Punendu C. Vasavada, Ph.D., written in August of 2005, “A mere two years ago, the food industry did not have a method to test for E. sakazakii…” [what we now have renamed Cronobacter sakazakii courtesy of researchers employed by the University of Zurich, Switzerland, Nestle Research Center, and University College of Dublin, Ireland]
Dr. Vasavada writes about the difficulty of determining how E. sakazakii gets into infant formula. He mentions how it has been isolated in very low concentrations, “and even at these low levels, exposed at-risk infants have suffered serious injury and death.” In this article, he describes 3 methods of isolating and enumerating E. sakzakii from powdered infant formula: the European Method, Canadian Method and the FDA Method. These methods are all slightly different. Then he discusses newer methods using PCR (polymerase chain reaction) for rapid screening of infant formula samples. He states, “In collaboration with Nestle Research Centers in Switzerland and the U.S., Dupont Qualicon developed and introduced in 2003 a PCR-based assay for rapid detection of E. sakazakii in infant formula, dry dairy and soy ingredients samples.”
foodsafetymagazine.com/article.asp?id=434&sub=sub1
So we have gone from no methods to test for this organism in powdered infant formula prior to the year 2003 to the development of rapid screening methods using PCR. Some of the same researchers (employed by Nestle) who renamed E. sakazakii to Cronobacter also wrote another paper called, “Development of a Novel Screening Method for the Isolation of “Cronobacter’ spp. (Enterobacter sakazakii),” published in Applied and Environmental Microbiology in February of 2008 with one of the authors affiliated with Oxoid Ltd. (a company that sells rapid test kits for the food industry, government, for such pathogens as Cronobacter sakazakii).
Oxoid Ltd. developed a PCR assay for the DuPont Qualicon BAX system. Dupont Qualicon “collaborated with the Nestle Research Centers in Switzerland and the United States to develop a PCR-based assay for rapid detection of Enterobacter sakazakii in food and environmental samples.”
rapidmicrobiology.com/news/603h55.php
Oxoid Ltd is one of the many partners to the CDC Foundation. Some of the many partners are Abbott Laboratories (Ross infant formulas), Bristol Myers Squibb Company (Mead Johnson formulas), Pfizer (which bought out Wyeth’s infant formula division), Target (which sells its own brand formula), The Bristol Myers Squibb Foundation, many other drug and food companies like Cargill, Coca-Cola, GlazoSmithKline, Gilead. OraSure (hiv testing), Eli Lilly, Genentech, Merck). These partners work with the CDC Foundation’s projects. cdcfoundation.org/what/partners#category-299
As someone looking at this situation from a perspective of research funding and influences, I am rather concerned. You have a huge food corporation, Nestle, funding the research for testing of powdered infant formula and other powdered milk products. Or should I say you have researchers who are paid by Nestle to create testing kits for Enterobacter sakazakii, renamed to Cronobacter (renaming based on research done by some Nestle researchers). While I understand a food company’s interest in the development of testing kits for food pathogens, I feel concerned about how in 2011 we cannot find this renamed organism in powdered infant formula. Yet, babies are still dying and being maimed by this organism. So should we believe that the infant formula industry has fixed the problem of contamination by this organism in powdered infant formula? And should we now believe that that the problem is in the environment, somewhere in the environment, either the parent improperly fixing the product or the hospital personnel improperly fixing the product? Legally for the infant formula industry, not finding this pathogen in powdered infant formula this year is financially beneficial. No lawsuits because they can prove by tests (that industry created) that the organism no longer resides in powdered infant formula. It leaves this situation in a terrifying muddle because parents cannot know exactly how to protect their infant, other than breastfeeding. And we know from the various infant formula blogging mommies that that isn’t going to happen anytime soon. I would feel more comfortable about this situation, if the tests that were developed had no one from the food industry involved. And I would feel more comfortable about this situation if the CDC was not getting its “projects” funded by the CDC Foundation that partners with most of the infant formula, food, and drug industry. Why aren’t we more concerned about the kind of influence and funding going on that impacts our health care system. Testing kits are becoming the bread and butter of our medical care, and yet their accuracy seems to go unquestioned. We use genetic engineering techniques for these tests based on the belief in the infallibility of the science. Yet from my perspective, it is akin to believing in the infallibility of the Catholic Pope. Medical science has become a faith-based system and all doubters are excommunicated.
Copyright 2012 Valerie W. McClain