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An outbreak of a newly recognized chronic diarrhea syndrome associated with raw milk consumption

M T Osterholm, K L MacDonald, K E White

    JAMA
    |July 25, 1986
    PubMed

    Insights

    A new chronic diarrhea illness affected 122 people in Minnesota, lasting over a year for most. Raw milk consumption was strongly linked to this secretory diarrhea, with no specific cause identified.

    Area of Science:

    • Gastroenterology
    • Infectious Disease Epidemiology
    • Public Health

    Background:

    • A novel chronic diarrhea syndrome emerged in Brainerd, Minnesota, affecting 122 individuals between December 1983 and July 1984.
    • The illness presented with acute onset, significant urgency, absence of systemic symptoms, and resistance to antimicrobial treatments.

    Observation:

    • Clinical and laboratory findings suggested a secretory mechanism underlying the diarrhea.
    • A strong association was found between illness and the consumption of raw milk from a single dairy source (odds ratio = 28.3).

    Findings:

    • The median incubation period for the illness was determined to be 15 days.
    • Despite comprehensive laboratory investigations, the specific etiologic agent responsible for the syndrome remains unidentified.
    • Evidence of potential secondary transmission within a household was observed.

    Implications:

    • This unrecognized clinical entity poses a significant public health challenge, with similar outbreaks reported in at least seven other states.
    • Further research is crucial to determine the etiology and develop effective therapeutic strategies for this condition.
    • The findings underscore the public health risks associated with consuming raw milk and the need for continued surveillance of unexplained diarrheal diseases.

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