By Anna Taylor

State health agencies have identified unpasteurized milk as the common factor linking five hospitalized children in a cluster of E. coli infections.

While unpasteurized, or raw, milk links all five, investigators said lab results have not proven the milk was the source of the infections.

All five children drank raw milk, said Wendy Keown, public information officer for the Lincoln Trail District Health Department.

“The likelihood is that’s the source, but we have no confirmation,” Keown said.

Keown said the investigation by the Lincoln Trail and state health agencies found raw milk was the only common factor among the sick children.

Keown said the five children included four from Hardin County and one from Oldham. She said two other cases, one in Nelson and another in Boone, were found not to be linked to the cluster after the investigation began. The first case was identified Aug. 11. The children were hospitalized from complications stemming from E. coli infections that attacked their red blood cells and affected their kidneys.

Keown said the investigation included testing milk for E. coli from the suspected dairy and from distributors. All samples tested came back negative.

Raw milk is unpasteurized. Pasteurization is the process of heating a liquid such as milk to a high enough temperature to destroy disease-causing microorganisms. It also increases the shelf life of milk by destroying spoilage microorganisms and enzymes.

The Kentucky Department for Public Health released a statement Tuesday warning consumers about the dangers of consuming unpasteurized milk as well as other products that could lead to disease-producing E. coli infection.

“Confirming a direct link to a given source of food or milk that causes an outbreak can be difficult, especially in situations where exposures occurred over a brief window of time,” according to the statement. “Laboratory testing has not yet definitively identified the source of the recent illnesses. However, DPH is stressing the dangers of unpasteurized milk after learning all the affected children had consumed it and because it is a known source of E. coli bacteria, as well as numerous other pathogens that can lead to illness.”

The Department of Public Health has been working with local health departments, hospitals and the provider community to investigate the outbreak. Four of the five children associated with the cluster developed hemolytic uremic syndrome, a disease caused by the most severe E. coli infections which may result in life­-threatening kidney failure.

Selling raw milk for retail is illegal in Ken­tucky. To get around that prohibition, “herd shares” have developed where members of a club or organization buy an interest in a cow and can then take that milk home. The milk is technically considered theirs, and thus not a “sale.”

Heartland Whole Life is a health food buying club in downtown Elizabethtown that is open to the public but also has a private herd share. Administrators on Monday confirmed some of the families of the sickened children were members of its raw milk club. They also confirmed the state had tested its raw milk and the dairy from which it comes and stressed all tests came back negative for E. coli. State health officials confirmed no tests in the investigation came back positive for E. coli.

“While we are deeply saddened by the illnesses that have occurred, all products associated with our club and our farm have tested negative,” Whole Life administrators wrote in a prepared statement.

Administrators and other patrons of the store said Monday there were many options in the area for other sources of raw milk. The website realmilk.com, operated by The Weston A. Price Foundation, a nonprofit nutrition education foundation, lists 29 farms in Kentucky offering “real milk,” with two of them in LaRue County.

Steve Burzlaff of Elizabethtown was in the store late Monday picking up a jar of raw milk along with a bag full of organic items and said he had been drinking unpasteurized milk for more than seven years with no ill effects.

“Never gave it a thought,” he said when asked if reports of food-borne illnesses linked to raw milk had made him reconsider the product.

“The enzymes are easier to absorb and digest,” Burzlaff said of his reason for drinking raw milk, as well its overall “wholesomeness” and “purity.”

Raw milk has been gaining popularity in recent years and, as of late, has become a political issue as libertarians have teamed with whole food advocates to loosen prohibitions of its sale.

Kentucky is one of 17 states where sales are illegal. However, Kentucky has no law either expressly legalizing or prohibiting herd shares, according to the Farm-to-Consumer Legal Defense Fund, which advocates for consumer access to raw milk.

All milk sold in Ken­tucky must be pasteurized, which is noted on the product label. If individuals are unsure if milk is pasteurized, they are advised to check the product labeling, ask their clerk or grocer, or to throw it out if pasteurization cannot be verified.

The Washington Post reported in April that 40 bills were introduced in 23 state capitals during the most recent legislative cycle seeking to legalize unpasteurized milk within states. Federal law bans the sale across state lines under the authority of interstate commerce, but Northern Kentucky U.S. Rep. Thomas Massie, a Republican, introduced two bills earlier this year he characterized as “milk freedom legislation” and would strip the U.S. Food and Drug Administration of its authority to police raw milk sales.

Advocates of raw milk credit increased resistance to disease, better growth, stronger teeth and even better behavior as some of its health benefits.

But public health agencies have cautioned consumers about the risks of unpasteurized milk and point to a rising trend of outbreaks they attribute to raw milk.

A Center for Disease Control study of food borne illnesses over a decade concluded “the risk of outbreaks caused by raw milk is at least 150 times greater than the risk of outbreaks caused by pasteurized milk.”

It also found illnesses caused by raw milk tend to be more severe. The hospitalization rate for outbreaks attributed to raw milk was 13 times higher than the rate from outbreaks caused by pasteurized milk, according to the study. It summarized that the E. coli in raw milk was more likely to be bacterial, which can cause kidney failure and death, compared to relatively mild viral infections from pasteurized.

Children also were found to be more susceptible to infection from raw milk. Sixty percent of those infected from raw milk were younger than 20, compared to 23 percent from outbreaks linked to pasteurized.

In its findings, the CDC cautions that even when farmers use sanitary practices, milk can become infected because cows’ skin is covered with bacteria harmful to humans.

“Even negative tests do not guarantee that raw milk is safe to drink,” the CDC states on its Raw Milk Questions and Answers webpage. “People have become very sick from drinking raw milk that came from farms that regularly tested their milk for bacteria and whose owners were sure that their milk was safe.”

No additional illnesses have been reported since the outbreak was first confirmed so the source of contamination is no longer believed to be a continuing public health threat, though consumers should be careful, officials say.