Sunday

Emerging pathogen, enterobacter sakazakii in powdered infant formula


















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
http://www.foodsafetynews.com/2011/12/cronobacter-fda-and-cdc-find-no-connection-to-formula/

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