About Campylobacter

From the nation’s leading law firm representing victims of Campylobacter and other foodborne illness outbreaks.

Outbreak News

Mari's Climb: Part One - The Decision

by Nick Grube, The Daily Triplicate

October 29, 2009

THE DECISION

Mari Tardiff hasn’t slept upstairs in her own bedroom for more than a year. Not since the night paramedics carried her down.

Earlier that evening a searing pain raced through the legs of the public health nurse. It felt like she was lying on asphalt that had been baking in 100-degree temperatures all day.

The only thing that soothed her was more heat. She doused her legs with hot water and wrapped them in warm towels and a heated blanket before going to sleep with her husband Peter.

Mari awoke to go to the bathroom. But when she tried to get up, she couldn’t move her legs.

Peter, a tall man with thick forearms, bear-hugged his wife and carried her into the bathroom. Then he called for help.

When the paramedics arrived, the angle at the top of the stairway was too sharp to fit a gurney. Instead, one held her by the arms, while the other grabbed her legs.

At Sutter Coast Hospital, doctors were mystified by the conflicting symptoms. Even though her paralysis was spreading, she was in extreme pain. It didn’t make sense.

Peter, a veterinarian, had his own ideas. He thought a neurotoxin — such as from a tick bite — might be attacking Mari’s nerve cells, shutting them down. If that was the case, he figured it was just a matter of getting her on the right antibiotics and anti-inflammatory medication. She would be fine in 24 to 48 hours.

“I wasn’t looking at anything grave at that point. Her respirations were good. She was alert. It was just a flash of paralysis.”

He had no way of knowing their lives had just changed forever.

TRAPPED ON FIRST FLOOR OF HER OWN HOME

Today, Mari Tardiff is a marionette without a puppet master to control the strings.

At age 54, she can’t stand up, spending most of her day in a wheelchair or on a motorized scooter. She’s upright only when a nurse or physical therapist lifts her while she’s in a pool or between parallel handrails.

The movements that have returned are awkward. When she lifts her arms to gesture or push the hair from her eyes, her shoulders do most of the work and her hands dangle from her wrists.

The paralysis is slowly departing, but it atrophied her muscles to a point where it seems there’s nothing there. Her face is young and vibrant, but her body is old and broken. Her arms are frail. The skin looks as if it’s wrapped only around bones, and her feet are swollen and purple from a lack of use and circulation.

Only recently has Mari started to brush her teeth and comb her hair, but it’s a struggle, because she still cannot grip a handle. She showers in a rolling chair made out of PVC pipes, and there’s little privacy. She has started sleeping in her own bed, but it’s in her living room.

Her home is her world, and she’s trapped on the first floor.

There’s little independence left in Mari’s life. She relies on two nurses to care for her while Peter’s at work. When he comes home, it’s his turn as caregiver.

“What people don’t see is how hard this is on Mari,” he said. “Of course when her friends come over, she’s going to shine and be happy. But I see Mari behind the scenes, and this has been rough. This has been rough on that poor girl. She’s not a homebody.”

'So many people drinking raw milk'

‘SHE’S THE ATHLETE IN THE FAMILY’

Mari had always been active. She grew up in a farming community in Aguila, Ariz., raising two horses and working as a cattle hand at a friend’s ranch. When she met Peter they were both living in San Luis Obispo. He was an undergraduate, and she was a nurse’s aide.

“We just hit it off because she was competitive,” Peter said, smiling at the memory of one of their first dates more than 30 years ago. “I mean from the get-go she was competitive. Our first handball game she kicked my butt.

“Mari’s always been physical and always fit. She’s the athlete in the family. She’s the better skier, the better baseball player. Mari was a tomboy as a kid. She has great coordination.”

Before her paralysis Mari spent much of her spare time at the gym taking spin classes on stationary bicycles, doing aerobics and lifting weights. She also enjoyed riding her bike around her neighborhood near Parkway Drive.

Her fitness obsession crossed over to her diet. Her kitchen cupboards and refrigerator were filled with organic labels and all-natural ingredients, and she avoided fast food at all costs.

Mari’s only real vice was Cheez-Its.

As a person who cared for her body and what went in it, she decided to reach for one more component she believed would improve her vitality —a glass of raw, unpasteurized milk.

“I’m in my 50s. I want to drink something that’s going to make me feel better. Maybe it’ll make me stronger, I don’t know. Whatever it is that’s going to help me, then I want to do that,” Mari said, glancing at the hands lying frustratingly still in her lap, then looking up. “Isn’t it interesting about hindsight?”

RAW MILK’S RESURGENCE AS A HEALTH FOOD

Raw milk essentially comes straight from the udder. It’s unpasteurized, meaning it hasn’t undergone a heating process to kill any pathogens, such as salmonella, campylobacter, listeria and E. coli.

People have drank raw milk and eaten its products, like butter and cheese, ever since livestock animals were domesticated. Even in the early 20th century its consumption was still common. Agriculture, though industrializing, was integral to many American families, and pasteurization was in its infancy.

Today, raw milk is making a resurgence as part of the healthy foods movement. It’s considered by some to be “beyond organic” because it’s completely unprocessed and tends to be a local product from a nearby dairy farmer.

Most people who drink raw milk say it’s superior in flavor and contains enzymes and beneficial bacteria that aid digestion. Some even believe it has curative properties for afflictions such as allergies, arthritis and asthma. Others have gone so far as to claim that it can be used to prevent heart disease and cancer.

Those beliefs, proliferated by the Internet but disputed by many in the food safety industry, have helped create a fundamentalist viewpoint among some raw milk advocates.

“I look at it as any sort of belief system,” Peter said of the raw milk movement. “When you’re a believer, you’re a hard-core believer.”

About three years ago this fervor came to Del Norte County.

DAIRY DEBATE AT A DINNER PARTY

Peter and Mari were attending a dinner party at a friend’s house in Hiouchi. It was late and many people had already had several cocktails when someone brought up the subject of raw milk and started touting its health benefits.

Peter cringed as his friends cited decades-old studies that supported claims that raw milk was a nutritional panacea. As a veterinarian, he didn’t trust the legitimacy of a pre-1950s scientific examination that compared the health of cats that drank raw milk to those that only consumed the pasteurized product.

But then, Peter never really got milk.

“I just don’t like milk. There’s no reason to drink milk. It’s been proven there’s not another animal out there, species-wise, that drinks milk once they’re weaned off … When someone says, ‘Oh, I love a glass of milk with an Oreo,’ psshh, give me a glass of water or give me a beer. I’d rather have that than a glass of milk.”

Peter told his friends about the dangerous bacteria and organisms that can get into milk during the collection process, and the reasons behind pasteurization and why it was readily accepted by scientists and government regulators.

What started as small talk turned into a debate.

“It was a healthy discussion,” Peter said. “I was definitely against it for a lot of reasons, but they were devout and they believed in it.”

Mari heard the escalating voices from another room and found her husband in the middle of an argument. She teased Peter about “making friends again,” and the conversation moved on.

Peter and Mari never really talked to each other about raw milk. Not that night, not ever.

“I know she went and did her research, and I don’t tell Mari what to do,” Peter said. “I’m not that kind of husband that said you can’t drink raw milk. She did her research and had gone to a couple of classes and she made the choice.”

COW-SHARING PROGRAM GAINS POPULARITY

Mari didn’t decide to drink raw milk on a whim. Her interest waxed and waned for two years.

As a county public health nurse, she knew it could contain bacteria that might make her sick. But she also trusted the source.

“I had a false sense of security in how it was obtained, I guess,” Mari said. “That’s where you run a risk. Because it’s not what’s in the raw milk, it’s the contamination.”

Located in Fort Dick, Alexandre Family EcoDairy Farms specializes in organic agriculture. Aside from its dairy operation, its grass-fed beef is prized on the North Coast, and its free-range chickens lay some of the most coveted eggs in Del Norte County.

The dairy had something else people wanted — raw milk.

The owners, Blake and Stephanie Alexandre, knew there was a demand, but the only way they could legally sell the product to consumers was to adhere to a strict regulatory process overseen by the California Department of Food and Agriculture.

At that time, there were only two dairies certified by the state to sell raw milk, Organic Pastures near Fresno and Claraville Farm in Paicines. Today, these are still the only two recognized raw milk bottlers in the state.

To avoid the cumbersome regulations, the Alexandres came up with a distribution method that allowed them to sate the local thirst for raw milk. It was called cow-sharing.

Customers bought shares of the Alexandre EcoDairy cows. Since the law didn’t prohibit people from getting raw milk from their own animals, the Alexandres could distribute the product to program participants.

“It came about because people were really asking for it and begging for it,” Stephanie Alexandre said in an interview with The Triplicate last year. “People were coming to us searching for raw milk because it’s hard to find.”

After enrolling in the program — and signing a liability waiver — customers received a key to a storage area at the farm where they could pick up organic eggs, beef, ice cream, cheese and raw milk.

The cow-sharing program flourished even though the Alexandres didn’t advertise. It flowed through underground currents powered by word of mouth, creating a subculture of sorts in an already isolated corner of California.

By the time Alexandre EcoDairy shut down the program in June 2008 after it was discovered that more than a dozen raw milk customers had fallen ill with campylobacter infections, the county Public Health Department estimated 300 to 500 people in Del Norte were consuming the product.

Doctors, nurses, teachers and correctional officers were involved in the Alexandres’ program.

“You couldn’t talk to anybody in town who didn’t drink it,” Mari said. “I mean there were so many people drinking raw milk that I knew that I probably wanted to be a part of that.”

Even one of her co-workers at the county Public Health Department drank it. Every day at lunch Mari watched her colleague drink a homemade kefir, created by combining grains with the raw milk so as to stimulate bacteria growth that turned the product into a probiotic.

Mari thought she might be able to do the same. She was about to start a new job at Pelican Bay State Prison, where she would have to work long shifts and might not have a lot of time for lunch. A kefir, she thought, would provide the nutrition she needed to last through the day.

“I thought, ‘Maybe I’ve been too much of a nurse, I’m just going to start drinking it.’”

She had no way of knowing what was about to happen, but there’s a possibility that she should have.

DELAY IN REPORTING THE FIRST CASES

Some of the first cases of campylobacter illnesses ultimately connected to Alexandre EcoDairy’s raw milk appeared in May 2008, several weeks before Mari decided to try it.

While campylobacter is a common bacteria found in domesticated animals, it is one of the most frequently reported causes of food-borne illness — more so than E. coli. Any health care provider or testing laboratory is required by state law to notify the local public health officer when there is a confirmed case of a campylobacter illness.

This didn’t happen, according to Del Norte County’s public health officer, Dr. Thomas Martinelli. The result, he said, was a delayed investigation into the source of the campylobacter.

“The initial case was not reported,” he said. “The subsequent cases, for some reason, were not reported properly, which would have made us start to look earlier than the time Mari became infected.”

Sutter Coast Hospital is the local testing facility that was responsible for reporting campylobacter infections to the county Public Health Department. Of the four culture-confirmed cases that came through the hospital in May 2008, a Sutter Coast official said only two were sent to the Public Health Department in a timely fashion.

The other two, according to the hospital’s chief executive officer, Eugene Suksi, were “missed” due to a glitch in the laboratory’s computer system that had just been installed.

“There were two cases that we did report per procedure and there were two cases that were delayed,” Suksi said. “The other cases were reported when we went back and did the search for positive cultures” in July.

The two cases that were reported properly were detected in late May, Suksi said. He added that the Public Health Department received the hospital’s reports on June 5, just three days after Mari drank the milk.

Suksi called this reporting delay a “standard lag” due to the time it takes to test the samples for campylobacter. He added that the results were also pushed back by the Memorial Day holiday.

But Mari and her former co-worker, Linda Schutz, said there was no way the reports came in at that time because they were the only two public health nurses in the department and the information would have crossed one of their desks.

“We were there,” said Mari, who worked until June 12. “We would have seen them.”

Schutz was the department’s lead public health nurse until she took a job at Pelican Bay State Prison. Her last day with the county was June 30, 2008. She said no campylobacter reports arrived from Sutter Coast related to the outbreak before she left the job.

“It’s a small health department,” Schutz said. “We’re not exactly inundated with morbidity reports. And we weren’t.”

It’s still unclear if proper reporting of the cases would have made an impact on Mari’s choice. She says it would have, but there’s no way of knowing whether the Public Health Department would have made the connection to Alexandre’s raw milk before she took her taste.

Instead, it took her own illness to launch the investigation.

A MILK RUN ON A SUNDAY

Mari made her appointment at Alexandre EcoDairy for a Sunday. Peter and Mari were working in their yard — part of their weekend routine — when she told him she was going to meet Stephanie Alexandre.

He had no indication that Mari was actually signing up for the program, and when she came home, he didn’t realize that she had brought the milk with her.

“It’s not like someone ran in on a whim, this is a public health nurse,” he said. “She’s aware of a lot of disease processes. Unfortunately, you put faith in somebody, you trust them and that’s where you’re let down.”

Mari put the milk in the refrigerator. She wouldn’t actually drink it until the following morning, and she wouldn’t be the only one in the family trying it.

Her youngest son, Kevin, was home for the summer working as a biologist for Green Diamond Resource Company. He’d gone with his mom to Stephanie Alexandre’s raw milk classes. Despite his background in biology and his skepticism about the supposed health benefits of unpasteurized milk, he enjoyed trying new things, especially foods.

“For me it was just curiosity, and until this I thought that was one of the best things about me,” Kevin said about his penchant to take chances. “It was just that drive to try something different.”

He also saw many people around him, in particular some of his parents’ friends, who were drinking raw milk regularly.

“No matter what you know, it’s just easy to be convinced when all these people around you tried it for years,” he said. “There wasn’t a single person who got sick, and they were around you. There were so many of them.”

Kevin paused for a moment, presumably to ponder the words that had just crossed his lips.

“That’s the kicker,” he said. We tried it once … It was just one time.”

Kevin and Mari didn’t drink the milk together. She poured herself a glass in the morning before she went to work, and he sloshed it over a bowl of cereal later that day.

Kevin doesn’t remember much about the milk, not even the flavor.

But Mari can never forget.

“It tasted great.”

More on this outbreak: Alexandre EcoDairy Farms Raw Milk Campylobacter Outbreak

Connect with Marler Clark

Office:

1012 First Avenue
Fifth Floor
Seattle, WA 98104

Hours:

M-F, 8:30 am - 5:00 pm, Pacific

Call toll free:

1 (800) 884-9840

If you have questions about foodborne illness, your rights or the legal process, we’d be happy to answer them for you.