Marler Clark has been retained by the family of a child who developed hemolytic uremic syndrome, a form of acute kidney failure, after eating Graziers raw milk cheese made by Sierra Nevada Cheese Company of Willows, California.
I have represented children with hemolytic uremic syndrome since 1993, when I represented Brianne Kiner, the most seriously injured survivor of the Jack in the Box E. coli O157:H7 outbreak. The disease has not changed in thirty-three years. The food that carries it has. This time it is a cheese that met the one federal rule that lets raw milk cross state lines as cheese, 60 days of aging, and that is the reason for the petition described at the end of this post.
The outbreak
On September 25, CDC and FDA announced a multistate outbreak of Shiga toxin-producing E. coli O26:H11linked to Graziers grass-fed raw milk cheese. Thirteen people are sick in nine states: three each in California and Nevada, and one each in Colorado, Georgia, Kentucky, Michigan, Oregon, Tennessee and Utah. Eight have been hospitalized and three have developed HUS. More than half of the sick are children five years old or younger; the ages run from one to 58 and the median age is five. Illnesses began between July 7 and August 26. Nine sick people or their caregivers have been interviewed, and all nine reported eating Graziers raw milk cheese, against a background rate of about five percent of the population eating any raw milk cheese in a given week.
FDA contacted the company on September 24, eleven weeks after the first illness, and recommended a recall. The company recalled all four Graziers raw milk cheeses the same day: medium cheddar, sharp cheddar, jalapeño jack and Monterey jack, in 8-ounce and 16-ounce retail packages and five-pound food-service loaves, sold nationwide in stores and online. No lot codes were listed, and the company has said the illnesses are associated with the medium cheddar. These cheeses keep for months. If you have any in a refrigerator or freezer, throw it out. I wrote about the outbreak when it was announced. CDC says the true number of sick people is likely much higher than 13, and that recent illnesses may not yet be counted.
What HUS does to a child
Hemolytic uremic syndrome develops in roughly five to ten percent of people infected with Shiga toxin-producing E. coli, and most of them are children under five. The bacteria stay in the gut. The toxin they make does not. It enters the bloodstream and damages the lining of the smallest blood vessels, especially in the kidneys. Red blood cells are shredded as they pass through the damaged vessels, platelets are consumed in tiny clots, and the kidneys stop filtering. That is the triad that defines the disease: hemolytic anemia, low platelets, and acute kidney failure. It usually announces itself about a week after the diarrhea starts, often just as the diarrhea is getting better.
There is no drug that stops it. Treatment is supportive: fluids managed to the milliliter, red blood cell transfusions for the anemia, and dialysis when the kidneys fail, which happens in up to half of the children who develop HUS. Antibiotics can make it worse and are avoided. The child is typically in an intensive care unit, and the parents are typically told that the next several days will decide whether the kidneys come back. Most children survive. Some do not. Of the survivors, a meaningful share are left with high blood pressure, protein in the urine, or reduced kidney function that has to be followed for the rest of their lives, and some will eventually need a kidney transplant. The medical literature, the symptoms, the treatment and the long-term outlook are collected at www.about-hus.com, a site we have maintained for families and physicians for many years.
Three children in this outbreak have HUS so far. That number is a floor, not a ceiling, because the outbreak count lags illness by three to four weeks and the cheese is still in freezers.
The label this family read
The Graziers package says grass-fed raw milk cheese and, on three of the four varieties, “Aged at least 60 days.” That is a statement of compliance with a federal rule written in the 1940s, and it is true. What the package does not say is what FDA itself wrote in 2015: that 60 days of aging had been presumed to control pathogens, that the data raised questions about the safety of raw milk cheese even when aged, and that peer-reviewed studies showed E. coli O157:H7 surviving 60 days in cheddar. The package does not say that FDA warns that raw milk products put children, pregnant women, older adults and the immune-compromised at particular risk. It does not say that California’s own raw milk warning, required since 1991, exempts cheese aged 60 days, so that even in the state where this cheese was made no warning was required on it. And it does not say that this is the fourth E. coli outbreak in 31 months linked to cheese that followed the 60-day rule: 43 people sick, 17 hospitalized, and at least six children with kidney failure.
A parent standing in a grocery aisle cannot be expected to know any of that. A parent reading “WARNING: This product is made from unpasteurized (raw) milk and may contain harmful bacteria that can cause serious illness in children, older adults, pregnant women, and persons with weakened immune systems” would know enough. FDA has required that kind of sentence on unpasteurized juice since 1998 and a safe handling statement on shell eggs since 2000. Raw milk cheese carries neither.
The petition, and one more request for comments
On Saturday I posted the full draft of a citizen petition to FDA asking the agency to require that warning on cheese made from unpasteurized milk, to reach cut-to-order cheese with a placard at the counter, to exempt cheese made from pasteurized milk or a validated equivalent process, to finish the reevaluation of the 60-day rule it announced in 2013 and took comments on in 2015, and to publish the raw milk cheese sampling data it already collects. It does not ask FDA to ban raw milk cheese, lengthen the aging period, or restrict who may buy it. The draft runs 22 pages with 47 footnotes, every one to a public source. I represent a claimant in the 2025 Twin Sisters Creamery raw milk cheese outbreak, and now this family, and the petition will disclose both.
I asked for comments before I file, and I am asking again. Cheesemakers, retailers, public health officials, physicians who treat HUS, lawyers on either side, and parents: tell me what is wrong with the draft, whether the wording of the statement is right, whether a counter placard will work for cut-to-order cheese, which validated processes should qualify for the exemption, and whether one year of placards before labels must change is the right compliance period for a small farmstead cheesemaker. If a fact is wrong, say so. Send comments to bmarler@marlerclark.com by [Friday, October 9]. I will read every one, change the petition where you persuade me, and file it. Once it is filed, FDA will assign it a docket on regulations.gov, where anyone can comment formally, and the agency will have 180 days to respond.
This family did not need a petition. They needed a sentence on a label, and it was not there.